Retinal detachment

A retinal detachment can happen to anyone, but it is more likely if you:

• Are older
• Are very nearsighted
• Have had cataract surgery or another eye surgery
• Have had a serious eye injury
• Have had a retinal detachment in your other eye
• Have family members who have had a retinal detachment
• Have thin or weak areas in your retina that your eye doctor has found
• Have eye disease from diabetes

Your eye doctor will ask about your symptoms and when they started. They will put drops in your eyes to widen (dilate) your pupils, so they can look at the whole retina, including its outer edges. They may press gently on your eyelid during the exam to see the very edge of the retina.

Your eye doctor may also take pictures or scans of the retina. If blood inside the eye blocks the view, an ultrasound of the eye can show whether the retina is in place. If they find a tear or a detachment, they will send you to a retina specialist, often the same day.

Treatment depends on whether the retina has a tear or has already detached.

A tear without a detachment can often be sealed with a laser or a freezing treatment. This creates a scar that holds the retina in place. It is usually done in the office.

A detached retina needs surgery, usually within days, and sometimes the same day. The main types are:

• Gas bubble repair. A small gas bubble is placed in the eye to press the retina back into place. The tear is then sealed with a laser or freezing treatment. You will need to hold your head in a certain position for several days.
• Scleral buckle. A thin, flexible band is placed around the outside of the eye to gently push the wall of the eye against the retina. It stays in place and can’t be seen.
• Vitrectomy. The gel inside the eye is removed and replaced with a gas bubble or oil that holds the retina in place while it heals.

Your retina specialist will choose the best repair for your eye. Most detachments can be repaired. How much vision comes back depends on how long the retina was detached and whether its center was affected. That is why getting care quickly matters so much.

After surgery, do exactly what your retina specialist tells you:

• Keep your head in the position you are told to, if you have a gas bubble.
• Don’t fly, travel to high mountains or have certain kinds of anesthesia while a gas bubble is in your eye. Changes in air pressure can make the bubble grow and raise the pressure in your eye. Tell any doctor who treats you that you have a gas bubble.
• Avoid heavy lifting and hard exercise until you are told it is safe.
• Use your eye drops as prescribed and keep every check-up.

Vision can keep improving for several months. You may need new glasses afterward. A vitrectomy can also speed up the growth of a cataract, which can be treated later.

Having a detachment in one eye raises the risk in the other eye. Learn the warning signs, get regular dilated eye exams, and wear protective eyewear for sports and risky work. Get care the same day if you notice new floaters, flashes or a shadow over your vision.