By David G. Miller, M.D.
Retinal detachment is an uncommon but serious medical emergency. It can cause irreversible blindness unless repaired promptly and correctly.
The retina is a thin, light-sensitive tissue that lines the back of the eye, almost like wallpaper. It is similar to the film in a camera, developing images and sending them to the brain. If this thin tissue detaches from the eye, it cannot send images to the brain, and vision is lost.
A common misconception is that retinal detachment is usually due to trauma, such as that caused by boxing or auto accidents. In fact, the vast majority of retinal detachments are simply the result of aging of the eye and the vitreous, the gel that fills the eyeball. As one ages, the vitreous gel begins to shrink and pull forward. Sometimes, as it pulls forward, it will tear a hole in the retina. Vitreous fluid can then work its way through the hole and begin to peel the retina off the back of the eye, causing a retinal detachment.
New-onset floaters or flashes are symptoms that can signal a retinal tear. If promptly diagnosed and treated, a retinal tear will not cause a retinal detachment. Most tears can be repaired in the office by a retina specialist using laser treatment.
A shadow or curtain in vision indicates that the retina has detached. If a retinal tear is not treated early, or if it is large and the retina detaches quickly, surgery in the operating room is often needed. In some cases, the doctor can inject a gas bubble into the eye instead of performing surgery.
Most retinal detachment patients are referred to retina specialists by their primary eye doctors. If you notice new flashes and floaters in your vision, you should see your eye doctor without delay, to be evaluated for possible retinal tearing or detachment. If there is a problem, you should be referred promptly to a specialist.
If retinal detachment is diagnosed and repaired promptly, before severe visual loss occurs, visual recovery approaches 90-95%. If the detachment is large and has already caused complete loss of vision, it can still be repaired, although the outcome will not be as good. Anyone with any unusual vision symptoms should make an urgent appointment with an eye doctor for evaluation, because, as in many medical emergencies, early diagnosis and treatment lead to better outcomes.