A retinal detachment often starts with a small tear or hole in the retina. Your natural eye fluid may seep through that hole and build up behind the retina. Over time, this can cause the retina to lift off the layer below it like wallpaper falling off a wall.
Only a doctor can tell you if you have a retinal detachment or a retinal tear. If you do need surgery, there are different types.
Your eye surgeon will decide which procedure for retinal detachment is right for you.
Injecting gas in the eye is one possibility to push the retina back in its original position. The doctor injects a bubble of gas into the center of your eye, which pushes the retina back. Your body will later absorb the gas over time. Doctors use this method, called pneumatic retinopexy, if the retina has just begun to detach.
Another option is “indenting" your eye, which doctors call a scleral buckle. The surgeon sews a silicone strip or sponge to the outside of your eye. This creates an indent, so that the wall of your eye wall can meet the detachment in your retina and help it heal.
Your doctor could also choose to replace your eye fluid in a procedure called a vitrectomy. They will remove the gel-like substance in your eye and will replace it with another material, depending on your needs.
Can You Avoid Surgery?
If your retina has a hole or tear, but has not started to detach, you won’t need those procedures. Your doctor may advise the following methods, though, to repair the hole.
Laser surgery is one way. An eye surgeon points a laser beam into your eye to cause tiny burns around the hole. This creates scars or a “seal” to wall off the tear to prevent it from developing into a retina detachment.
Freezing, which doctors call “cryopexy,” is another possibility. For this procedure, the doctor will numb your eye and then put a small, freezing probe on it. Like laser surgery, the freezing method creates a scar tissue around the hole to correct the problem.
Sometimes the retina detaches with no tear. This usually happens if you have a disease or injury that causes fluid to build up behind the retina. In these rare cases, the detached retina may be fixed by treating the disease, and no surgery is needed.
Risks of Surgery
Most surgeries to repair a detached retina don’t need general anesthesia, so you’ll be awake for it. The surgery itself can cause other problems, though, including:
- Not getting your full vision back
- Failure to repair the detached retina, which can mean more surgery
- An increase in eye pressure
Before surgery, you and your doctor will talk about its risks and benefits.
What to Expect After Surgery
You can get surgery for a retinal detachment in a doctor’s office or a hospital.
After your operation, it could take a few months to find out how good your vision will be. You stand the best chance at a good outcome if the repair is done before the center part of the retina, called the macula, detaches. A lot of times after surgery you may need to have certain positioning of your eye and head laying face down.
In some cases, you could lose your sight. That’s why you need to see your doctor right away if you have sudden changes in your vision, especially if you suddenly start to see a lot more “floaters” -- these are dots or squiggles that appear before your eyes -- or you see flashes of light or a dark curtain moving into your vision.