RETINAL DETACHMENT

by Royal National Institute for the Blind & Royal College of Ophthalmologists

What is the retina?

Imagine that your eye is like a camera, and the retina is the film. The retina is a fine sheet of nerve tissue lining the inside of the eye (see diagram). Rays of light enter the eye and are focused on the retina by the lens. The retina produces a picture which is sent along the optic nerve for the brain to interpret. It's rather like the film in the camera being developed so that pictures can be produced.

What is retinal detachment?

Usually the retina is attached to the inner surface of the eye. If there is a tear or hole in the retina then fluid can get underneath it. This weakens the attachment so that the retina becomes detached - rather like wallpaper peeling off a damp wall.

When this happens the retina cannot compose a clear picture from the incoming rays and your vision becomes blurred and dim.

Who is more likely to get it?

Detachment of the retina happens more to middle aged, short sighted people. It is quite uncommon however and only about one person in ten thousand is affected.

Very rarely, younger people can have a weakness of the retina.

What are the symptoms?

The most common symptom is a shadow spreading across the vision of one eye. You may also experience bright flashes of light and/or showers of dark spots called floaters. These symptoms are never painful.

Many people experience flashes or floaters and these are not necessarily a cause for alarm. However if they are severe and seem to be getting worse, and/or you are losing vision then you should see a doctor urgently. Prompt treatment can often minimise the damage to your eye.

What is the treatment?

If you get help early, it may only be necessary to have a laser or freezing treatment. This is usually performed under a local anaesthetic.

Often however, an operation to repair the hole in the retina will be needed. This is usually done under a general anaesthetic and can be repaired with a single operation in 90 per cent of cases. This does not usually cause much pain but your eye will be sore and swollen for a few days afterwards. You will usually need to stay in hospital for two or three days after your operation.

We want to reassure you that your surgeon does not take your eye out of its socket to operate on it.

How much vision can I expect after a successful operation?

This depends on how much the retina has detached and for how long.

The shadow caused by the detachment will disappear in all cases when the retina has been put back in place. However, if the detachment involves the part of the retina which is responsible for your central vision, this may not recover. The longer this part of the retina has been detached, the smaller the chance that your central vision will recover to its former level. But, if this is the case, you will still have some useful vision left.

What happens after the operation?

Usually you can return home after two or three days in hospital. And you will be encouraged to get up and carry on as usual on the day after the operation. Sometimes you will be asked to keep your head in a particular position to help the healing process.

You can resume normal activities, including sex, as soon as you feel able.

What happens if the retina is not put back in place?

Most people will lose all useful vision if no operation is carried out, or if the treatment is unsuccessful. Occasionally, if the detachment involves the lower portion of the retina, some vision may recover by itself.

Can retinal detachment be prevented?

If your family has a history of retinal detachment, or your doctor finds a weakness in your retina then preventive laser or freezing treatment may be needed. In most cases however it is not possible to take preventive action. Retinal detachment does not happen as a result of straining your eyes, bending or heavy lifting.

Am I likely to get one in the other eye?

If you have had a retinal detachment in one eye, you are at increased risk of developing one in the other eye. But there is only about a one in ten chance of this happening.

What if my sight cannot be fully restored?

Much can be done to help you use your remaining vision as fully as possible. You should ask your doctor to refer you to the hospital low vision clinic. There are a variety of optical aids such as brighter reading lights, simple magnifying glasses and more sophisticated equipment that can help you. RNIB can also advise you about the help that is available.

This leaflet has been produced jointly by the Royal College of Ophthalmologists and the Royal National Institute for the Blind with sponsorship from Alcon Laboratories (UK) Ltd