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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Retinal Detachment

If the retina becomes detached from the choroid (the thin, bloodvessel- rich membrane surrounding the eye), vitreous humor may seep in and behind the retina and cause further detachment.

What is it?

Retinal detachment is a vision-threatening condition that results when the retina, the layer of light-sensitive cells lining the back surface of the eye, becomes separated from the back wall of the eye, which contains blood vessels that nourish the retina. The retina is also attached in places to the vitreous humor, a transparent, jellylike substance that fills the interior of the back portion of the eye. In many cases detachment follows a small tear or hole in the retina, which occurs when there is age-related shrinkage or degeneration of the vitreous humor that causes part of it to pull away from the retina. As this detachment of the vitreous humor occurs, the retina may tear at points where the retina and vitreous meet.Once a tear forms, vitreous humor may seep between the retina and the back wall of the eye, causing a progressively larger area of detachment over a period of hours, days, or months. The retina must be reattached as soon as possible to minimize or prevent permanent vision loss in the affected eye.

What Causes It?

  • Trauma to the eye may cause a tear in the retina.
  • Spontaneous retinal detachment increases with age.
  • Hereditary factors may play a role.
  • A disease called cytomegalovirus retinitis, common among AIDS patients, may cause retinal detachment.
  • Those with severe myopia (nearsightedness), tumors or inflammation in the eye, diabetes mellitus with diabetic retinopathy, or a family history of retinal detachment are at greater risk.
  • Cataract surgery may increase risk.

Prevention

  • Regular eye examinations may aid in early detection.
  • Use protective gear, such as goggles or helmets with face shields, during vigorous activities like motorcycling or racquet sports.

Diagnosis

  • Dilated eye examination by an ophthalmologist.
  • Ultrasound scans or fluorescein angiography (injection of a special dye into the bloodstream that allows clear photographic images to be taken of the blood vessels in the retina) may be necessary.

How to Treat It

  • In some cases the retina may be reattached by laser surgery or cryosurgery (use of liquid nitrogen to freeze the targeted tissue) and sometimes by the installation of a gas bubble into the eye. These procedures produce scarring around the edges of the retinal tear, sealing it into place.
  • In cases of more severe detachment, more complex surgical procedures may be necessary.
  • Medicated eyedrops and ointments may be prescribed to aid healing following surgery.
  • A silicone-based oil can be injected into the eye to assist holding the retina in place; this treatment is reserved for the most complicated cases that have failed initial surgical repair.

When to Call a Doctor

  • EMERGENCY See an ophthalmologist immediately if you suddenly experience flashing lights, black spots in the visual field, visual loss, or visual field loss.