The retina is a light-sensitive membrane located at the back of the eye. When light passes through the eye, the lens focuses an image on the retina. The retina converts the image to signals that it sends to the brain through the optic nerve. The retina works with the cornea, lens, and other parts of the eye and the brain to produce normal vision.
Retinal detachment describes an emergency situation in which a thin layer of tissue (the retina) at the back of the eye separates the retinal cells from the layer of blood vessels that provides oxygen and nourishment. The longer retinal detachment goes untreated, the greater your risk of permanent vision loss in the affected eye.
Warning signs of retinal detachment include the sudden appearance of floaters and flashes and reduced vision. Contacting an eye specialist (ophthalmologist) right away can help save your vision.
There are three different types of retinal detachment:
- Rhegmatogenous [reg-ma-TAH-jenous]—A tear or break in the retina allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. These types of retinal detachments are the most common.
- Tractional—In this type of detachment, scar tissue on the retina’s surface contracts and causes the retina to separate from the RPE. This type of detachment is less common.
- Exudative—frequently caused by retinal diseases, including inflammatory disorders and injury/trauma to the eye. In this type, fluid leaks into the area underneath the retina, but there are no tears or breaks in the retina.
Retinal detachment can occur as a result of:
- A sagging vitreous (VIT-ree-us) — the gel-like material that fills the inside of your eye
- An injury to the eye or face can cause a detached retina, as can very high levels of nearsightedness. Extremely nearsighted people have longer eyeballs with thinner retinas that are more prone to detaching.
- On rare occasions, a detached retina may occur after LASIK surgery in highly nearsighted people. In a study of more than 1,500 LASIK patients, just four suffered retinal detachment; their pre-LASIK prescriptions ranged from -8.00 D to -27.50 D.
- Cataract surgery
- eye disease
- Systemic diseases such as diabetes and sickle cell disease also may cause retinal detachments.
- New blood vessels growing under the retina — which can happen in diseases such as diabetic retinopathy — may push the retina away from its support network as well.
- Sometimes fluid movement in the eye pulls the retina away.
With modern therapy, over 90 percent of those with a retinal detachment can be successfully treated, although sometimes a second treatment is needed. However, the visual outcome is not always predictable. The final visual result may not be known for up to several months following surgery. Even under the best of circumstances, and even after multiple attempts at repair, treatment sometimes fails and vision may eventually be lost. Visual results are best if the retinal detachment is repaired before the macula (the center region of the retina responsible for fine, detailed vision) detaches. That is why it is important to contact an eye care professional immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over the field of vision.