Detached retina (retinal detachment)
A detached retina, also known as retinal detachment, occurs when the retina at the back of the eye pulls away from the blood vessels supplying it with oxygen. This is a medical emergency and can result in vision loss.
Risk factors include age-related changes in the eye, previous cataract surgery, eye injury, and diabetes.
Getting a quick diagnosis and urgent treatment gives the best chance of a good outcome for your vision.
Retinal detachment symptoms
The warning signs of retinal detachment can begin quickly. It’s important to get medical advice immediately if you notice signs of retinal detachment, as prompt treatment can improve the outcome. Symptoms include:
- New floaters: tiny specks or lines drifting across your vision can suddenly appear. If you usually experience floaters in your vision, the number may increase, or they may change in type.
- Flashes of light: flashing lights indicating risk of retinal detachment are sudden and at the edge of your vision. It's better to be cautious and get your eyes checked.
- Blurred vision: if you suddenly experience a deterioration in your vision, rather than a gradual change, this could indicate a problem, especially if accompanied by other symptoms.
- Shadow: a 'curtain' or shadow of darkness at the side or in the middle of your vision can be a sign the retina has pulled away from the back of the eye. This happens when the retina has detached and needs urgent attention.
Retinal detachment treatment
A detached retina happens when the retina, a light-sensitive layer of tissue, starts to pull away from the back of the eye. It can begin with a retinal tear that allows fluid within the eye to collect behind the retina. This pushes the retina away from the tissues, like blood vessels, that it's normally connected to.
The retina converts light to electrical signals which are sent to our brain, which produces the images we see. That's why, when the retina detaches, there's a risk of sight loss. This is especially so if the macula, at the very centre of the retina, is affected. The macula provides our central vision, used for reading and seeing fine details.
Surgery is usually recommended within 24 hours to a few days of diagnosis, depending on exactly how the retina is affected. In some cases, urgent surgery can help prevent the macula from detaching to reduce the risk of significant vision loss.
An operation aims to return the retina to its normal position, flat at the back of the eye. There are different types of procedures to achieve this:
Your doctor will assess the best approach based on your diagnosis and circumstances. Surgery may be done under local or general anaesthetic, and your surgeon will discuss this with you.
Recovering from retinal detachment surgery
It can take several weeks to recover from the surgery. While recovering, you might:
- Have blurred vision
- Experience some discomfort and soreness (paracetamol can help with this)
- Need time off work
- Be unable to drive
- Need to avoid flying
If you've had retinal detachment surgery, your eye doctor will explain what you can and can't do while recovering. Don't be afraid to ask them if you're not sure about something.
For example, you may not be able to drive or fly for a while after and will likely need some time off work to recover. You'll probably also need to avoid some activities like sports for a while.
You'll have antibiotic and steroid eye drops after surgery to help your eye recover. During recovery, if your eye pain is severe, your vision or redness in the eye worsens, or you experience nausea and headaches, you should speak to your team as these can be signs of a complication.
Your doctor will check your sight at a follow-up appointment and advise whether you'll need further surgery or treatment. Additional eye surgery is necessary for one out of every ten people treated (Source: Patient).
You can get retinal detachment more than once. So even after treatment, it's important to be aware of the symptoms. This is especially the case if you have known risk factors such as severe near-sightedness, previous cataract surgery, or a family history of retinal detachment. Follow the advice of your eye doctor if you experience signs such as new or different types of floaters in your vision, flashes of light, sudden blurred vision, or sudden loss of vision.
What causes retinal detachment?
The risk factors vary for different types of retinal detachment. Some of the more common causes for a detached retina include:
- Age-related changes to the eye: being over 40 years is associated with increased risk, along with posterior vitreous detachment (PVD).
- Cataract surgery: having an operation for the common eye condition can raise the chances of a detached retina.
- Severe short-sightedness (myopia): and conditions that are more likely due to this, such as lattice degeneration.
- Eye injury: retinal detachment can happen immediately, but also months or even years after the injury.
- Family history: a family history of retinal detachment is associated with increased risk.
- Diabetes: if the condition isn't under control, the risk of retinal detachment and other eye conditions is increased.
- Eye inflammation and infection: for example, from conditions such as uveitis.
- Previously having retinal detachment.
- Biological sex: more common in men.
The risk factors vary for different types of retinal detachment.
None of the above risk factors means you'll definitely experience retinal detachment, but it's good to be aware of the symptoms and get prompt medical advice if these happen to you.
Retinal detachment can happen more than once in the same or both eyes. So even if you've been treated for it, get help if symptoms come back.
Types of retinal detachment
There are three main types of retinal detachment, and each can significantly affect your vision. The treatment for each type may vary, in each case, getting medical help urgently is important.
Retinal detachment diagnosis
The sooner a retinal detachment diagnosis is made, the better the chance of treatment preventing permanent vision loss.
- Regular eye tests are important for monitoring your eye health, especially if you have an eye condition or a previous eye injury that puts you at greater risk.
- If you're experiencing symptoms, an optician should be able to confirm whether you have a retinal tear or detachment. They can make an urgent referral to a hospital ophthalmologist for specialist assessment and treatment.
- To make a diagnosis, your optician or ophthalmologist will examine the inside and back of your eyes. You may be given eye drops that help them examine the retina more easily. These will affect your eyesight for a while, so it's best not to drive yourself to the appointment.
Eye exams and retinal detachment
Regular eye tests can detect eye conditions that develop without causing noticeable symptoms. The NHS recommends getting your eyes tested at least every two years. If you're at increased risk of eye problems (e.g. a family history of eye conditions), you may need to have more frequent eye exams.
How to prevent a detached retina
It's not always possible to prevent retinal detachment from happening, but you may be able to reduce the risk by:
- Having regular eye tests to monitor your eye health, especially if you're at increased risk.
- Keeping diabetes under control. Advanced diabetic retinopathy is a risk factor for retinal detachment when diabetes isn't well managed.
- Taking sensible precautions and using protective eyewear like safety goggles when doing activities such as DIY and some sports.
- Seeing an optician urgently if you develop signs of a possible retinal tear. This can be treated to prevent it from developing into full detachment.