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Bascom Palmer Eye Institute

Retinal Detachments and Retinal Tears

Retinal Detachments and TearsA retinal detachment occurs when the retina is pulled off of the back surface of the eye. The most common cause for a retinal detachment is a tear in the retina, which can sometimes occur when the vitreous gel separates from the back of the eye as a normal part of aging. With a tear, fluid from inside the eye can then migrate behind the retina and detach it from the back wall of the eye.

Symptoms

Retinal detachments may be gradual or sudden, but are usually accompanied by a dramatic loss of vision. Many people see flashes of light, floaters, or the appearance of a dark or gray curtain moving across the field of vision. If these symptoms are present, an ophthalmologist should be consulted immediately as a detachment can cause permanent vision loss.

Diagnosis

An ophthalmologist can diagnose retinal detachments and tears during a dilated pupil examination.

Treatment

Retinal detachments are almost always repaired surgically. Treatment depends on the cause and extent of the retinal detachment. Surgical options include pneumatic retinopexy, scleral buckling procedure, or vitrectomy with gas or silicone oil tamponade.

  1. Pneumatic retinopexy involves injecting a gas bubble into the vitreous space. The bubble pushes the retinal tear against the back of the eye, which is then treated with laser or freezing therapy (cryo) to close the tear.
  2. A scleral buckle is a tiny, flexible band that is placed around the outside of the eyeball to gently push the wall of the eye against the detached retina. Laser or freezing therapy is then used to close the tear.
  3. Vitrectomy is the surgical extraction of the vitreous humor and simultaneous replacement with a clear sterile solution or a dissolvable gas bubble.

Early treatment improves the vision of most patients with retinal detachment. 10%-20% of patients will need more than one procedure to repair the damage.

Most retinal tears are treated with laser therapy, which prevents future retinal detachment.