Retinal Detachement

Retinal detachments can be pretty frightening.  Often, I don’t get to see a patient soon enough as most hope the symptoms will “just go away.”  Basically, the earlier I can diagnose and manage a retinal detachment, the better chance of doing well.

If not treated promptly a retinal detachment can result in permanent vision loss. A detachment occurs when the retina is lifted or pulled from its normal position in the eye. It may begin with a small tear or break that leads to a full detachment. It is extremely important to recognize that a retinal detachment is a medical emergency and should be treated as one.

Signs of a detachment or tear include a sudden or gradual increase in floaters or specks that float in your field of vision. It may also begin with a curtain over the field of vision.

A retinal detachment can occur at any age, but it is more common in people over age 40. It affects men more than women, and Whites more than African Americans.

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.

Causes and Risk Factors

A detached retina usually stems from a retinal tear or retinal hole.  Occasionally is there a history of trauma.  Retinal detachments usually happen in normal, healthy individuals.  Surgery is required in most cases and is about 90-95% successful in reattaching the retina.  Visual return is dependent upon age, length of detachment and involvement of the macula.

A retinal detachment can occur at any age, but it is more common in people over age 40. It affects men more than women, and Whites more than African Americans.

A retinal detachment is also more likely to occur in people who:

  • Are extremely nearsighted
  • Have had a retinal detachment in the other eye
  • Have a family history of retinal detachment
  • Have had cataract surgery
  • Have other eye diseases or disorders, such as retinoschisis, uveitis, degenerative myopia, or lattice degeneration
  • Have had an eye injury

Symptoms and Detection

Symptoms include a sudden or gradual increase in either the number of floaters, which are little “cobwebs” or specks that float about in your field of vision, and/or light flashes in the eye. Another symptom is the appearance of a curtain over the field of vision. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.

 

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