Retinal Detachment: Symptoms, Causes & Treatment

Retinal detachment is a serious condition in which the retina pulls away from its normal position. Symptoms may include dark floaters in the vision, flashes of light, and blurry vision.

This condition may happen due to natural aging, but it can also occur after eye trauma or in people with diabetic retinopathy, infections, inflammatory diseases, or myopia.

Retinal detachment is treatable, but care should be started as soon as possible to prevent permanent complications. Treatment may include medications, laser treatment, or surgery.

Retinal detachment symptoms

The main symptoms of a detached retina include:

• Eye floaters, which are small dark spots that may look like threads, hairs, or dots in the field of vision

• Flashes of light that appear suddenly in one or both eyes

• Blurry or reduced vision

• A dark shadow covering part of the visual field

However, if only a small part of the retina is detached, a person may not have any symptoms. In this case, the detachment may be found during a routine eye exam.

In children, symptoms may be harder to identify and can include strabismus or a white reflex in the pupil.

What does retinal detachment look like?

To someone who is not a specialist, an eye with retinal detachment often looks normal. This is because the changes happen inside the eye, toward the back of the eyeball.

However, on examination, the eye of a person with retinal detachment shows characteristic changes. The ophthalmologist may observe a retina that appears smooth and tense, with a wavy, convex, or opaque surface.

Confirming a diagnosis

The diagnosis is made by an ophthalmologist (eye doctor) through a clinical exam of the back of the eye with the pupils dilated.

To confirm the diagnosis, the doctor may also order other tests, such as an eye ultrasound, fundus exam, retinal imaging, or optical coherence tomography.

Main types

The types of retinal detachment are:

1. Rhegmatogenous detachment

Rhegmatogenous retinal detachment is the most common type of this condition. It happens due to a small tear or hole, which causes the retina to separate from the back wall of the eye.

2. Tractional detachment

Tractional retinal detachment is the second most common type. It occurs when scar tissue grows inside the eye and contracts, pulling on the retina and causing it to detach from the layer underneath.

3. Exudative detachment

Exudative retinal detachment happens when fluid leaks from blood vessels and builds up under the retina.

Because the eye cannot drain this fluid quickly enough, the excess fluid pushes the retina out of place.

Possible causes

The causes of retinal detachment vary depending on the type of condition and include:

• Diabetic retinopathy

• Natural aging

• Myopia (nearsightedness)

• Eye trauma

• Tumors, such as retinoblastoma and choroidal melanoma

• Previous surgeries

• Degeneration

• Retinopathy of prematurity

• Malignant hypertension

• Infections, such as syphilis, tuberculosis, neuroretinitis, and toxocariasis

Retinal detachment may also be caused by inflammatory diseases, genetic conditions such as Stickler syndrome and Marfan syndrome, sickle cell anemia, toxocariasis, and persistent fetal vasculature.

Treatment options

The treatments recommended by the doctor for retinal detachment vary depending on the type of condition.

1. Laser or cryotherapy

Laser treatment or cryotherapy may be done by the doctor for people with a very small retinal detachment, or when there is only a small retinal tear that has not yet caused a complete detachment.

These procedures allow the doctor to create a scar and “seal” the retina in place, helping prevent the problem from getting worse.

2. Pneumatic retinopexy

This procedure is often done in a doctor’s office or outpatient clinic. The doctor injects a gas bubble into the eye, and the person must then keep their head in a specific position so the bubble pushes the retina back into place.

Afterward, the doctor uses laser treatment or cryotherapy to seal the tear.

3. Medications

Depending on the cause of the retinal detachment, the doctor may prescribe medications such as corticosteroids or immunosuppressants in cases of uveitis, Vogt-Koyanagi-Harada disease, posterior scleritis, or sarcoidosis, for example.

Antibiotics, antiparasitic medications, and chemotherapy drugs may also be prescribed for people with bacterial infections, toxocariasis, or tumors, respectively.

4. Surgery

Surgery is the main treatment for most cases of retinal detachment, especially rhegmatogenous and tractional types.

However, the need for surgery and how urgently it should be done depend on the type, location, and cause of the detachment.

The doctor may recommend procedures such as scleral buckling or pars plana vitrectomy, for example.

Is retinal detachment curable?

Yes, retinal detachment can often be successfully treated, especially when it is diagnosed and managed early.

According to the National Eye Institute, early treatment for retinal detachment can help prevent permanent vision loss. However, the final quality of vision depends on how quickly treatment is started, as the longer the retina remains detached, the lower the likelihood of fully recovering vision.

If left untreated, retinal detachment almost always leads to complete vision loss in the affected eye. In chronic untreated cases, the eye may also shrink or develop painful neovascular glaucoma.

Although treatment is usually effective, retinal detachment can recur if scar tissue forms on the retina and pulls it away again. People who have had a retinal detachment in one eye also have a higher risk of it occurring in the other eye.