The Retina

The retina is a membrane inside the eye which receives images when light falls on it and transmit the pictures to the brain, similar to the film in a camera.
 

Retinal Detachment

This is when there is a separation between the two main layers of the retina.  It occurs when there is tension pulling at the retina which tears and allows fluid to seep in and collect between the layers.   People who are myopic (short-sighted) are at a slightly higher risk of retinal detachment due to thinner retinal layers.

Symptoms

• flashes of light 
• floaters 
• shadows or a curtain across the vision. 

Any loss in vision may be at the edge of the visual field and may not be immediately noticed.  If the centre of the retina that allows detailed vision becomes detached there will be a sudden loss of vision.
Pain is not usually associated with retinal detachment as the retina has no pain nerve fibres.
 

Treatment

An operation under general anaesthetic is usually necessary to re-attach the retinal layers.  This is done by attaching a small sponge to the outside of the eye and sometimes a bubble of gas on the inside, bringing the layers of the retina together. I f the jelly in the centre of the eye (the vitreous) is removed (vitrectomy) gas or fluid may also be injected to maintain the correct pressure.  Any fluid that has collected between the layers will be drawn off.
The other eye will be examined thoroughly whilst you are asleep and any weak areas of retina sealed to prevent further retinal detachments.
 

What else to expect

Before the operation:
You will be prescribed ‘pre-med’ tablets to help you relax before going to the theatre.

After the operation:
Your eye might feel sore and your lids slightly swollen, this will ease over a couple of days and you will be given pain-killers.  You may also feel quite tired for a couple of weeks after the general anaesthetic.
If you have had gas or air inserted, you will have to rest with your head on your side or front until the retina looks properly re-attached.  You may have to continue at home for up to a week or 10 days after your operation.
You may need to stay in hospital for more than one night depending on the extent of the detachment and surgery.  On going home, you should ask your doctor about returning to work or driving. Your eye drops usually continue for 4 weeks and you should avoid any strenuous activity for about 4-6 weeks. You will be given an appointment for clinic follow-up for about a fortnight after the operation.
 

Results of Surgery

In the majority of cases, the retina can be repositioned with one operation.   In some cases further procedures may be required.   Some people have good vision with a retinal detachment because the central part of the retina is still in place.  After surgery the vision may be initially worse because of the surgery.  You may need to change your glasses once the eye has healed to get best vision.

Some people do not have good vision with a retinal detachment, either because of associated bleeding or because the central part of the retina has been detached. Blood will slowly clear or may be removed with a further operation.  If the central part of the retina is involved, vision takes some time to improve and may not return fully to normal.