Retinal detachment

Posted on 24 April 2015

Simply put, retinal detachment occurs when the retina separates from the tissue around it. It’s a serious eye condition and you are at risk of losing vision if it isn’t repaired promptly. Dr RA Joseph, an ophthalmologist at Mediclinic Plettenberg Bay, fills us in.

What causes retinal detachment?
Most retinal detachments are a result of a retinal break, hole, or tear, which is caused by a breakdown in the forces that attach the neurosensory retina to the retinal pigment epithelium. As a result, fluid fills this space.

Tractional detachment is another cause, where the neurosensory retina is pulls away by contracting membranes. This condition is usually associated with diabetes.

Exudative detachment is caused by fluid build-up underneath the retina, neither from a tear nor traction – this is usually associated with systemic diseases and tumours of the eye.

Retinal detachment can also happen after trauma, but will be due to one of the reasons mentioned above or a combination.

What are the signs of retinal detachment?
If you notice flashing lights in your periphery, much like a camera flash going off in your eye, this could be retinal detachment. People commonly describe this image as an arc of light. This is usually followed by ‘floaters’ in the eye – seen as either worms, a shower of lights, peppercorns or dense clouds floating by. These symptoms, however, don’t necessarily mean that your retina is coming loose but are an indication that you need to see your ophthalmologist.

The most dangerous sign is a permanent ‘black curtain’ or ‘oil slick’ hanging or floating in your eye. This should be seen to immediately.

Can it be cured?
It can usually be cured, depending on the cause and the extent of the detachment, as well as the areas involved. If vital structures in the eye are involved, for example the macula (the centre of the retina), the visual prognosis isn’t usually as good, even if you gain 100% anatomical reattachment.

Most detachments require surgical reattachment. Your ophthalmologist will make a decision on how to treat the detachment depending on the nature, the site of the detachment, age of the patient and whether or not they have their own lens in the eye or have had cataract surgery. Methods that are commonly used include encircling bands and sponges, air tamponade, vitrectomy (removal of the gel from the eye), or a combination of these.
If left untreated, retinal detachment can lead to blindness.

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.