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Detached and Torn Retina

An ocular emergency requiring immediate attention

Condition


The retina is a "Saran Wrap" thin membrane which is held to the inside back portion of the eyeball by a kind of suction force. In the front part of the eye the retina is firmly attached at a ring just behind the lens called the pars plana. In the back part of the eye, the retina is continuous with-the optic nerve-which carries 1.5 million nerve fibers back to the brain. In between the pars plana and the optic nerve the retina is attached by suction.  The interior portion of the eye is filled with a material called vitreous, which is like a thin bag of gel. As one gets older, the vitreous tends to shrink, a process which is accelerated by prior cataract extraction or being greatly nearsighted. The bag of vitreous is also attached firmly in the front part of the eye at the pars plana.  However, as the vitreous shrinks, it ultimately strips itself free from the surface of the retina in the back of the eye and begins to bobble around in the fluid. If it happens that the vitreous was glued on too tightly at a single point or several points just behind its firm attachment in the front part of the eye, the bobbling of the vitreous gel bag can tear the retina at these points. Such a tear potentially breaks the suction holding the retina on. Depending upon the strength of the suction force that holds the retina on, the size of the tear, and the continued traction of the vitreous jelly bag on the tip of the tear, the retina may detach.  Because it can cause devastating damage to vision if left untreated, retinal detachment is considered an ocular emergency that requires immediate medical attention and surgery.

Risk factors


Those over forty are at increased risk, as are those with previous ocular surgery, previous retinal tear/detachment, a family history of tears/detachment, and/or nearsightedness. Another type of retinal detachment, called tractional detachment, can be caused by uncontrolled diabetes, chronic inflammation, or previous retinal surgery.

Prevalence


Retinal detachment is relatively rare, occurring in 1 in 15,000 of the general U.S. population.

Symptoms


Flashing lights, new floaters, and/or a gray curtain moving across the field of vision indicate a possible retinal tear/detachment.

Treatment


It is as simple and as complex as finding all the holes and adequately closing them.  Laser surgery or cryotherapy (freezing) is used to seal retinal tears and prevent detachment which can be performed in the clinic.  If you suffer from a retinal detachment, however, a surgical procedure will be needed to repair it. Please click on the link for an explanation of retinal detachment repair surgeries.

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