Retinal detachment is separation of the retina from the underlying layer to which it is attached.

• People notice a sudden increase in floaters, a sudden onset of flashing lights, a curtain or veil across vision, or sudden loss of vision.
• Doctors make the diagnosis by looking in the eye with an ophthalmoscope.
• Most retinal detachments can be repaired, resulting in improved vision if done soon after the detachment occurs.

A retinal detachment may begin in a small area, usually as the result of a retinal tear. If the small area is not soon reattached, the entire retina can detach. Retinal tears that can lead to retinal detachment are more likely to occur in people who have or have had the following:

• Severe nearsightedness (myopia)
• Cataract surgery
• An eye injury

When the retina detaches, it separates from part of its blood supply. Unless the retina is reattached, it may be permanently damaged by lack of blood. Fluid or blood from a damaged blood vessel may also collect between the retina and the underlying tissue, further worsening vision.

Symptoms

A retinal detachment is painless. People usually see an increase in small, floating objects (floaters) or many flashes of bright light that last less than a second. Peripheral vision is typically lost first, and vision loss spreads as the detachment progresses. The loss of vision resembles a curtain or veil falling across the line of sight. If the macula becomes detached, vision rapidly deteriorates, and everything becomes blurred.

After applying eyedrops to dilate the pupil, doctors examine the retina using an ophthalmoscope and can usually see a detachment. If the detachment is not visible, an ultrasound scan of the eye can reveal it.

Retinal Detachment

Treatment

Most retinal detachments can be repaired. The surgeon seals the tears with laser surgery or freezing therapy (cryopexy). Then the surgeon draws the retina and the eye wall together either by placing a band around the eye (a scleral buckle) or by removing the vitreous jelly behind the lens and in front of the retina with surgery called a vitrectomy. A gas bubble is often used to hold the retina is place.

Prognosis

Vision usually improves, except in the following conditions:

• The retina has been detached for several days or weeks.
• Bleeding or scarring has occurred.
• The macula has been detached or is damaged.

Last full review/revision November 2008 by Sunir J. Garg, MD