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Retinal Detachment

Retinal detachment is a serious problem that usually affects middle–aged or older people. It is more likely to develop in near–sighted people and those whose relatives have had retinal detachments. It may also be caused by a hard, solid blow to the eye. Occasionally, it is hereditary. If not treated early, retinal detachment may lead to impairment or loss of vision.

The retina is a thin, light–sensitive tissue that covers the inside back portion of the eye. In most cases retinal detachment is caused by the presence of one or more small tears or holes in the retina. These tears may be due to thinning of the retina with age, but more often they are caused by shrinkage of the vitreous, a clear, gel–like substance that fills the inside of the eye. The vitreous helps maintain the shape of the eye and allows light to pass through to the retina.

Retina

The vitreous is firmly attached to the retina in several places. As people get older, the vitreous shrinks and often separates from the retina. By the age of 50 years the vitreous has separated from the retina in about 50% of all people. As the vitreous shrinks, it may pull a piece of the retina away with it, leaving a tear or hole in the retina. Abnormal growth of the eye (sometimes a result of near–sightedness), inflammation or injury may also cause the vitreous to shrink.

Retinal Tear

When a retinal tear is present, watery fluid from the vitreous space may pass through the hole and flow between the retina and the back wall of the eye. This separates the retina from the back of the eye and causes it to detach. The detached portion of the retina will not work properly, and there will be a blur or blind spot in the vision. In some cases retinal detachment is caused by other diseases of the eye, such as tumors, severe inflammations and complications of diabetes mellitus. In these cases there are no tears or holes in the retina, and treatment of the disease that caused the detachment is the only treatment that may correct the detachment.

Symptoms

Retinal Detachment

In some cases the sudden appearance of spots or flashes of light may indicate substantial shrinkage of the vitreous, with tears in the retina. In other cases the person may notice a wavy or watery quality in their overall vision or the appearance of a dark shadow in some part of their peripheral vision. Further development of the retinal detachment will blur the central vision and create significant loss of vision unless the detachment is repaired.

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