Imagine that your eye is like a camera, and the retina is the film. The retina is a fine sheet of nerve tissue lining the inside of the eye. Rays of light enter the eye and are focused on the retina by the lens. The retina produces a picture that is sent along the optic nerve for the brain to interpret. It’s rather like the film in the camera being developed so that pictures can be produced.

Usually, the retina is attached to the inner surface of the eye. If there is a tear or hole in the retina then fluid can get underneath it. This weakens the attachment so that the retina becomes detached – rather like wallpaper peeling off a damp wall. When this happens the retina cannot compose a clear picture from the incoming rays and your vision becomes blurred and dim.

If the retinal detachment is too severe for scleral buckling or pneumatic retinopexy (see below), surgery to reattach the retina may be necessary. Under general anaesthetic, the surgeon removes the vitreous entirely, replacing it with air or a fluid compatible with the eye. Over time, the fluid (or air) is absorbed, and replaced with the eye’s own fluid. Lack of vitreous does not affect the patient’s vision.

The detachment of the retina is more common in middle-aged, short-sighted people. It is quite an uncommon condition however and only about one person in ten thousand is affected.

Very rarely, younger people can have a weakness of the retina often associated with short-sight.

The most common symptom is a shadow or veil spreading across the vision of one eye. You may also experience bright flashes of light and/or showers of dark floaters. These symptoms are never painful.

Many people experience flashes or floaters. These are not necessarily a cause for alarm, however, if they are severe and seem to be getting worse, and/or you are losing vision then you should see an optometrist or eye specialist urgently. Prompt treatment can often minimise the damage to your eye.

If you get help early, it may only be necessary to have laser or freezing (cryotherapy) treatment. This is usually performed under a local anaesthetic.

Often, however, an operation to repair the hole in the retina will be needed. This is usually done under a general anaesthetic and can be repaired with a single operation in 90 per cent of cases. This does not usually cause much pain but your eye will be sore and swollen for a few days afterwards. You will usually need to stay in the hospital for two or three days after your operation.

The two most common operations for retinal detachment are:-

Scleral buckling – where a sponge or length of silicon plastic is placed on the outside of the eye and sewn in place, pushing the sclera (outer white tissue of the eye) toward the tear in the retina.

Pneumatic retinopexy – a less severe treatment where the surgeon injects a gas bubble inside the vitreous cavity. The bubble pushes the retina against the wall of the eye, allowing the tear to seal itself against the eyewall. 

NB. The eye surgeon (ophthalmologist) does not take your eye ‘out of its socket’ during the operation.

This depends on how much the retina has detached and for how long.
The shadow caused by the detachment will disappear in all cases when the retina has been put back in place. However, if the detachment involves the part of the retina that is responsible for your central vision, this may not recover. The longer this part of the retina has been detached, the smaller the chance that your central vision will recover to its former level. But, if this is the case, you will still have some useful vision left.

Usually, you can return home on the same day as the operation. Rarely you may have to spend a a night or two in hospital. You will be encouraged to get up and carry on as usual on the day after the operation. Sometimes you will be asked to keep your head in a particular position to help the healing process.

You can resume normal activities as soon as you feel able. It might be week or two before you can drive a motor vehicle.

Most people will lose all useful vision if no eye operation is carried out, or if the treatment is unsuccessful. Occasionally, if the detachment involves the lower portion of the retina, some vision may recover by itself.

If your family has a history of retinal detachment, or your optometrist or eye specialist finds a weakness in your retina then preventive laser or freezing treatment may be needed. In most cases, however, it is not possible to take preventive action.

Retinal detachment does not happen because of straining your eyes, bending or heavy lifting.

If you have had a retinal detachment in one eye, you are at increased risk of developing one in the other eye. But, there is only about a one in ten chance of this happening.

Most people will lose all useful vision if no eye operation is carried out, or if the treatment is unsuccessful. Occasionally, if the detachment involves the lower portion of the retina, some vision may recover by itself.

Much can be done to help you use your remaining vision as fully as possible. You should ask your optometrist or eye specialist to refer you to the hospital low vision clinic (LVA clinic). There are a variety of optical aids such as brighter reading lights, simple magnifying glasses and more sophisticated equipment that can help you.

Floaters can be particularly annoying. They get in the way of seeing things and can make some things difficult, for example reading a book. There is a way of trying to cope with this that some people find useful. If you move your eyes around you can create currents in the jelly within your eyes this can sometimes move the floater out of your direct field of vision. This works best if you have one large floater rather than lots of small ones. Making things bigger can also help while you have floaters so that you are able to see things around the blank spots the floaters cause. However, most people find that with time the floaters become less and less of a problem.