Retinal
detachment is a serious condition that can lead to severe visual impairment for
even total blindness in the affected eye. It can occur at any age, but it
is more common in midlife and later. It is more likely to occur in people
who are extremely nearsighted and diabetes. Heredity may also play a part
since it tends to run in families.
The retina
normally lies smoothly and firmly against the inside back wall of the eyeball
and functions much like the film in the back of a camera. Most of the
eye's interior is filled with vitreous, a gel-like substance that helps
maintain its round shape. The vitreous contains millions of fine fibers
that are normally attached to the retinal surface. As we age, the
vitreous slowly shrinks away from the retina and may at some point be pulled
free (this is called a vitreous detachment). Once in a while, this
pulling results in one or more tears or tiny holes in the retina. Any tiny
tears or holes in the retina can allow fluid to seep under the retina,
separating it from the back wall of the eye. If any part of the retina is
lifted or pulled from its normal position, it is called retinal detachment and
will cause some vision loss.
Because retina
is such a sensitive part of the visual system, anything that disturbs it will
cause visual symptoms. When it tears, you are likely to have a
sudden appearance of floaters-a shower of "cobwebs" in your field of
vision-which may be accompanied by "flashes", a sensation of
seeing a flashing bright light. Though it is normal to have a few floaters, a
sudden increase in their number and size is a warning that small amounts of
blood and debris have suddenly appeared in the vitreous. The flashes are
sensations from the retina as it is pulled or torn, or is rubbed by the
loosened vitreous. If a tear breaks a larger retinal blood vessel, the blood
spilling into the vitreous can cause a massive increase in floaters or even
total loss of vision in that eye. The floaters will usually decrease in a
few weeks or months and vision will improve, as long as the retina does not
detach.
When the
process of retinal detachment begins, you may not notice any change
in vision at first if rhe detachment is off to the side. Later, a
"curtain" of darkness will start moving in and block out vision from
one direction to the other. When the detachment reaches the central zone
of the retina, vision will suddenly and dramatically blur. As time goes
on, the curtain will continue to darken more and more of your vision until you
are left only able to see bright light. The detachment will almost
always progress unless it is treated surgically. Therefore, any retinal detachment
is always considered an emergency and need prompt management by a qualified
ophthalmologist.