• Alternative names
• Definition
• Causes, Incidence and Risk Factors

• Prevention
• Symptoms
• Signs & Tests
• Treatment

• Expectations
• Complications
• Calling Your health care provider

Definition

The retina is a thin tissue composed of layers of cells that lines the inside back wall of the eye. In part, it contains the light-sensitive cells that send visual information to the brain. It is held in place by the vitreous, a transparent gel composed largely of water and fibers of collagen, that fills the center of the eye and lies between the retina and the more anterior tissues, such as the lens. When a retinal detachment occurs, the retina pulls away from the wall of the eye, causing impairment or loss of vision. Once retinal tissue dies, the body cannot replace it.

Causes, Incidence and Risk Factors

The first step to most retinal detachments is the "clumping" of collagen fibers in the eye, with release of water. The vitreous can pull away from the retina and where an adhesion exists, cause a small hole in the retina. Fluid from the vitreous cavity can seep through the hole or tear and lift it away from the wall of the eye.

Besides a change in or a shrinkage of the vitreous gel, a retinal detachment may occur as a result of a traumatic injury to the eye. Injury can also cause abnormal vitreous shrinkage.

Symptoms

While retinal detachments can happen at any age, they most commonly occur in people over the age of 60. Although detachments sometimes occur for no identifiable reason, several pre-existing conditions (such as high myopia, Marfan's syndrome, retinopathy of prematurity, ocular inflammation, complications following cataract surgery, or hereditary factors) may prompt a retinal detachment.

Signs & Tests

The warning signs of Retinal Detachment are

• Light "flashes" and blurred central vision.
• The presence of a "veil," or shadow, over part of the field of vision.
• Large "floaters" or spots that travel across the field of vision, possibly indicating a partial retinal detachment or of clumped vitreous collagen fibers.

Treatment

Small holes and tears and very limited retinal detachments are usually treated with laser photocoagulation or cryopexy. These procedures are usually administered in the physician's office. Laser photocoagulation is a procedure whereby pinpoints of laser light are used to create tiny burns around a small hole to "weld" the retina back to the wall of the eye. Cryopexy is a similar procedure which, instead of using heat, freezes the area around a hole back into place.

Extensive detachments are treated surgically with a procedure called scleral buckling. In scleral buckling, a tiny synthetic band is implanted on the outside of the eyeball to gently push the wall of the eye against the detached retina. If necessary, a vitrectomy may also be performed to treat more severe cases. During a vitrectomy, the diseased vitreous is surgically removed and an artificial substance is inserted to push the retina back against the eye wall.

If treated early, sight is usually improved in 80% of the patients with the first treatment. In other cases, more treatments are necessary to remedy the damage