Retinal Detachments

A retinal detachment is a very serious and vision threatening condition. It happens when the photo-sensitive retina separates from the wall of the eye. The retina is then left without its blood supply or nourishment and promptly stops working. If not promptly treated, retinal detachment can cause permanent vision loss. Retinal detachments can be categorized based on their cause. 

• Rhegmatogenous retinal detachment – the most common type. this occurs when the vitreous gel filling the interior of the eye leaks behind the retina through a hole or tear and pushes the retina away from its connective tissue. 
• Tractional retinal detachment – occurs when scar tissue on the retina’s surface contracts and pulls the retina apart from the back wall. This scar tissue can occur from diabetes or prior injury or surgery. 
• Exudative retinal detachment – fluid leaks out of blood vessels into the area underneath the retina and pushes the layers apart from below, but there are no tears or breaks in the retina. This is caused by a variety of retinal diseases such as inflammatory disorders, trauma, or tumor. 

Signs and symptoms of a retinal detachment are very similar to that of a posterior vitreous detachment and retinal tear. Retinal detachment itself is painless, but you may notice flashing lights, floaters, and/or a shadow or curtain darkening your peripheral vision and moving centrally.  

The goal of treatment is to re-attach the retina to the back wall of the eye and seal the holes or tears that caused the detachment. Laser retinopexy or cryopexy freezing treatments are applied surrounding the tears to fuse them closed. This could also mean removing scar tissue in the case of a tractional detachment.  

• Scleral buckle – this outpatient surgery involves putting a silicone band around the outside of the eye, supporting it and push it closer to the retina. 
• Vitrectomy – tiny instruments and powerful microscopes are used to remove the vitreous gel from the eye and repairs can be done from the inside. A gas bubble is then used to fill the eye and push the retina against the back wall of the eye. During recovery, your eye makes fluid to replace the gas bubble as it slowly dissolves. 
• Pneumatic retinopexy – a gas bubble is injected into the eye as you are asked to maintain a certain head position to help gravity push the gas against the detachment. Cryo or laser is then applied to the tear. 
• Laser – in the case of small detachments located in the periphery, a laser can be used to wall off the detachment so it cannot progress further. 

Repairs for retinal detachments are successful about 90% of the time. The approach will be determined by your doctor as to what is most suitable. At Retina Specialists of Michigan, you will be well informed and educated on your condition and will be given all choices with a full understanding of treatments including risks, benefits, as well as alternatives. Not repairing a retinal detachment can result in permanent vision loss, so we’d like to see you as soon as you have symptoms or are diagnosed with one. If you have questions regarding your vision or symptoms, speak with one of our staff at (616) 954-2020.