Detached Retina

A detached retina is a serious and sight-threatening event, occurs when the retina becomes separated from its underlying supportive tissue.

The retina cannot function when these layers are detached. And unless the retina is reattached soon, permanent vision loss may result.

Detached Retina Symptoms and Signs

If you suddenly notice spots, floaters and flashes of light, you may be experiencing the warning signs of a detached retina. Your vision might become blurry, or you might have poor vision. Another sign is seeing a shadow or a curtain descending from the top of the eye or across from the side.

These signs can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches immediately.

About one in seven people with sudden onset of flashes and floaters will have a retinal tear or detachment, according to a study reported in late 2009 in the Journal of the American Medical Association. Up to 50 per cent of people who experience a retinal tear will have a subsequent detachment.

Seeing a curtain-like shadow coming down across your field of vision can be a sign of retinal detachment.

No pain is associated with retinal detachment. If you experience any of the signs, consult your eye doctor right away. Immediate treatment increases your odds of regaining lost vision.

What Causes Retinal Detachments?

An injury to the eye or face can cause a detached retina, as can very high levels of nearsightedness.

Extremely nearsighted people have longer eyeballs with thinner retinas that are more prone to detaching.

On rare occasions, a detached retina may occur after LASIK surgery in highly nearsighted people. In a study of more than 1,500 LASIK patients, just four suffered retinal detachment; their pre-LASIK prescriptions ranged from -8.00 D to -27.50 D.

Cataract surgery, tumours, eye disease and systemic diseases such as diabetes and sickle cell disease also may cause retinal detachments.

New blood vessels growing under the retina — which can happen in diseases such as diabetic retinopathy — may push the retina away from its support network as well.

Sometimes fluid movement in the eye pulls the retina away.

Treatment for Detached Retina

Surgery is required to repair a detached retina. The procedure usually is performed by a retinal specialist — an ophthalmologist who has undergone advanced training in the medical and surgical treatment of retinal disorders.

Generally, the sooner the retina is reattached, the better the chances that vision can be restored.

Surgical procedures used to treat a retinal detachment include:

  • Scleral buckling surgery. This is the most common retinal detachment surgery and consists of attaching a small band of silicone or plastic to the outside of the eye (sclera). This band compresses (buckles) the eye inward, reducing the pulling (traction) of the retina and thereby allowing the retina to reattach to the interior wall of the eye.The scleral buckle is attached to the posterior portion of the eye and is invisible after surgery. Scleral buckling surgery often is combined with one of the following procedures to fuse the retina to its underlying supporting tissue (called the retinal pigment epithelium, or RPE).
  • Vitrectomy. In this procedure, the clear jelly-like fluid is removed from the posterior chamber of the eye (vitreous body) and replaced with clear silicone oil to push the detached portion of the retina back onto the RPE.
  • Pneumatic retinopexy. In this procedure, the surgeon injects a small bubble of gas into the vitreous body to push the detached portion of the retina onto the RPE.

If the detachment is caused by a tear in the retina, the surgeon usually uses a laser or a freezing probe to “spot weld” the retina firmly onto the RPE and underlying tissues and thereby seal the tear. If a laser is used, this is called laser photocoagulation; use of a freezing probe is called cryopexy.

Surgical reattachment of the retina isn’t always successful. The odds for success depend on the location, cause, and extent of the retinal detachment, along with other factors.

Also, successful reattachment of the retina doesn’t guarantee normal vision. Generally, visual outcomes are better after surgery if the detachment is limited to the peripheral retina and the macula is not affected.

Famous People Who Suffered Detached Retinas

One of the most famous people in history to have detached retinas was journalist, publisher and politician Joseph Pulitzer. Both eyes became blind when he was in his 40s, but he was able to run his newspaper empire regardless.

Other celebrities with retinal detachments tend to be in sports, with the condition usually resulting from an eye injury. Examples are basketball player Amare Stoudemire, soccer star Pele, boxer Sugar Ray Leonard, Cuban ballerina Alicia Alonso and mixed martial artist Alan Belcher.

Stoudemire, whose eye was injured more than once, wore sports goggles during a few games, then stopped. After undergoing surgery to repair his retina, he pledged to wear goggles for the rest of his career. Since then he has promoted the idea of wearing sports goggles in many public appearances, including on the Late Show with David Letterman.

If you were to name a U.S. president who was also a sports figure, it would have to be Theodore Roosevelt, who was very fond of boxing. In a match during his presidency, he received a punch to the head that reportedly caused partial blindness in his left eye (though some sources say it was earlier injuries that had caused it).

According to the American Academy of Ophthalmology, eye doctors now speculate that a detached retina may have caused Roosevelt’s vision loss. Today we know that protective eyewear can help prevent retinal detachments, and immediate medical care after eye trauma may prevent long-term vision loss. — L.S.


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