A retinal detachment is a very serious condition that is considered an eye emergency. This condition can result in blindness or permanent vision loss if it is not treated quickly after occurring.
Basics of the Retina
The retina is the back portion of the eye which contains nerves and photoreceptors that collect light and send it to the brain.
This light collection is the first step in the process of vision. The cells in the retina connect with the optic nerve which then connects into the brain directly to transmit information.
In a normal eye, the retina is composed of several layers which rest one on top of another and pass information between the layers.
All of the layers of the retina together compose what is called the “sensory retina” or the nerve tissue in the eye.
Beneath this layer of nerve tissue, there is another layer of tissue which has blood vessels and helps provide the retina with nutrients and oxygen called the retinal pigmented epithelium.
The retinal pigmented epithelium and sensory retina must remain attached to each other to transfer nutrients and oxygen from the blood into the retina.
Detachment of Retina from the RPE
If the retina becomes detached from the underlying retinal pigmented epithelium, it will separate forward into the vitreous or gel like part of the eye.
When this occurs, a retinal detachment has happened. However, not all retinal detachments are complete, in fact, most are partial retinal detachments.
When only part of the sensory retina pulls away from the RPE, it is considered a partial retinal detachment. In contrast, if the entire retina has pulled away and is floating in the vitreous, a complete retinal detachment has occurred.
Types of Retinal Detachments
Beyond partial or complete retinal detachments, there are three categories of retinal detachments.
Serous retinal detachments occur when there is a fluid build up between the retina and the RPE which causes the retina to pull away.
Tractional retinal detachments occur when there is new blood vessel growth into the vitreous that pulls the retina away from the underlying RPE, giving the name “tractional” detachments.
Rhegmatogenous retinal detachments occur when there is a break or tear in the retina which leads to a further retinal detachment. This break may be a hole, a horseshoe tear, or other type of break in the retina.
Treating Retinal Detachments
A retinal detachment is an emergent condition given that if the entire retina become detached, or if the center of the retina becomes detached, there is likely to be permanent vision loss.
To treat these detachments, an eye surgeon will perform one of several different retinal surgeries.
The goal of any retinal detachment treatment is to have the retina to lay flat back against the RPE and not to separate again.
Since this surgery is such a delicate process, there will be a recovery of days to weeks in which mobility, specifically bending over, will be limited.
Prognosis of a Retinal Detachment
Any retinal detachment is a very concerning finding. With appropriate, early intervention and treatment, most vision can be recovered from a small retinal detachment.
However, if the detachment has advanced or treatment is delayed, there is very likely to be some vision loss that is permanent.