Retinal Detachment
Retinal detachment
What is it?
Retinal detachment means the retina has come away from the back wall of the eye.
The retina is the part of the eye that works like the film in a camera. It lines the inside of the eye, like wallpaper, and captures the image before it is sent to the brain. If it becomes detached from the wall it will stop working and the vision will be affected.
What causes it?
The most common cause of retinal detachment is a tear in the retina. This hole allows fluid to get in between the retina and the wall of the eye and this part of the retina is now known as a detachment. The detachment is initially small but, if left untreated, will get larger until the entire retina is detached. This can happen reasonably fast and it is imperative to get treatment early to prevent significant vision loss.A detailed explanation of this process can be found here.
The eye can be thought of as a hollow ball filled with gel called vitreous. This vitreousconsists of a watery liquid mixed with proteins. At birth these proteins are evenly dispersed in the liquid and the vitreous is firm and clear. As we age the proteins start to break up and stick together.
As more proteins stick together, they create pockets of liquid that gradually join up and weaken the vitreous (the gel becomes watery). Eventually the remaining gel becomes so weak that it collapses and moves away from the retina, like a deflating balloon. A small patch on the back of the vitreous may now become visible as a floater. It is often very intrusive and may initially be distressing. The gel at the front usually remains attached to the inside of the eye.The vitreous at the front may also be firmly attached to the retina near the front of the eye. Normal eye movements cause the vitreous to tug on these areas of retinal attachment which stimulates the retina. This stimulation is experienced as a flash of light. The flash is rather dim and usually only noticed in the evening or in a dark environment.
In some cases,if the tug is sharp and firm enough, it may cause the retina to tear. The resulting retinal flap remains attached to the vitreous which prevents it from reattaching to the back of the eye. The pools of liquid that formed when the vitreous degenerated can now move between the flap and the wall of the eye, causing a retinal detachment. The detached retina is unable to function normally and, consequently, the vision in that eye will have a patch missing. As more of the retina becomes detached the patch of vision loss becomes larger. This process normally starts on the outer edges of your vision and gradually enlarges towards the centre. If not treated the process may progress until the entire retina is detached and all useful vision has been lost in that eye.
Do I have it?
When the vitreous detaches it normally causes a change in your vision. It may be a bit blurred. You may notice a floater in your vision, or you may develop flashing lights. A vitreous detachment does not mean that you have a retinal detachment. It means that you are at risk and you will need an ophthalmologist to examine your retina to make that diagnosis.How is it treated?
A retinal detachment can be treated. The smaller the retinal detachment the better the vision will be afterwards. A retinal detachment will slowly get bigger and it is therefore essential that you are examined by an ophthalmologist as soon as possible to avoid delaying treatment. Once the retina has been reattached it will start to function again. However, it rarely functions as well as it did before the detachment.The longer it remains detached before effective treatment the greater the risk of vision loss and the greater the risk of developing another retinal detachment.
An untreated retinal detachment will result in vision loss in that eye.
Treatment involves surgery. In most cases this will be a day case procedure and you will not be required to stay in hospital overnight.