Retinal Detachment

A retinal detachment (ablatio retinae) occurs when the retina detaches from the eyeball. This can be caused by the vitreous humor pulling away from the retina, which can lead to small tears in the retina. Fluid can seep under the retina through such a tear. If left untreated, this can lead to vision loss or even blindness. Retinal detachment occurs in about 1 in 10,000 people each year. It can occur at any age, but the risk is higher in older adults. People who are nearsighted (with a prescription of -6 or higher) and those with a family history of retinal detachment are at higher risk.

What symptoms might indicate a retinal detachment:

• Floating spots: You may suddenly see black floating spots that look like tiny flies or dots.
• Flashes of light: Sometimes you may see flashes of light in your field of vision.
• Impaired vision: Your vision may become worse.
• Curtain-like sensation: For some people, it feels as if there is a curtain covering part of their eye, or as if they have to look over a small wall.

You can’t tell from the outside of the eye that the retina has detached. The ophthalmologist will examine your eyes using different lenses. First, you’ll be given eye drops to dilate your pupil. If the ophthalmologist is unable to see anything, an ultrasound of the eye will be performed. This will allow the ophthalmologist to make a diagnosis.

If there is a small tear in the retina but it has not (yet) detached—or has barely detached—laser treatment can be performed. In this procedure, the retina is reattached to its underlying layer, the choroid, using a laser.

Once a diagnosis of retinal detachment has been made, the only treatment option is surgery. There are two types of surgery that are routinely performed to treat a retinal detachment:

1. Cerclage and retinal patch: In this retinal surgery, the ophthalmologist places a cerclage (band) around the eye to provide additional support to the retina. Next, a patch (cushion) is placed between the band and the eye at the site of the retinal tear. This presses the tear closed. Sometimes it is necessary to make a small puncture in the eye to ensure the retina is completely sealed. Sometimes, a mixture of air or gas is injected into the eye to seal the retinal tear. Finally, the tear is often frozen shut or sealed with a laser a few weeks later.
2. Vitrectomy: During a vitrectomy, the ophthalmologist makes an incision in your eye to remove the fluid that fills the eye (vitreous humor). The hole in the retina is then sealed with a laser. Next, the doctor injects gas, fluid, air, or oil into the eye to push the retina back against the underlying layer. Gas and air dissipate on their own from the eye, but the oil must be removed after a few weeks.

In about 90 percent of retinal detachments, surgery results in a cure. After surgery, vision often does not fully return due to damage to the retina. The likelihood of regaining full vision depends on where the retina was detached.

So, after a retinal detachment, you may lose (almost) all vision in one eye or see a distorted image. In such cases, the doctor may need to remove the entire eye to prevent further complications, or a scleral lens may be prescribed.

You’ll face new challenges. You’ll face new challenges. On this website, you’ll find, among other things, tips for people who see with one eye, information about prosthetic eyes and eye removal surgeries, and the emotional challenges you may face.

Life after a retinal detachment mainly requires adaptation and patience. With the right information and support, you can continue to carry out your daily activities.

Read about other people’s experiences with retinal detachment in our library. And be sure to check out this video of Afke’s experience. You can also join our WhatsApp community and select the retinal detachment group.