Retinal Detachments

The central portion of the eye is filled with a clear gel called vitreous. With aging, the consistency and position of the vitreous gel changes; as the vitreous gel liquefies, it separates from the front surface of the retina in a process referred to as a posterior vitreous detachment (PVD). As the vitreous gel disinserts from the retina, it may tug on the retina itself and cause retinal tears and/or retinal holes to develop. Retinal tears and/or retinal holes arise in approximately 10-15% of posterior vitreous detachments.

Retinal Tears and Retinal Detachment

If left undetected and untreated, retinal tears and holes may contribute to the development of a retinal detachment. As a result of a retinal tear or retinal hole, fluid has access to the space underneath the retina, and it may accumulate with time. When fluid develops underneath the retina and effectively lifts the retina off of the back wall of the eye, this is referred to as a retinal detachment. Intervention is necessary to restore vision if a retinal detachment develops.
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Risk Factors for Retinal Detachment

A retinal detachment may occur at any age, but it is more common in people over the age of 40. Certain factors may increase the likelihood of a retinal detachment arising: myopia (nearsightedness), prior eye surgery, trauma, family history, and having a retinal detachment in the other eye.

Retinal Detachment Symptoms

New onset flashes and floaters may herald the onset of a posterior vitreous detachment. These symptoms in and of themselves warrant a prompt eye examination to rule out the presence of retinal tears, retinal holes, and/or retinal detachment. Retinal detachment symptoms may likewise include loss of peripheral vision in an eye.

Treatment of Retinal Tears and Retinal Holes

If a retinal tear or a retinal hole is detected on dilated examination, it may be treated in the office with laser surgery. A coagulative laser is used to seal around the retinal tear or the retinal hole, preventing the development of a retinal detachment.

Retinal Detachment Treatment

If a retinal detachment has already developed at the time of dilated examination, surgery is usually required to repair the retina. In some cases, in-office coagulative laser may be used to prevent the detachment from progressing. The majority of retinal detachments are repaired in the operating room. Some retinal detachments require repair with a scleral buckle. Many retinal detachments are repaired via vitrectomy, using laser and gas to aid in reattachment of the retina.