Retinal Detatchment

What it is.
Retinal detachment is a fairly uncommon occurrence, more likely to occur after 50 years of age. It is a bit more common in males versus females, and similarly occurs slightly more often in white than black patients. Nearsighted patients, whose eyes are bigger than average and who have retinas that are stretched somewhat to fill the eye, also are more likely to have spontaneous retinal detachments. The illness also shows a genetic component because there is a tendency for it to occur in families.

Why do some people get detached retinas?
Any small opening – a tear or hole – in the delicate retina will permit fluid to get between the retina and the wall of the eye. As the fluid leaks into this space, the retina will slowly peel off from the back wall of the eye. By analogy, think of a thin sheet of wallpaper attached to your bedroom wall. If a small hole was made in the paper and if fluid could get through this hole and into the area between the wallpaper and the wall, the wallpaper would start to peel off, or detach from the wall onto which it had been glued. What causes small, spontaneous, openings in the retina? These tears may be caused by aging changes in the vitreous gel attached to the retina or degenerative changes in the thin peripheral areas of the retina itself.

The interior portion of the human eye is filled with a gelatinous substance called the vitreous, which helps the globe maintain its shape. When you are a child, the vitreous has the consistency of firm, cold Jello (gelatin). Light that is focused by the cornea and lens then passes through the clear vitreous to place an image on the retina, the membranous layer of nerve tissue at the back of the eye. As you get older, the vitreous may start to liquefy a bit and condense. As we approach our 50s, the vitreous gel slowly shrinks and pulls away from its attachments to the retina. If it pulls free completely, the vitreous is said to become separated or detached (a posterior vitreous detachment, or PVD). This is not the same thing as the much more serious retinal detachment.

As the PVD occurs, you may get the sensation of floaters or flashing lights within the eye. These symptoms can be a warning sign that a tear has occurred in the peripheral retina. If these symptoms occur, you should see your eye doctor for an eye examination. Sometimes the process of PVD takes a few weeks to complete itself, so your eye doctor may want to repeat the examination again about one month later. A vitreous detachment does not require treatment as long as there are no retinal holes or tears associated with it.

If your doctor discovers a tear or hole in the retina, it may need to be repaired. By performing the repair, your ophthalmologist will be attempting to prevent a retinal detachment from beginning. The type and size of hole, symptoms and conditions of the other eye all influence the decision of whether or not it needs treatment.

In addition to spontaneous occurrence, retinal tears may also appear after trauma to the eye.