If your sight is impaired by a dark curtain, loss of peripheral vision or an unusual flurry of specks or flashing lights, you may have a torn or detached retina. This is a serious condition that can lead to blindness if it is not treated immediately.
Our fellowship-trained UCI Health retina specialists at the Gavin Herbert Eye Institute can quickly determine whether surgery is needed to help bond the detached area of the retina to the back of the eyeball.
More than 90 percent of retina detachments and tears can be repaired using laser light or freezing methods. If a patient is treated quickly enough, they can achieve close to 100 percent recovery of vision.
Signs & Symptoms
The retina is the light-sensitive membrane lining the back of the eye. As we age, the vitreous gel-like fluid in the eyeball begins to shrink and break down, creating threads or specks of collagen that cast shadows as they float across the retina.
Called posterior vitreous detachment, this condition occurs in about 75 percent of people over the age of 65. Over time, these so-called “floaters” subside or people adapt to them, experiencing no loss in visual clarity.
In some cases, though, this shrinking can cause small rips or tears that pull part of the retina from the back wall of the eyeball. This can produce flashing lights, a dark curtain obscuring the field of view or loss of peripheral vision. Vision can also appear watery, wavy or distorted.
This detachment reduces the blood supply to the retina’s photoreceptor cells — called rods and cones — and interferes with their ability to process light rays between the eye and brain. The retina must be reattached to the back of the eyeball as rapidly as possible to preserve vision.
A detached retina also may be caused by inflammatory disorders and trauma or injury to the eye.
Pneumatic retinopexy — If the rip or tear is small, a skilled retina specialist can perform this office procedure in as little as 30 minutes under a local anesthetic. It involves injecting a bubble of gas into the eye ball to push the retina back in place. This is followed by laser light or freezing treatment to seal the hole or tear.
Vitrectomy — More serious detachments are treated with a vitrectomy, an outpatient procedure that is usually performed in a hospital operating room or a specially equipped outpatient surgery center, such as our eye institute.
The surgeon uses small instruments to make tiny holes of less than one millimeter in the eye to remove the vitreous fluid and fill the eye ball with air to flatten the retina against the back wall of the eye. Bursts of laser light or intense cold (cryopexy) are used to weld the retina in place. Next, an inert gas is injected to keep the retina both dry and attached for the four to six weeks it takes the eye to heal. The procedure takes about 90 minutes to perform under local anesthesia.
Scleral buckle — A detached retina also may be repaired with a scleral buckle, a narrow, non-reactive band of silicone that is wrapped around the middle of the sclera — the white exterior of the eyeball — and sewn into place. It helps to relieve pressure on the retina. This procedure, which is performed under general anesthesia, is technically less invasive than a vitrectomy and thought to be less likely to cause cataracts, a potential risk for patients who undergo vitrectomy.
A fourth procedure combines the scleral buckle and a victrectomy. It is performed in more complicated cases or in patients with extensive damage to their retina.
Vision loss is minimized if the detachment is repaired before it affects the macula, the central area of the retina that captures the fine details required for reading and other tasks.
That is why it is important to contact an eye care professional immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over your field of vision.
Retinal detachments can occur at any age, but it is more common in people over age 60. It affects men more than women and whites more than African Americans, according to the National Eye Institute.
A retinal detachment is also more likely to occur in people who:
- Are extremely nearsighted
- Have already had a retinal detachment in one eye
- Have a family history of retinal detachment
- Have had cataract surgery
- Have other eye diseases or disorders, such as retinoschisis, uveitis, degenerative myopia or lattice degeneration
- Have had an eye injury
Our fellowship-trained retinal specialists at the Gavin Herbert Eye Institute include:
For more information or to schedule an appointment, call the Gavin Herbert Eye Institute at 949-824-2020.