Detached or Torn Retina: Causes, Symptoms and Treatment

Our eyes are like cameras. Light enters the eye through the pupil and reaches the lens. The lens focuses the light onto the retina, which can be likened to a camera film. The retina is a light-sensitive nerve layer or membrane at the back of the eye. It receives images and transmits them to the brain.

Between the lens and the retina is the vitreous, a clear gel that fills up most of the inner space of the eyeball or the middle of the eye. As we age, the vitreous sometimes pulls away from its attachment to the retina. Usually this separation occurs without any noticeable problems.

If, however, the vitreous doesn't easily separate from the retina, it may pull the retina inward, toward the center or middle of the eye. When this occurs, and the retina pulls away from the wall of the eyeball, it's called a detached retina. Sometimes, the vitreous pulls so hard on the retina that it may tear one or more holes in this membrane. When that occurs, fluid may pass through the retinal tear, causing the retina to lift away from the back of the eye, much like peeling wallpaper.

In addition to the shrinking of the vitreous and tears in the retina that let fluid in, there are several other factors or conditions that can cause, or at least increase a person's chances of, retinal detachment: severe nearsightedness, which can cause spontaneous retinal detachment; tumors; glaucoma; cataract surgery, although this is infrequently the sole cause of retinal detachment; previous detached retina in the other eye; family history of detached retinas; severe trauma to the eye that literally knocks the retina loose; and bleeding behind the retina due to diabetic retinopathy or injury.

There are symptoms or warning signs that may indicate retinal detachment. A person may notice a sudden partial loss of vision or the sense that a gray curtain or shadow is moving across their field of vision. There may also be only a small hole of vision or a blind spot that is barely noticeable. Retinal detachment is often associated with new floaters, best described as little black gnat-like pieces or strings that float across the eye. A person may also have a sudden onset of flashing lights or flashes of light. The sudden onset of either new floaters or flashing lights should prompt a person to contact their eye doctor right away. At the very least, a person should get an eye exam to rule out tears or retinal detachment because if a detachment of the retina is not repaired within 24-72 hours, permanent damage may occur.

A detached retina is fixed by one of several types of surgery, most done under local anesthesia. Although there is some risk of infection and bleeding, as is the case with all surgeries, most retinal detachment surgery is successful.

It may take several months for a person's vision to improve; sometimes the person's vision never fully returns. Because the severity of the detachment often determines the degree of vision return, it is critical a person get medical attention at the first sign of trouble.