Retinal Detachments

Chanté Roets - B.Optom (UOFS) CAS(SA)

What is a retinal detachment?

Retinal detachment is when your retina (a layer at the back of your eye) is pulled away from its supportive tissue at the back of your eye.

Retinal detachment is an emergency. The tissue at the back of the eye pulls away from a layer of blood vessels that provide necessary oxygen and nourishment.

What causes a retinal detachment?

There are many causes of retinal detachment, but the most common causes are aging or an eye injury.

There are 3 types of retinal detachment: rhematogenous, tractional, and exudative. Each type happens because of a different problem that causes your retina to pull away from the back of your eye.

Your retina could tear before it detaches. If your retina gets torn, the fluid inside your eye can leak underneath and detach the retina from its underlying tissue. That's a retinal detachment.

  • Rhegmatogenous. This is the most common type. It happens because of a retinal tear. Age usually causes it, as the fluid (vitreous gel) in your eyeball pulls away from your retina. You can also have it because of an eye injury, surgery, or shortsightedness (unable to see far).

  • Tractional.  This type happens when scar tissue or tissue growing on your retina pulls on your retina. This type is usually because of diabetes or any damage to the blood vessels in the back of your eye. 

  • Exudative. This type happens when fluid builds up behind your retina. With this type there is no retinal tear and then the fluid accumulates and pushes your retina away from the tissue behind it. Common causes include leaking blood vessels and swelling because of conditions such as an injury, inflammation, or age-related macular degeneration.

Retinal Detachment Treatment

  1. Your treatment may involve one or more of these procedures:

  2. Laser (thermal) or freezing (cryopexy). Both methods can repair a tear if it’s diagnosed early enough.

  3. Pneumatic retinopexy. This works well for a small tear. Your doctor injects a tiny gas bubble into your vitreous gel. It presses against the upper part of your retina, closing the tear. 

  4. Scleral buckle. A silicone band (buckle) is sewn around the white of your eye (called the sclera). This pushes it toward the tear or detachment until it heals. 

  5. Vitrectomy. This surgery repairs large tears or detachment. The vitreous gel is removed and replaced with a gas bubble or oil.