About the retina
The eye is shaped like a ball. The retina is a fine sheet of nerve tissue lining the inside of the eye (see diagram below). Rays of light enter the eye and are focused onto the retina by the cornea and the lens. The retina produces a picture which is sent along the optic nerve for the brain to interpret. The eye and the brain together produce the images that we see.
Retinal detachment
Retinal detachments often develop in eyes with retinas weakened by a hole or tear. This allows fluid to seep underneath, weakening the attachment so that the retina becomes detached - rather like wallpaper peeling off a damp wall.
When detached, the retina cannot compose a clear picture from the incoming rays of light and vision becomes blurred and dim.
Risk factors
Retinal detachment is more frequent in middle aged, short sighted people. However, it is quite uncommon and only about one person in ten thousand is affected. It is rare in young adults.
Symptoms of retinal detachment
The most common symptom is a shadow spreading across the vision of one eye. You may also experience bright flashes of light and/or showers of dark spots called floaters. These symptoms are never painful.
Many people experience flashes or floaters and these are not necessarily a cause for alarm. However, if they are severe and seem to be getting worse and you are losing vision, then you should seek medical advice. Prompt treatment can often minimise the damage to your eye.
Treatment for retinal detachment
If you get help early, it may only be necessary to have laser or freezing treatment. This is usually performed under a local anaesthetic.
Frequently, however, an operation will be needed to repair a hole or put the retina back in place. This is usually done under a general anaesthetic. In about 75 per cent of cases the retina can be repaired with a single operation. The operation does not usually cause much pain, but your eye will be sore and swollen for a few days afterwards. Typically, you will be in hospital for a few hours or an overnight stay, depending on your particular condition.
We want to reassure you that the surgeon does not take your eye out of its socket to operate on it.
Outcomes of surgery
This depends on how much the retina has detached and for how long. The shadow caused by the detachment will usually disappear when the retina has been put back in place. If your ability to see fine detail has been damaged before the operation, this usually does not fully recover afterwards.
Often retinal operations involve the use of a gas bubble which is inserted into the eye. This gas bubble helps the retina to heal correctly inside the eye. If a gas bubble is used then sight may be very poor for several weeks until the bubble is absorbed.
After the operation
Some people will be encouraged to get up and carry on as usual on the day after the operation, although most people will be asked to keep their head in a particular position to help the healing process. Your eye specialist will prescribe eye drops and you will need to use these for a few weeks.
You can resume normal activities, including sex, as soon as you feel able.
Necessity for surgery
Most people will lose all useful vision if no operation is carried out, or if the treatment is unsuccessful.
However, if the first operation does not succeed, it is usually possible to have one or more operations to re-attach the retina.
At each stage your surgeon will discuss with you the prognosis and the need to have more treatments.
Prevention
If your family has a history of retinal detachment and your doctor finds a weakness in your retina, then preventive laser or freezing treatment may be advised. However, in most cases it is not possible to take preventive action.
Retinal detachment does not happen as a result of straining your eyes, bending or heavy lifting.
Risk of PVD in your other eye
If you have had a retinal detachment in one eye, then there is a small risk of developing one in the other eye.
Helping you to make the most of your sight
You can be helped to see many of the things you used to by making use of remaining sight. Low vision services can help. They can help you find the best magnifiers for you, and can give advice and training about the many, often simple, ways that you can make the most of your sight. Ask your eye specialist, optometrist (ophthalmic optician), GP, social worker or local voluntary organisation about low vision services near you. RNIB can also advise on the help that is available.
What next
Talk to someone
The RNIB Helpline is your direct line to the support, advice and products you need. We'll help you to find out what's available in your area and beyond, both from RNIB and other organisations.
Whether you want to know more about your eye condition, buy a product from our shop, join our library, find out about possible benefit entitlements, be put in touch with a trained counsellor, or make a general enquiry, we're only a call away.
RNIB Helpline
Telephone: 0303 123 9999
Email: helpline@rnib.org.uk
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Unfortunately, RNIB can only answer email enquiries from the UK. But you may find an organisation for people with poor sight in your country through our organisations database.
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RNIB's guide to Adapting to sight loss offers ideas for people with sight problems on making life easier and ways of getting the most out of life.
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About this guide
This information has been produced jointly by the Royal College of Ophthalmologists and Royal National Institute of Blind People, with sponsorship from Alcon Laboratories (UK) Ltd.
© RNIB and RCOphth 2007
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