A detached retina is a medical emergency. It is characterized by the retina pulling away from where it should attach.
It separates the cells of the retina from the blood vessels. This results in a lack of nourishment and oxygen, which could lead to vision loss without treatment.
The symptoms of a detached retina do not usually include pain. They may be nonspecific. Over time, they can become worse as the issue advances.
The symptoms are typically the same for all types of a detached retina. Knowing the different types makes it easier to understand how the condition manifests and how to reduce your risk.
Working to prevent a full detachment is imperative. There are certain procedures doctors can perform to repair tears before the retina completely detaches.
Once it becomes a full tear, there are some surgical options your doctor will discuss with you. It is important to have the surgery as soon as the doctor recommends it, to reduce the risk of further complications.
Learn more about each procedure and their respective recovery times and guidelines to stay informed on your options. This information can also reduce the risk of post-surgical complications.
Retinal Detachment Types
There are three primary types of retinal detachment.
- Tractional: This type occurs when the detachment is due to scar tissue on the surface of the retina. It is usually seen in people with certain medical conditions, such as poorly controlled diabetes.
- Rhegmatogenous: This is the most common detachment type. It results from a tear or hole in the retina. These abnormalities make it possible for fluid to get through and accumulate below the retina. The result is the retina pulling away from the tissues. This can cause a loss of vision once it fully detaches.
- Exudative: This type is similar to rhegmatogenous since fluid accumulates, but there are no retinal tears or holes. This type can result from eye injuries, age-related macular degeneration, inflammatory disorders, or tumors.
Detached Retina Symptoms
When the retina detaches, it does not cause pain. The following symptoms are possible:
- Sudden increase in floaters and the size of floaters, which may indicate that the retina is torn
- A shadow in your peripheral vision
- A sudden reduction in vision
- Sudden appearance of flashes
- The appearance of a gray curtain in your visual field
If you notice flashes and floaters, these symptoms do not automatically mean that you have a retinal tear or detachment. If they are severe or sudden, it is important to seek medical attention. Any loss of vision should also be evaluated right away.
Retinal Tears Procedures
If the retina is torn, take care of it right away to reduce the risk of a complete detachment. Laser surgery and cryopexy are the most common treatment methods for a tear.
Laser surgery is referred to as photocoagulation. The purpose of the surgery is to create scar tissue or to destroy or shrink abnormal retinal structures. These actions can help to prevent a full detachment.
This is an outpatient procedure. Your doctor will dilate your pupils with eyedrops. Then, they will use a laser and direct it through your pupil. This will go around the retinal tear to create the scar tissue. This scarring essentially works as a “weld” to keep the retina attached to the underlying tissue.
Cryopexy works to achieve the same result because it stabilizes the tear to reduce the risk of a retinal detachment. The primary difference is that instead of using the heat of a laser, it uses a freezing probe to seal the tear.
Both procedures keep the retina in place. They also prevent fluid from being able to get below the retina where it can collect and increase your risk of a retinal detachment.
Surgical Repair Methods
There are three primary surgical techniques your doctor might discuss with you. The best option depends on multiple factors, such as the type of detachment and your overall health.
Pneumatic retinopexy is a surgical procedure that can be done in your doctor’s office in most cases, unlike other procedures to reattach your retina. The doctor will inject a gas or air bubble into the eye’s vitreous cavity.
The purpose is for the bubble to push the part of the retina that has holes against the eye’s wall. This works to stop fluid from accumulating in the area. The fluid that is already there is then absorbed, allowing your retina to adhere itself to the eye’s wall. In some cases, your doctor will also perform cryopexy with this surgery.
For several days, you might need to keep your head in a certain position. This will ensure the bubble is in the right spot to allow the retina to reattach.
Scleral buckling may be performed for a detached retina associated with the following circumstances:
- You have the rhegmatogenous type of retinal detachment.
- There is no tear, but the detachment is associated with dialysis.
- You are young and also have an attached hyaloid.
- There are multiple tears, or your detachment is complex.
This procedure involves the use of a small piece of silicone material. Your doctor will take this silicone and suture it to the sclera (the white part of your eye). This indents the eye wall to alleviate some of the force associated with the retina being tugged on by the vitreous.
In some cases, the doctor will encircle your entire eye to reattach the retina. This is typically only done when there is an extensive detachment or several holes or tears in your retina.
Vitrectomy is a procedure that allows the doctor to remove the fluid that could be tugging on your retina. Once the excess fluid is removed, the doctor will replace it with another substance, such as gas, air, or liquid. Your body can usually absorb these, so there is no need for an additional procedure to remove them.
The exception is silicone oil. Several months following the procedure, your doctor may go in and remove the oil.
In some cases, this procedure is done alone. It can also be performed with scleral buckling.
Following this surgery, it is common for the doctor to inject a gas bubble, saline, or a silicone oil into the vitreous gel. This will work to ensure that your retina remains in the proper position.
Recovering From a Detached Retina
Recovery will depend on the procedure your doctor performs. Some require little to no downtime, while others come with strict instructions you must follow to recover properly.
If your doctor performs a procedure that uses a gas bubble, such as vitrectomy with gas, you must avoid flying for an average of 3 to 12 weeks. It may be longer, but it is important to precisely follow your recovery instructions.
You may receive eyedrops following surgery. These drops help to prevent infection and reduce inflammation. Your doctor might also recommend a pain reliever, such as acetaminophen, to promote comfort.
You may need to wear an eye patch after surgery. In most cases, you will wear it for about 24 hours following surgery. Your doctor will tell you when it is safe to remove it. After the patch is removed, wearing sunglasses is often recommended.
Depending on the procedure, it is possible to experience some drainage, redness, and swelling. These are normal effects of the surgery. The drainage and swelling usually subside after about a week, but the redness may persist for up to four weeks. Should any of these worsen or not improve, talk to your doctor.
It is not uncommon for your vision to worsen the day following surgery. Double vision may persist for a few days. Over the course of six months, your vision should start to improve gradually.
Your doctor will provide instructions about any physical restrictions you might have. These restrictions will depend on the surgery you had and your overall health. You may need to avoid driving or going to work or school for a short period of time.
A detached retina can be a serious issue. If you suspect it, you should not delay getting treatment. There are viable surgical options that can help you to heal from this injury.
Retinal Detachment: Torn or Detached Retina Symptoms. (March 1, 2016). American Academy of Ophthalmology.
Laser Photocoagulation – Eye. Mount Sinai.
Laser Photocoagulation and Cryopexy for Retinal Tears. (August 7, 2011). American College of Cardiology.
What Is Pneumatic Retinopexy? Johns Hopkins Medicine.
Scleral Buckle. (February 27, 2017). Medscape.
Vitrectomy. American Society of Retina Specialists.
Patient Information Instructions Following Retinal Surgery. University of California, Davis.