Retinal detachment happens when the retina, which is the thin, light-sensitive layer of tissue lining the back of the eye, pulls away from its normal position. This separation disrupts the retina’s ability to function properly, cutting off its supply of oxygen and nutrients, which can lead to permanent vision loss if not treated promptly.
The most common cause of retinal detachment is a **tear or hole in the retina**. This tear allows fluid from the inside of the eye to seep underneath the retina, lifting it away from the underlying tissue. This process is similar to wallpaper peeling off a wall when water gets behind it. The retina can develop these tears when the gel-like substance inside the eye, called the vitreous, shrinks or pulls away from the retina as people age. This condition is known as posterior vitreous detachment. When the vitreous tugs too hard on the retina, it can cause a tear, which then leads to detachment if fluid passes through[1][2][5][8].
Besides tears caused by vitreous detachment, there are other ways the retina can detach:
– **Tractional retinal detachment** occurs when scar tissue or fibrous tissue on the retina’s surface contracts and pulls the retina away. This is often seen in people with diabetic retinopathy or other diseases that cause abnormal blood vessel growth and scarring inside the eye.
– **Exudative retinal detachment** happens without any tears or holes. Instead, fluid accumulates underneath the retina due to inflammation, injury, tumors, or vascular diseases like hypertension or age-related macular degeneration. This fluid buildup pushes the retina away from the back of the eye[2][6].
Several risk factors increase the likelihood of retinal detachment:
– **Aging**: As people get older, the vitreous gel inside the eye naturally shrinks and can pull away from the retina, increasing the chance of tears.
– **Severe nearsightedness (myopia)**: People with high myopia have longer eyeballs, which stretches and thins the retina, making it more prone to tears and detachment.
– **Previous eye surgery or trauma**: Surgeries like cataract removal or injuries to the eye can weaken the retina or cause scarring, increasing detachment risk.
– **Family history**: Some people inherit a predisposition to retinal problems.
– **Other eye diseases**: Conditions like diabetic retinopathy or inflammatory diseases can cause traction or fluid buildup leading to detachment[2][4].
Symptoms of retinal detachment often appear suddenly and can include:
– Seeing flashes of light or sparks in the vision, caused by the vitreous tugging on the retina.
– The appearance of floaters, which are small dark spots or cobweb-like shapes drifting in the field of vision.
– A shadow or curtain effect creeping across part of the visual field, indicating the retina is detaching.
– Sudden decrease in vision or blurry vision.
Because retinal detachment is painless, many people only realize something is wrong when vision changes occur. Immediate medical attention is critical to prevent permanent vision loss[1][2][3].
In summary, retinal detachment is primarily caused by a retinal tear or hole that allows fluid to separate the retina from the back of the eye. This tear often results from the vitreous gel pulling away with age or injury. Other causes include scar tissue pulling on the retina or fluid accumulation from inflammation or vascular problems. Risk factors include aging, severe myopia, trauma, surgery, and certain diseases. Recognizing symptoms like flashes, floaters, and shadows in vision is essential for timely treatment.
