Retinal Detachment

What is Retinal Detachment?
The covering of light sensitive patches at the back of the eye forms a thin film known as the retina. If this film peels off from the back of the eye then a Retinal Detachment is said to have occurred.

Why does the Retina Detach?
A tear or hole can develop in the retina. This allows water from within the eye to leak behind the retina. The water then seeps under the retina slowly lifting it off the inside of the back of the eye. Eye doctors call this a ‘Rhegamatogenous’ Retinal Detachment. This is the most common way the retina detaches after an eye injury or in short sightedness.

Sometimes water and fat can collect under the retina without there being a hole or tear present. The effect is the same with the retina being lifted off the back of the eye leading to a detachment. The water and fat often comes from leaking blood vessels. Eye doctors call this an ‘Exudative’ Retinal Detachment. This happens in some rare eye conditions such as Coat’s disease. See the VI Scotland medical information document for a discussion of Coat’s Disease.

Sometimes instead of the retina being ‘lifted’ off from underneath it can be ‘pulled’ off from on top. Some eye conditions can cause damage inside the eye. As the damage heals scars form. With time the scar tissue can shorten and pull the retina off the back of the eye. Eye doctors call this a ‘Tractional’ Retinal Detachment. Tractional Retinal Detachment can complicate Retinopathy of Prematurity. See the VI Scotland medical information document for a discussion of Retinopathy of Prematurity.

What conditions can cause Retinal Detachment?
There are many different conditions that can cause Retinal Detachment. Sometimes there is no obvious cause and we don’t know why it happens. Some of the more common causes include:

•Short Sightedness (Myopia)
•An injury to the eye
•Retinopathy of Prematurity
•Coat’s Disease
•Cataract Operation
•Coloboma
•Retinal Detachment runs in some families Repair

Most detachment repair operations are urgent. A detached retina lacks oxygen, which causes cells in the area to die. This can lead to blindness.
If holes in the retina are found before a detachment occurs, an opthalmologist can close the holes using a laser. This is usually done in the doctor’s office.
If the retina has just started to seperate, a procedure called pneumatic retinopexy may be done to repair it. Pneumatic retinopexy (gas bubble placement) is also usually an office procedure. The health care provider injects a bubble of gas into your eye. You will be positioned so the gas floats up against the hole in the retina and pushes it back into place. The surgeon will use a laser to permanently seal the hole.

More severe detachments require more advanced surgery. There following procedures are done in a hospital or outpatient surgery center:

•The scleral buckle method bends the wall of the eye inward so that it meets the hole in the retina. Scleral buckling can be done under local or general anesthesia.

•The vitrectomy procedure uses very small instruments inside the eye to pull the retina forward. Most vitrectomies are done under local anesthesia.

•For some complex detachments, both procedures may be done during the same operation