Many people have heard of or been warned about a retinal detachment but understanding the condition and its severity is important for everyone.
What is the Retina?
The retina is a part of the eye in the back of the eyeball. This is the part of the eye responsible for creating vision and sending a message to the brain.
The retina is a thin layer of nerve cells that help produce the signal that is sent to the brain.
There are blood vessels within the retina which can be seen through an eye exam or special photography.
How is the Retina Attached?
Before understanding a retinal detachment, it is important to understand how a healthy retina is attached to the eye.
The retina is attached to the vitreous humor which is the gelatin-like substance that fills most of the eyeball and provides support and shape for the eye.
In the back, the retina is attached to the retinal pigmented epithelium (RPE), a layer of cells which anchor the retina and prevent fluid leakage into the retina.
The strength of all the attachments is not all equal. The strongest attachment to the vitreous humor is in the far periphery, called the ora serrata.
There are weaker attachments from the retina to the vitreous humor at the macula, the center of the vision, and the optic nerve, which is the channel that connects to the brain.
The strength of the attachment between the retina and the retinal pigmented epithelium is fairly uniform throughout the retina in a healthy eye.
How Does a Retina Become Detached?
If there is trauma or damage to any of the attachments of the retina, it can lead to a detachment.
The simplest way for a retinal detachment to occur is if there is already a break within the retina and the remaining retina is then pulled away at that location.
A retinal detachment that occurs due to a break in the retina is known as a rhegmatogenous detachment.
Another way that a retinal detachment can occur is if fluid gets between the attachments and causes a separation.
A retinal detachment caused by fluid buildup is known as a serous retinal detachment.
The last way for a retinal detachment to occur is by new blood vessels growing into the vitreous humor and pulling the retina away from the lower attachments.
A retinal detachment caused by blood vessels pulling on the retina is known as a tractional retinal detachment.
What Conditions can Cause a Retinal Detachment?
Each type of retinal detachment can be caused by many different conditions.
Rhegmatogenous retinal detachments are often caused by trauma from an injury especially if there are thinned areas of retina caused by lattice degeneration.
Serous retinal detachments can be caused by central serous chorioretinopathy, inflammation of the choroid, or a tumor within the retina or behind it.
Tractional retinal detachments are caused by a number of conditions which can cause neovascularization such as diabetes, vein occlusions, or sickle cell anemia.
What are Symptoms of Retinal Detachments?
There are varying symptoms of retinal detachments depending on the size and severity of the detachment.
Symptoms such as new onset floaters, flashes of light, or a curtain coming over your vision can indicate a retinal detachment.
What are Retinal Detachments Treated?
Treating a retinal detachment is considered an emergency if the eye still has good central vision as retinal detachments will progress quickly and can lead to permanent vision loss.
Treatments include laser retinal surgery, vitrectomy, and a scleral buckle.
Despite treatment options, not all vision is able to be recovered from retinal detachments. In some cases, there will be significant vision loss even with the best treatments.
Since there is a risk of quick and lasting vision loss, any symptoms should be evaluated for a retinal detachment as soon as possible.
