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Retinal detachment
Introduction
The retina is a thin layer of nerve cells lining the inside of the back of the eye. You need the retina
to see properly. It turns the light that enters the eye into an image by sending a message along the
optic nerve to the brain.
When this light-sensitive layer becomes separated from the inner wall of the eye, it is called retinal
detachment. If this is not treated, it usually leads to blindness in the affected eye.
Retinal detachment normally occurs in one eye.
Outlook
Retinal detachment can be treated with surgery to seal the holes and reattach the retina (see
Treatment, above). This usually brings back some but not all of your sight and prevents you from
going blind.
Vision is affected because the retina is unable to function properly (see Symptoms, above). This
What to do
It is normal to see the occasional floater, but floaters and flashes may be a sign of
retinal detachment. If you experience these symptoms, consult your GP.
Having these symptoms does not always mean your retina has detached, but it is sensible to be
cautious. Prompt treatment for retinal detachment minimises damage to your eye.
Many retinal detachments happen as a result of a tear or hole developing in the retina. This often
occurs when the retina becomes thin, particularly among those who are short-sighted.
When the retina has holes in it, fluid in the eye can creep underneath the retina and separate it
from the lining of the eye.
Surgery
Surgery for retinal detachment may be done under a general anaesthetic (where you are put to
sleep) or a local anaesthetic. You may need to stay in hospital for one or two days, but you may be
able to leave on the same day, depending on the circumstances. You will be asked not to eat or
drink anything for six hours before the operation.
Before you are given the anaesthetic, you will be given eye drops to widen your pupil.
The retina is usually reattached using either scleral buckling or vitrectomy.
Scleral buckling
Scleral buckling is the preferred way of reattaching the retina if it has a tear or hole in it.
Fine bands of silicone rubber or sponge are stitched onto the outside white of the eye (the sclera)
in the area where the retina has detached. The bands act as a 'buckle' and press the sclera in
towards the middle of the eye, so the torn retina can lie against the wall of the eye.
Laser or freezing treatment is used to scar the tissue around the retina (see the box, right), which
creates a seal between the retina and the wall of the eye and closes up the tear or hole.
The bands can be left on the eye and should not be noticeable after the operation.
Vitrectomy
Vitrectomy works by removing the vitreous (jelly-like substance) from the inside of the eye and
replacing it with either a gas or silicone bubble. This holds the retina in position from the inside.
Tiny dissolving stitches are used to close the wound. It is also possible to perform such surgery
without the use of stitches, using smaller instruments. While this may lead to less discomfort, it is
not known whether it is more effective.
After the procedure, you will be asked to keep your head in a certain position for a while, known as
posturing, so the bubble lies against the retina.
If you have had a gas bubble in your eye, you will not be able to travel by air for a while. Your
doctor will tell you when it is safe to fly again. If you need another operation requiring general
anaesthetic, you must tell your doctors about the gas bubble in your eye.
Possible complications
If you have had a gas bubble in your eye, your vision will be very blurry for a while. This is only
temporary.
However, your eyesight cannot always be completely restored. This depends largely on how much
of the retina was detached and for how long.
The Royal National Institute for the Blind (RNIB) offers support and advice on your eyesight (see
Useful links).