Retinal Detachment

Retinal Detachment is an ocular emergency which can permanently affect central and peripheral vision. This article will explore what retinal detachment is, its symptoms, risk factors and treatment options.

What is Retinal Detachment?

Retinal detachment is a serious eye condition where the retina (the neurosensory layer at the back of the eye responsible for detecting light and sending vision signals to the brain) pulls away from its normal position, resulting in tissue death. This can occur centrally at the macula (the most sensitive area of the retina responsible for detailed central vision), affecting central vision, and/or peripherally, affecting peripheral vision, and lead to permanent vision loss in these areas if not treated promptly.1

Symptoms

It is crucial to seek immediate medical attention if you experience any of these symptoms of retinal detachment:
  • sudden appearance of floaters (small specks drifting in your field of vision)
  • flashes of light
  • a curtain-like shadow over your visual field.
However, some may not be aware of symptoms of retinal detachment if they occur gradually or only in one eye, therefore it is important to have regular eye health examinations to catch eye conditions such as this as early as possible.

Risk Factors 2,3

Given the potential for significant vision loss associated with retinal detachment, numerous efforts have been made to identify its primary risk factors, which can include:
  • Age: Retinal detachment is more common with age and can be related to the vitreous gel in front of the retina naturally shrinking (called Posterior Vitreous Detachment) occurring during our 50s-70’s. This can cause a pulling or ‘traction’ on the retina, increasing the risk of retinal tears and detachments.
  • Myopia: Individuals with nearsightedness are at a greater risk as their eyes tend to be longer, making the retina more prone to detachment. Studies show a 10-fold increase in the risks of development with myopia over just -3.00D. See our article on “Myopia: Not Just A Refractive Error”.
  • Previous Eye Surgery or Injury: Individuals who have undergone eye surgeries such as common Cataract surgery have a strong associated risk of retinal detachment. Other eye injuries can also elevate the risk due to trauma.
  • Weak Areas in the Retina: Some people have thinner areas in the retina called Lattice Degeneration, making them more prone to retinal detachment.
  • Family History: If you have a family history of retinal detachment, you may be more susceptible. One Singapore study also found a higher incidence for people of Chinese ethnicity.4
  • Previous Retinal Detachment: If you’ve had a retinal detachment in one eye, you are at an increased risk of it happening in the other eye.

Treatment3

Treatment typically involves surgery, with the goal of reattaching the retina to its proper position. There are different surgical techniques, including scleral buckle, vitrectomy, and pneumatic retinopexy, depending on the location and severity of the detachment. Small retinal tears may only require laser surgery to reattach and seal the retina. Cases where the central macula is detached have a worse visual prognosis due to the sensitivity of the cells in this area.

Conclusion

Retinal detachment is a serious eye condition which can lead to blindness. There are several common risk factors for its development and its symptoms should not be avoided. Regular eye exams, especially for individuals at higher risk, can help in the early detection of retinal detachment which is crucial for prompt treatment.

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If you are concerned about your own or your child’s vision it’s best to book an eye examination to have this properly tested and diagnosed.
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References

  1. K. Blair, C. N. Czyz. Retinal Detachment. National Library of Medicine, StatPearls (2022).
  2. D. Kriebel, S. R.. Sama, M. Bradbury, B.Buchholz, S. Curti, B. Daines, K. Deliso, R. DeVries, T. Fleckner, R. Gore, S. Mattioli, C. Shah and D. H. Wegman. Risk Factors for Retinal Detachment. J Occup Environ Med (2020). doi:10.1097/JOM.0000000000001867.
  3. Z. N. Sultan, E. I. Agorogiannis, D. Iannetta, D. Steel, T. Sandinha. Rhegmatogenous retinal detachment: a review of current practice in diagnosis and management. BMJ Open Ophthalmology (2021). doi:10.1136/bmjophthal-2020-00474
  4. T. Y. Wong, J. M. Tielsch, O. D. Schein. Racial difference in the incidence of retinal detachment in Singapore. Arch Ophthalmol (1999). doi:10.1001/archopht.117.3.379