The retina is the inside lining of the back of your eye.  It contains millions of photoreceptors (rod and cone cells) that detect light from the image you are looking at, and send a signal to your brain.  The retina is like the film in a camera.


A detached retina occurs when the retina becomes separated from its underlying supportive tissues.  The retina cannot function when these layers are detached.  A retinal detachment is a serious and sight-threatening event, and permanent vision loss may result unless the retina is reattached soon.


Symptoms of a Detached Retina

If you suddenly notice many spots (floaters) in your vision and/or flashes of light, you may be experiencing the warning signs of a small retinal tear or detached retina.  Your vision might also become blurry.  If you see a dark region like a shadow or curtain at the top, bottom, or sides of your vision, it is very possibly a retinal detachment.


These signs can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches quickly.


Flashes of light and floaters can also be the sign of less serious conditions, such as a vitreous detachment.  However, one in seven people who experience a sudden onset of flashes and floaters will have a retinal tear or detachment.  Up to 50 percent of people who experience a retinal tear will have a subsequent detachment.


No pain is associated with retinal detachment.  If you experience any of the signs, stop by Frontier Eye Care or another eye doctor right away.  Immediate treatment increases your odds of regaining lost vision.


What Causes Retinal Detachments?

An injury to the eye or head can cause a detached retina, as the force of trauma can cause the retinal to loosen or tear.  Cataract surgery, tumors, eye disease and systemic diseases such as diabetes and sickle cell disease also may cause retinal detachments.  Over time, the vitreous (jelly-like filling of the eye) tends to shrink.  The vitreous eventually pulls away from the retina.  This is called a vitreous detachment.  If the vitreous tears the retina, instead of pulling away gently, this can cause a hole in the retina, which can lead to a retinal detachment.


Certain diseases such as diabetic retinopathy or wet macular degeneration can cause abnormal leaky blood vessels to grow under the retina.  The leakage may push the retina forward and lead to a “serous” or fluid retinal detachment.


Interestingly, very nearsighted people have longer eyeballs with thinner retinas that are more prone to detaching.


Treatment for Detached Retina

Surgery is required to repair a detached retina. The procedure usually is performed by a retinal specialist — an eye surgeon who has undergone advanced training in the medical and surgical treatment of retinal disorders.


Surgical procedures used to treat a retinal detachment include:


Scleral buckling surgery. This is the most common retinal detachment surgery, and consists of attaching a small band of silicone or soft plastic to the outside back of the eye.  This band compresses (buckles) the eye inward, reducing the pulling traction of the retina and allows the retina to reattach to the inner wall of the eye.  This also makes additional detachments less likely.


Vitrectomy. In this procedure, the clear jelly-like fluid is removed from the posterior chamber of the eye (vitreous body) and replaced with clear silicone oil to push the detached portion of the retina back.


Pneumatic retinopexy. In this procedure, the surgeon injects a small bubble of gas into the vitreous body to push the detached portion of the retina onto the supporting tissues.


If the detachment is caused by a tear in the retina, the surgeon usually uses a laser or a freezing probe to “spot weld” the retina firmly onto the underlying tissues and thereby prevent the tear from leading to a retinal detachment.  If a laser is used, this is called laser photocoagulation.  The freezing probe is called cryopexy.


Surgical reattachment of the retina isn’t always successful.  The odds for success depend on the location, cause, and extent of the retinal detachment, along with other factors.  Also, successful reattachment of the retina doesn’t guarantee normal vision. Generally, visual outcomes are better after surgery if the detachment is limited to the peripheral retina and the macula is not affected.


Time is of the essence during a retinal detachment.  If you experience a sudden onset of multiple floaters in your vision, flashes in your vision, and/or a dark region in your vision, do not wait or ignore these signs.  Stop by Frontier Eye Care in Casper right away.  If it is after hours, visit the Wyoming Medical Center emergency room, and the ophthalmologist on-call will examine your eyes.