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Medical Author:

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• What is the retina?
• What is a retinal detachment?
• What are retinal detachment symptoms and signs?
• What are retinal detachment causes and risk factors?
• Which diseases of the eyes predispose to the development of a retinal detachment?
• How does cataract surgery lead to a retinal detachment?
• What other factors are associated with a retinal detachment?
• Why is it mandatory to treat retinal detachments?
• What is the treatment for retinal detachment?
• What are complications of surgery for a retinal detachment, and what is recovery like after retinal detachment surgery?
• What are the results of surgery for a retinal detachment?
• Retinal Detachment At A Glance
• Patient Comments: Retinal Detachment - Experience
• Patient Comments: Retinal Detachment - Symptoms
• Patient Comments: Retinal Detachment - Treatment
• Patient Comments: Retinal Detachment - Surgery
• Find a local Eye Doctor in your town
• Retinal Detachment Index

A retinal detachment is a separation of the retina from its attachments to the underlying tissue within the eye. Most retinal detachments are a result of a retinal break, hole, or tear. These retinal breaks may occur when the vitreous gel pulls loose or separates from its attachment to the retina, usually in the peripheral parts of the retina. The vitreous is a clear gel that fills two-thirds of the inside of the eye and occupies the space in front of the retina. As the vitreous gel pulls loose, it will sometimes exert traction on the retina, and if the retina is weak, the retina will tear. Most retinal breaks are not a result of injury. Retinal tears are sometimes accompanied by bleeding if a retinal blood vessel is included in the tear. Many people develop separation of the vitreous from the retina as they get older. However, only a small percentage of these vitreous separations result in retinal tears.

Once the retina has torn, liquid from the vitreous gel can then pass through the tear and accumulate behind the retina. The buildup of fluid behind the retina is what separates (detaches) the retina from the back of the eye. As more of the liquid vitreous collects behind the retina, the extent of the retinal detachment can progress and involve the entire retina, leading to a total retinal detachment. A retinal detachment almost always affects only one eye at a time. The second eye, however, must be checked thoroughly for any signs of predisposing factors that may lead to detachment in the future.

Flashing lights and floaters may be the initial symptoms of a retinal detachment or of a retinal tear that precedes the detachment itself. Anyone who is beginning to experience these symptoms should see an eye doctor (ophthalmologist) for a retinal exam. In the exam, drops are used to dilate the patient's pupils to make a more detailed exam easier. The symptoms of flashing lights and floaters may often be unassociated with a tear or detachment and can merely result from a separation of the vitreous gel from the retina. This condition is called a posterior vitreous detachment (PVD). Although a PVD occurs commonly, there are no tears associated with the condition most of the time.

The flashing lights are caused by the vitreous gel pulling on the retina or a looseness of the vitreous, which allows the vitreous gel to bump against the retina. The lights are often described as resembling brief lightning streaks in the outside edges (periphery) of the eye. The floaters are caused by condensations (small solidifications) in the vitreous gel and frequently are described by patients as spots, strands, or little flies. Some patients even want to use a flyswatter to eliminate these pesky floaters. There is no safe treatment to make the floaters disappear. Floaters are usually not associated with tears of the retina.

If the patient experiences a shadow or curtain that affects any part of the vision, this can indicate that a retinal tear has progressed to a detached retina. In this situation, one should immediately consult an eye doctor since time can be critical. The goal for the ophthalmologist is to make the diagnosis and treat the retinal tear or detachment before the central macular area of the retina detaches.