Retinal detachment

Retinal Detachment

Retinal detachment

Retinal detachment is a disease that occurs when a layer of the retina (neural tissue that allows the eye to perceive images and colours) lifts away, taking with it the blood vessels that supply the eye with oxygen and nutrients.

Just 48 hours after the detachment, cell death and the progressive loss of vision begin, which is why it is so important to intervene immediately.

There are at least three types of retinal detachment: 
 

  • Rhegmatogenous: the most common, generated by retinal tear following which fluid from the vitreous chamber penetrates and accumulates in the sub-retinal space.
  • Tractional: occurs in conjunction with other eye diseases such as Diabetic Retinopathy or inflammation of the interior of the eye and consists in the lifting of the retina following the formation of membranes on the retinal surface that exert a traction force.
  • Exudative: caused by conditions outside the eye, such as metastases of tumours and particular inflammatory diseases within the eye, without tear or traction occurring. Sub-retinal fluid is derived from the fluid present in the retinal and/or choroidal vessels.

Symptoms of Retinal Detachment

Retinal detachment is a pathology that can be asymptomatic, which is why it is important not to neglect episodes such as: 
 

  • Photopsia: sudden flashes of light that particularly affect the periphery of the visual field
  • Myodesopsia: floating bodies that blur vision
  • Vitreous haemorrhage: blood poured into the vitreous humour (vitreous gel, in contact with the retina)
  • Scotoma: vision of a shadow (or 'dark curtain') in the visual field
  • Rapid deterioration of vision, with perception of blurred images
  • Sudden loss of vision

Causes of Retinal Detachment

Generally speaking, the most frequent cause of Retinal Detachment is due to the formation of breaks or tears within the retina, which can appear as a result of predisposing diseases or conditions, such as: 
 

  • Eye trauma
  • Degenerative retinal diseases (e.g. high myopia)
  • Positive family history of Retinal Detachment
  • Consequence of eye surgery (e.g. post-cataract)


Retinal detachment occurs more frequently with ageing, but also affects young people with predisposing injuries. Particular consideration is given to detachment after ocular contusion trauma (e.g. as a result of sports injuries).

Retinal Detachment Diagnosis

In the case of a Retinal Detachment, early diagnosis is essential in order to reduce the consequences. During the examination, the ophthalmologist instils some eye drops to dilate the pupils and performs a series of thorough examinations to establish the extent and type of Retinal Detachment:
 

  • Examination of the ocular fundus by indirect ophthalmoscopy
  • Optical Coherence Tomography (OCT): to assess the involvement of the macular region (macula ON/OFF)
  • B-SCAN ultrasound useful if the fundus is difficult to explore due to cataracts or vitreous haemorrhage
  • Measurement of eye pressure

Treatment of Retinal Detachment

Retinal detachment must be treated surgically as soon as possible to avoid complications inherent in functional loss of vision, eyeball atrophy and, although rarer, the development of neovascular glaucoma.

Treatment may vary depending on the type of detachment: 
 

  • Ab-external surgery (scleral buckle), when the intervention is made on the outer layer of the eye
  • Ab-internal (vitrectomy), when the vitreous body of the eye is removed and the retina is repositioned from the inside of the eye
  • Argon laser photocoagulation for localised retinal elevations

Treatment of Retinal Detachment - Recovery Time

It may vary depending on the clinical complexity and the type of surgery. In the first instance we must calculate a minimum of 7 days to one month of absolute rest post-surgery.

Possible Intervention Techniques

Minimally Invasive Vitreo-Retinal Surgery

Minimally invasive vitreo-retinal surgery is a surgery performed with small-gauge operating instruments.

Retinal detachment

Retinal laser therapy

Retinal Laser Therapy involves the treatment of pathological conditions of the retina by means of argon laser photocoagulation.

Retinal detachment

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