The retina is a transparent film at the back of the eye that processes the images focused on it by the cornea and the lens. Retinal detachments are associated with a tear or hole in the retina through which the internal fluids of the eye may leak, causing separation of the retina from the underlying tissues. This may be caused by trauma, the aging process, a tumor, or an inflammatory disorder, but it frequently occurs spontaneously. In newborns born before full-term, retinal detachment can be caused by retinopathy of prematurity (abnormalities of the retina associated with being premature).

Bleeding from small blood vessels may cloud the vitreous fluid. Central vision becomes affected if the macula, the central part of the retina, becomes detached.

The risk factors are nearsightedness, a family history of retinal detachment, Caucasian background, and male sex. Approximately 20,000 people per year are affected with retinal detachments.

Prevention:

Using protective eyewear may prevent eye trauma.

Symptoms:

• flashes or flickers of light, especially in peripheral vision
• translucent specks of various shapes (floaters) in the eye
• blurred vision
• shadow or blindness in a part of the visual field of one eye

Signs and Tests:

• direct and indirect ophthalmoscopy to view the retina
• visual acuity
• pupillary reflex response
• slit lamp examination
• intraocular pressure determination
• ultrasound of the eye
• retinal photography

Treatment:

Laser surgery can be used to seal the tears or holes in the retina that generally precede detachment.

The application of intense cold with an ice probe (known as cryopexy) leads to the formation of a scar that holds the retina to the underlying layer.

Surgical reattachment involves indentation of the sclera (with a 'scleral buckle') to relieve pressure on the retina, allowing it to re-attach.

Prognosis:

The outcome depends upon the location and extent of the detachment and early treatment. If the macula has not detached, the results of treatment can be excellent. On the other hand, total blindness in an eye can result if the detachment is not tended to immediately, or if circumstances allow the detachment to become total.

A retinal detachment is a medical emergency requiring immediate treatment! See your eye doctor at once if you notice any of the symptoms listed above. If you have a family member that had a retinal detachment, you are more likely to develop it yourself, so make sure your eye doctor is aware of the family history.