Retinal Detachment: Causes, Symptoms, Types and Treatment

Retinal detachment or a detached retina is an emergency condition in which the layer of the retina (the light-sensitive layer of tissue in the back of the eye) pulls away from its normal position. It must be treated quickly to reduce the risk of permanent vision loss.

Retinal detachment is an emergency condition that may be presented differently depending on the cause of the condition. There are three types of retinal detachment:

1. Rhegmatogenous retinal detachment: This type of detachment occurs with a small tear, hole or break in the retina. This allows the eye fluid (vitreous) to travel through the tear and collect underneath the retina. The fluid pushes the retina away, detaching it from the back of the eye. Rhegmatogenous detachment usually happens in elderly people. 
2. Tractional retinal detachment: This type of detachment occurs when scar tissue or other tissue grows on the retina’s surface, pulling it apart from the back of the eye. The condition is typically seen in diabetic people. The prolonged high blood sugar level can damage the blood vessels in the eye and result in scar tissue formation. The scars can get bigger, leading to retinal detachment from the back of the eye. 
3. Exudative retinal detachment: In this type of detachment, fluid builds underneath the retina without any holes or tears in the retina. The main causes of fluid buildup include:
   1. Eye inflammation, leading to leaking blood vessels or swelling behind the eye
   2. Injury to the eye
   3. Age-related macular degeneration
   4. Cancer behind the retina

There is no pain experienced with retinal detachment. But the warning signs usually appear before the detachment occurs or advances. Signs and symptoms of retinal detachment include:

1. Blurred vision
2. Partial vision loss
3. Photopsia (seeing flashes of light in one or both eyes)
4. Seeing a lot of floaters (dark spots, threads, or small bits of debris that drift through the field of vision)
5. Reduced peripheral vision (side vision)
6. A shadow-like curtain covering part of the vision

Retinal detachment happens when the retina is pulled away from its normal position. There are many retinal detachment causes, but the most common causes are ageing or an eye injury. Other causes of retinal detachment include:

1. Small tear in the retina
2. Scar tissue growth on the retina
3. Eye inflammation
4. Structural changes to the eye
5. Age-related macular degeneration
6. Cancer behind the retina

Anyone can experience retinal detachment, but the risk of developing retinal detachment can increase due to several factors, including:

1. Ageing: More common in people over 50 years of age
2. Family history of retinal detachment
3. Previous eye injury
4. Intraocular surgery (surgeries involving the eyes)
5. Extreme myopia (nearsightedness)
6. Posterior vitreous detachment (thick fluid in the middle of the eye pulls away from the retina)
7. Diabetic retinopathy (eye condition caused due to diabetes)
8. Lattice degeneration (thinning of the retina)
9. Retinoschisis (retina separates into two layers)

Since the most common cause of retinal detachment is ageing, there is often no way to prevent it. However, if the patient takes the following measures, he/she can lower the risk of retinal detachment.

1. Get regular eye care: regular eye checkups help to protect eye health. People with nearsightedness (Myopia) makes them more prone to retinal detachment. 
2. Stay safe: use safety goggles or other protective gear when playing sports or doing risky activities.
3. Get prompt treatment: a patient must consult the doctor immediately if he/she notices symptoms of retinal detachment.

The doctor will generally be able to diagnose retinal detachment by dilating the eye to check the retina. The doctor will put eye drops in the eye that will dilate (widen) the pupil. After which the doctor will get a close look at the retina. The doctor may also recommend some of the following additional tests after the dilated eye exam.

1. Fluorescein Angiography: The doctor will use some dye and a camera to check the blood flow in the retina.
2. Tonometry: The doctors do this test to check the pressure inside the eye.
3. Retinal examination: In this diagnostic test, the doctor uses an instrument with a bright light and a special microscope to examine the back of the eye. The device provides a detailed view of the complete eye, allowing the doctor to look for retinal tears, holes, or detachments. 
4. Optical Coherence Tomography (OCT): The doctor dilates the eyes with eye drops for this imaging. The test uses an OCT machine that scans the eyes to differentiate the layers within the retina and measure the retinal thickness. 
5. Ocular Ultrasound: During this test, the doctor gently places an instrument in front of the eye to scan it. He/she will then use the same instrument to scan the eyeballs with closed eyes.

How to prepare for the doctor's consultation?

1. List down symptoms including any that may seem unrelated to the condition.
2. List down the relevant events that may be related to the condition.
3. The patient must tell the doctor the list of medications and supplements that he takes.
4. The following questions should be asked the doctor:
   1. What treatment is best suitable for me?
   2. How can I stay comfortable in this condition?
   3. Do you think I have any other conditions?
   4. Do I need to see a specialist for my condition?
   5. Why is surgery needed?

Depending on the age, health condition, the degree to which the retina is detached and the type of retinal detachment, the doctor may recommend one of the following treatment methods to fix the retinal detachment.

Retinal Detachment treatment with surgery

1. Laser (thermal) therapy or cryopexy (freezing): the doctor will use a medical laser or a freezing tool to seal the tear. The devices will make a scar that will hold the retina in place.
2. Pneumatic retinopexy: this method is done when there is a small detachment. The doctor will place a gas bubble in the eye to help the retina flow back into place. Then the retina is sealed by a laser.
3. Scleral buckle: the doctor will gently push the eye wall up against the retina.
4. Vitrectomy: this method is used for the largest tear and detachment. It is done to remove gel or scar tissue pulling on the retina.

Retinal detachment is an emergency condition and requires medical attention. If a retinal detachment is left untreated it can lead to the following complications:

1. Permanent vision loss
2. Cataract formation (loss of clarity of the lens of the eye)
3. Glaucoma (raised pressure in the eye)
4. Infection
5. Haemorrhage (bleeding) into the vitreous cavity

When to see a doctor?

The patient can consult the doctor if he/she experiences:

1. Blurred vision
2. Partial vision loss
3. Seeing a lot of floaters 
4. Reduced peripheral vision

Diet cannot treat retina detachment, but the doctor may recommend a diet rich in certain nutrients to prevent retinal tears. Below mentioned are some of the food items that will help keep the good health of the retina.

1. Dark green, leafy vegetables that include kale, spinach, chard and collard greens are rich in lutein and zeaxanthin as the retina needs this nutrition for its good health.
2. Food items rich in Vitamin C include oranges, apples, peaches, tomatoes and grapefruits.
3. Food items rich in Omega 3 fatty acids include salmon and tuna
4. Food items rich in Zinc include eggs and salmon.
5. Food items rich in Vitamin E include walnut, almonds, and hazelnuts.