What is retinal detachment and how can it be treated?

The retina is a layer of neural tissue that lines the cavity of your eye. It receives the light from the front of the eye and communicates that information with the brain, which interprets those signals as vision.

A retinal detachment is a separation of this neural tissue from its normal anatomical position. Most commonly a retinal detachment will occur because of a retinal tear. Most commonly a retinal tear will arise because of a vitreous separation.

The vitreous is the jelly that fills the cavity of the eye and sits in front of the retina. With aging, the vitreous degenerates and pulls away from its normal anatomical position and this can result in a retinal tear.

Most often the symptoms of a vitreous separation will include flashing lights and floaters. If these symptoms arise, it’s very important to seek an ophthalmic assessment, to determine whether a retinal tear has resulted as a consequence of separation of the vitreous.

In addition to increasing age, vitreous separation is more likely to occur at a younger age if you are highly myopic or very short-sighted, or if you have had intraocular surgery such as cataract surgery, or if you have had significant eye trauma.

If a retinal tear is found at the time of ophthalmic examination, prophylactic treatment can be applied in the form of laser or freezing. And this significantly reduces the risk of progression to a retinal detachment. If there is a retinal tear, and this is not treated, then 50% of retinal tears will progress to a retinal detachment.

If a retinal detachment becomes evident, then typically vision will slowly deteriorate. And in the first instance, there’ll be a shadow in the peripheral vision. This shadow will progress centrally if neglected to potentially involve the center of the retina and detach the macular. This will result in significant loss of vision.

Early intervention for retinal detachments is the best. And we often want to intervene before the macular detaches. However, if the macular has detached, we can intervene early and this can similarly lead to a good visual outcome.

If a retinal detachment becomes evident, the only intervention is surgery. There are three main surgical interventions which include vitrectomy, Scleral buckle or pneumatic retinopexy. Your retinal surgeon will advise as to the most appropriate intervention in your situation.

The overall success rate with surgical intervention is between 90% and 95% of primary success, which means that most of the time, we’re able to reattach the retina with one operation. However, intraocular surgery for retinal detachments is a very complicated and involved process and involves a long recovery often up to three months, and is associated with a small risk of failure and a small risk of permanent loss of vision.

Consequently, it is very important if you do develop symptoms of flashing lights or floaters to have an eye examination properly, to ensure that any retinal tear is appropriately treated as this is the most likely intervention which will reduce your risk of progression to a regular detachment.