|  Find a Doctor   |   Getting to NUH   |  Appointments   |  Contact Us   |  Newsroom  |  About NUH  |  Make a Gift 

Ophthalmology (Eye) Department

Common Conditions:

Aesthetic Eye-facial Treatment

Dry Eyes

Age-related Macular Degeneration

Floaters

Blepharitis / Meibomitis

Glaucoma

Cataract

Lazy Eyes

Common Eyelid Problems

Myopia

Diabetic Retinopathy

Squints

Retinal Detachment


This condition refers to the separation of the retina from its underlying tissue. This occurs by the following 3 basic mechanisms:

  • A tear in the retina (also known as rhegmatogenous RD)
  • Traction from fibrous membranes on the surface of the retina
  • Exudation (formation) of fluid material into the space behind the retina (subretinal space)


Of the 3 types of retinal detachment, rhegmatogenous RD is the most common, deriving its name from rhegma, meaning rent or break. Vitreous fluid enters the break and separates the retina from the underlying tissue, resulting in detachment.

Tractional retinal detachment occurs as a result of adhesions between the vitreous gel and the retina. Mechanical forces cause the separation of the retina from the underlying tissue without a retinal break. The most common causes of tractional RD are proliferative diabetic retinopathy, advanced retinopathy of prematurity, and penetrating trauma.

Exudative or serous detachments occur when subretinal fluid accumulates and causes detachment without any corresponding break in the retina. This may be due to tumour growth or inflammation.

The most common factors associated with RD are myopia (ie, nearsightedness), aphakia (cataract removed without intraocular lens implant), and trauma. Approximately 40-50% of all patients with detachments have myopia and 10-20% have encountered direct ocular trauma. Traumatic detachments are more common in young persons, and myopic detachment occurs most commonly in persons aged 25-45 years. Although no studies are available to estimate incidence of RD related to contact sports, specific sports (eg, boxing and bungee jumping) have an increased risk of RD.

How do I know if I have a retinal detachment?

  • Initial symptoms commonly include the sensation of a flashing light (photopsia) accompanied by a shower of floaters. Flashing lights usually are caused by separation of the posterior vitreous. As the vitreous gel separates from the retina, it stimulates the retinal tissue mechanically, resulting in the sensation of light.
  • Over time, the patient may report a shadow in the peripheral visual field, which, if ignored, may spread rapidly to involve the entire visual field in a matter of days.
  • Patients often may note decreased visual acuity and a wavy distortion of objects (metamorphopsia). If a RD involves the macula (center of the retina), vision is severely reduced.

Top

Who is at risk for retinal detachment?

A retinal detachment is also more likely to occur in people who:

  • Are extremely short-sighted
  • Have had a retinal detachment in the other eye
  • Have a family history of retinal detachment
  • Have had cataract surgery
  • Have had an eye injury

Top

How will the doctor know if I have a retinal detachment?

The retina will be examined for tears and detachment after the pupil is dilated with eye drops. In cases where the view of the retina is not adequate, an ultrasound scan of the eye can be performed to detect the detachment.

Top

How is a retinal tear treated?


When only a small retinal tear is detected, laser can be applied to the retina to seal the tear. This is an out-patient procedure which is performed in the clinic.

Top

How is a retinal detachment treated?


When the retinal tear is large or when the retina has detached, surgery has to be performed to flatten the retina and seal the tear. The surgery can either be a scleral buckle or vitrectomy. In complex cases, gas or silicone oil may be injected into the eye to stabilize the retina. Most cases are performed as a day surgery procedure.

Top

Brochures