retinal detachment

This is when the retina peels off in the back of the eye, leading to catastrophic vision loss.  Because the retina works like film in a camera, it needs to be perfectly smooth and flat to take a good “picture.”  The retina is plastered smooth against the inner eye like wallpaper.  A retinal detachment occurs when the retina begins to peel off (like wallpaper coming off a wall).  There are many potential causes for a detachment.  Most occur secondary to aging changes in the vitreous jelly that fills the eye. The vitreous is a gel-like fluid that fills the back of the eye. As we age, this jelly liquefies and becomes watery, and then can contract inwards.  This contraction is called a vitreous detachment and is almost always a normal and harmless event. However, sometimes the vitreous gel can pull on the retinal surface and create a small tear in the retina.  This tear can extend and turn into an actual retinal detachment. There are other causes for detachment, such as traction caused by diabetic retinopathy and even tumors, though these are rare.  A detached retina can cause significant vision loss, especially if the macula (the part of the retina responsible for fine central vision) has detached as well.  There are many methods for repairing a detachment, depending upon the severity of findings.  Lasers can be used to seal a retinal tear. A vitrectomy is often required. This is a surgical procedure where a retina specialist removes the vitreous jelly from the eye in order to remove this as a source of traction.  Gas bubbles are sometimes injected to hold the retina in place (a pneumatic retinopexy), and sometimes a silicone buckle (called a scleral buckle) is sewn around the outside of the eye to keep the retina in place.

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Dr. Timothy Root is a practicing ophthalmologist and cataract surgeon in Daytona Beach, Florida. His books, video lectures, and training resources can be found at:

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