Retinal detachment
Your health expert: Professor Simon Taylor, Consultant Ophthalmic Surgeon
Content editor review by Rachael Mayfield-Blake, February 2023
Next review due February 2026
Retinal detachment is when your retina (a light-sensitive layer of your eye) separates from the back of your eyeball. This can permanently affect your sight, so it’s important to seek expert advice straight away. Make an urgent appointment with an optician. If they aren’t available within 24 hours, look up where your nearest eye casualty is or go to the hospital accident and emergency department.
About retinal detachment
Your retina is a layer of light-sensitive tissue that lines the inside of the back of your eye. When light travels into your eye through your pupil, it's focused onto your retina. The cells of your retina send signals to your brain, which interprets them as the images you see. In the centre of your retina, there’s a small area called the macula, which is responsible for what you see right in front of you. The macula is important for things like reading.
If you have a retinal detachment, this thin layer of light-sensitive tissue separates from the layers beneath. Your vision can then become distorted and blurred or you may develop a black shadow in your vision. This may start at the side and spread across your vision.
Retinal detachment usually just affects one eye, but it can affect both. Most retinal detachments happen in people aged around 60.
Types of retinal detachment
There are three ways that your retina can detach from the back of your eye.
Rhegmatogenous retinal detachment
This is the most common type of retinal detachment and almost all retinal detachments are this type. It can happen if a tear or hole develops in your retina. This can cause fluid in your eye to seep underneath your retina and separate it from the back wall of your eye. This is often caused by the gel (the vitreous) inside the back of the eye becoming more fluid, which is a normal part of ageing.
Exudative retinal detachment
If the blood vessels underneath your retina start to leak fluid, it can build up underneath your retina, which can sometimes cause it to detach. There are many reasons why this can happen – for example, severe inflammation in your eye. Exudative retinal detachment is rare.
Tractional retinal detachment
This is when your retina is pulled away by scar tissue within your eye. This can happen if you have an abnormal growth of blood vessels in your eye, most often because of diabetes. This is a rare type of retinal detachment.
For more information, see our section: Causes of retinal detachment.
Causes of retinal detachment
Causes of retinal detachment include the following.
- Age-related changes to your eye. Getting older can make you more likely to get retinal detachment – usually when you’re over 60. For example, one condition you can get as a natural part of ageing is called posterior vitreous detachment (PVD). This can lead to retinal detachment. PVD affects the vitreous (a jelly-like fluid in the centre of your eye). As you get older, the vitreous begins to lose its shape and consistency, and can start to pull away from the back of your eye. PVD can lead to tears in your retina, which may then develop into retinal detachment.
- Previous eye surgery for cataracts. If you’ve had a cataract operation, the jelly-like vitreous inside your eye can be disturbed, which may increase your risk of a detached retina.
- Retinal lattice degeneration. This is when the outer edges of your retina become thinned in a lattice pattern. It may then tear or holes may form.
- Short-sightedness (myopia) can make you develop a detached retina at a younger age. This may be due to your eyeball being longer and the edge of your retina (peripheral retina) being thinner and more likely to tear.
- An eye injury. This may cause your retina to detach straightaway. Detachment can also happen months or even years later.
- A family history of retinal detachment can make you more likely to get it.
- Diabetic retinopathy (due to diabetes). This is an abnormal growth of blood vessels from your retina that can cause bleeding and scarring, which can pull on your retina.
- Scar tissue. If you have scar tissue on the surface of the retina and inside your vitreous, it can pull on the retina. This is called traction and can cause retinal detachment.
Symptoms of retinal detachment
The most common retinal detachment symptoms are changes in your eyesight that may happen suddenly or over hours, days or weeks. There may be some warning signs of a detached retina. You may get things appearing in your vision for the first time such as:
- flashes of light
- spots or floaters
These may be followed by a dark curtain or shadow that spreads across the vision of one eye. If the central macula area of your retina detaches, you might find it difficult to see at all.
If you get these retinal detachment symptoms, seek expert advice from an optician (optometrist) as soon as possible. Particularly if flashes of light persist and you notice them during the day, and if you have significant floaters or a cloud of fine black spots. If an optician isn’t available, go to your closest eye casualty or your hospital’s accident and emergency department or contact a GP.
Diagnosis of retinal detachment
The sooner you seek expert advice, the less chance there is of permanent damage to your sight.
An optician or doctor will ask about your symptoms and medical history, and will do some tests to check your eyesight. For example, they might look at the inside and back of your eyes with an ophthalmoscope. Ask a friend or relative to drive you to your appointment as these tests might affect your vision for a couple of hours afterwards. This is because of the eye drops that your optician or doctor may put in your eye.
If the optician suspects your retina is detached or is at risk of detaching, they’ll refer you urgently to an ophthalmologist. This is a doctor who specialises in eye health. You might then have other tests such as an ultrasound scan.
Treatment of retinal detachment
Retinal detachment treatment is usually surgery to reattach your retina. Your doctor may recommend retinal detachment surgery is done within 24 hours or within a few days, depending on which part of your eye is affected. If your macula (for central vision) isn’t affected yet, urgent surgery may prevent this happening. This will increase the chance of your vision returning to normal. If your macula is already affected, a few days’ delay won’t make such a difference.
In about eight out of 10 people, one surgical procedure is enough to repair their detached retina. But some people need further retinal reattachment surgery.
There are three main types of surgery for retinal detachment. They all aim to make your retina lie flat against the inside of your eye again. Your doctor will also repair any tears or holes using cold treatment (cryotherapy) or light (laser) treatment.
- Vitrectomy. Your doctor will remove the vitreous (clear gel) from the back of your eye and replace it with either a gas bubble or, less commonly, a silicone oil bubble. This will hold your retina in place while it heals. The gas bubble will slowly disappear over two to 12 weeks (depending on which type of gas your doctor uses). If your doctor uses a silicone oil bubble, they may need to remove it later.
- Scleral buckle surgery. Your doctor will attach a thin band of synthetic material to the outside white of your eye. This will press on the outside of your eye, which will cause the inside wall of your eye to move inwards slightly. This pushes the inside of your eye against the detached retina and into a position that helps it to reattach.
- Pneumatic retinopexy. Your doctor will inject a small gas bubble over the site of your detachment, without removing any of the vitreous. This bubble will press the retina back in place. This procedure is only possible if your retinal detachment covers just a small area.
Retinal detachment surgery can often be done under a local anaesthetic but sometimes a general anaesthetic is best. Your doctor will discuss which type of anaesthesia is appropriate for you.
After your treatment
Your doctor will give you antibiotics and corticosteroid eye drops after retinal reattachment surgery. These will help prevent infection and reduce any swelling.
After the operation, your eye may feel sore and look red. Your eye may feel uncomfortable for a few weeks too. Over-the-counter painkillers should help.
Your doctor or nurse will give you advice about what to do when you get home and when you can return to work or drive again. Call your hospital if:
- you have severe pain
- your vision gets worse
- your eye gets redder
- you have a headache or feel sick
You’ll need to take time off work after surgery for a detached retina – usually about two to four weeks. Your hospital team can give you more advice about what to do and not do.
You may have blurry vision for a few days, weeks or even months after your surgery. It usually takes about two weeks before you and your doctor can get an idea about how well you’ll see again. Don’t worry if you cannot see well straightaway – the gas (or oil) bubble that your doctor injects in your eye will affect your vision. As the bubble dissolves, your vision should improve, but this may take some weeks to happen, depending on the type of gas your doctor uses.
Posturing (if you have a gas bubble in your eye)
If you had gas put into your eye during your treatment, your doctor may ask you to keep your head in a certain position afterwards. This is called ‘posture’ and is to keep the gas bubble in position to help it heal. You may need to keep your head on one side or be face down. Follow the instructions that your doctor or nurse gives you and ask them if you are unsure. You may need to do this for at least a week after your operation. Ask a friend or family member to come and stay with you to help during this time if you can.
While any gas remains in your eye, your vision will be blurred. This will gradually improve as the gas disappears. You may notice a line across your vision that will move down and disappear over the next weeks or months.
There are some restrictions while the gas remains in your eye. You won’t be able to fly, for example. The change in air pressure would expand the bubble of gas and increase the pressure inside your eye. This would be really painful and you would lose your sight.
If you need a general anaesthetic for another operation while you still have gas in your eye, tell your anaesthetist. This is because some anaesthetics can have an effect on the gas bubble.
Ask your doctor how long the gas will be in your eye because this can vary depending on what type of gas they use. Your doctor will give you a bracelet to wear, which will tell medical staff which gas is in your eye. Keep this on until they tell you the gas bubble has fully dispersed.
Complications of retinal detachment
The most serious complication of retinal detachment is partial or total loss of your eyesight, which is very likely if you don’t get treatment. That’s why you should seek expert help straightaway.
If you have a retinal detachment in one eye, you’re more likely to get one in the other eye. This is because the same things that led to you getting a detachment in one eye may cause it to happen in the other. Your doctor will look at your other eye and tell you if you’re more at risk of this happening. Some people have another retinal detachment in the same eye, even after treatment.
Prevention of retinal detachment
If you have a tear or hole in your retina, you may be able to have preventive laser treatment or cold treatment (cryotherapy) to repair it. This may help stop a retinal detachment developing.
You may be able to reduce your chance of getting a retinal detachment by helping to prevent the causes. This includes wearing eye protection if you’re doing DIY or during contact sports. If you have diabetes, keeping it under control will help to prevent the eye problems that can lead to retinal detachment.
If you notice symptoms of retinal detachment, get them checked quickly to help prevent the detachment getting worse. It’s also good to have an eye test regularly, at least every two years, to check that your eyes are healthy.
Ask your doctor if you can drive again after surgery for a retinal detachment. If you’ve had treatment in both eyes – you must, by law, tell the Driver and Vehicle Licensing Agency (DVLA). If you have surgery in just one eye, you must tell the DVLA if you think it might affect your driving – check with your doctor if you’re unsure. If you drive a bus, coach or lorry you must tell the DVLA you’ve had retinal surgery even if it was just in one eye.
Whether a retinal detachment permanently affects your vision depends on whether your macula is affected and on how soon you get treatment. The macula is the part of your retina that processes the central part of your vision. If this is detached, the sight in that eye may never fully recover. If you have retinal detachment surgery soon enough, your vision might be as good as it was before. The longer your retina is detached, the more likely it is that your eyesight will be permanently affected.
For more information, see our section: Treatment of retinal detachment.
The signs of a retina detaching are changes to your eyesight. You may get things appearing in your vision for the first time such as flashes of light or spots or floaters. A dark curtain or shadow may then spread across the vision of one eye.
For more information, see our section: Symptoms of retinal detachment.
Retinal detachment can happen suddenly. If you have a detached retina, you may notice your eyesight suddenly getting worse. The things that can cause a detached retina may have a gradual effect or can lead to a sudden detachment. For example, if you injure your eye, it can cause your retina to detach straightaway or it can happen months or even years later.
For more information, see our section: Causes of retinal detachment.
A detached retina is usually fixed with surgery to reattach it. There are three main types of retinal detachment surgery, which all aim to make your retina lie flat against the inside of your eye again. And your doctor will repair any tears or holes.
For more information, see our section: Treatment of retinal detachment.
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- Retinal detachment. BMJ Best Practice. bestpractice.bmj.com, last reviewed 12 November 2022
- Schwartz SG, Flynn HW Jr, Wang X, et al. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy. Cochrane Database of Systematic Reviews 2020, Issue 5. doi: 10.1002/14651858.CD006126.pub4
- Retinal detachment. Patient. patient.info, last edited 14 May 2021
- Retinal detachment. RNIB. www.rnib.org.uk, accessed 1 September 2022
- Blair K, Czyz CN. Retinal detachment. StatPearls Publishing. www.ncbi.nlm.nih.gov, last update 7 October 2022
- What is the macula? Macular Society. www.macularsociety.org, last reviewed March 2022
- Reading and writing. Macular Society. www.macularsociety.org, last reviewed February 2022
- Sena DF, Kilian R, Liu S-H, et al. Pneumatic retinopexy versus scleral buckle for repairing simple rhegmatogenous retinal detachments. Cochrane Database of Systematic Reviews 2021, Issue 11. doi: 10.1002/14651858.CD008350.pub3
- Posterior vitreous detachment. Patient. patient.info, last edited 19 May 2022
- Cataracts. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised August 2022
- Detached retina. The College of Optometrists. lookafteryoureyes.org, accessed 12 December 2022
- Gas in eye. British and Eire Association of Vitreoretinal Surgeons. beavrs.org, accessed 12 December 2022
- Vitrectomy. National Eye Institute. www.nei.nih.gov, last updated 31 October 2022
- Detached retina. The College of Optometrists. lookafteryoureyes.org, accessed 13 August 2020
- Eye examinations. RNIB. www.rnib.org.uk, accessed 12 December 2022
- Retinal treatment and driving. GOV.UK. www.gov.uk, accessed 12 December 2022
