Retinal Detachment

The three main types of retinal detachment are as follows:

• Rhegmatogenous retinal detachment happens when a small tear or hole in the retina allows fluid to pass underneath, lifting it away from the tissue below. This is the most common type.
• Tractional retinal detachment happens when scar tissue on the retina pulls it away from the back of the eye. This type is more common in people with diabetes or after eye surgery.
• Exudative retinal detachment happens when fluid builds up under the retina without a tear, often due to swelling, injury, inflammation, or rare eye diseases.

Although retinal detachment is painless, several visual symptoms appear before it advances. These signs include:

• Appearance of floaters (small dots or irregular strands, drifting across the visual field)
• Appearance of flashes of light in one or both eyes
• Blurring of vision
• Appearance of a curtain-like shadow encompassing the field of vision
• Gradual loss of peripheral vision

If any of the above symptoms are noted, patients are advised to seek medical attention immediately or within a maximum of 48 hours. This will help rule out a retinal tear or detachment and minimise the long-term visual damage that the retinal detachment may cause.

Most cases are linked to the normal ageing process known as posterior vitreous detachment (PVD), which cannot be prevented. Certain factors increase the risk of retinal detachment:

• Short-sightedness
• Previous cataract surgery
• Severe direct trauma to the eye
• Family history (rare)

An eye specialist examines the retina using detailed tests. If a detachment or tear is found, you will be referred to a hospital for surgery. 

Surgical options include:

• Cryopexy and scleral buckle involve sealing retinal holes and placing a silicone band around the outside of the eye to keep the retina in position.
• Vitrectomy involves removing the gel inside the eye (vitreous humour), sealing retinal breaks via laser treatment or freezing, and inserting a gas bubble, air, or silicone oil to hold the retina in place while it heals. 

A local anaesthetic is usually given before surgery to prevent pain during the process.

After surgery:

• Use prescribed eye drops to reduce infection and swelling.
• Avoid rubbing the eye.
• Take painkillers (e.g., paracetamol) if needed.
• Some blurred vision.

Do not worry if you experience:

• Itchy or sticky eyelids and mild discomfort (gritty sensation caused by the stitches) 5–10 days after surgery.
• Some fluid leakage from around the eye after surgery.
• Blurred vision after surgery.
• The area surrounding the eyes may show slight bruising, especially after a scleral buckle procedure.

Any discomfort should ease after 1–2 days. The eye requires about 2–6 weeks to heal in most cases. An appointment with the treating doctor is usually scheduled within 7–14 days of surgery.

See a doctor urgently if you notice:

• Sudden floaters, flashes of light, or vision loss.
• A shadow or curtain moving across your vision.
• Any sudden change in vision after an eye injury.

If the pain or blurry vision intensifies after the operation, the patient is advised to contact the hospital immediately as further treatments may be necessary. 

Taking steps to protect your eyes and seeking timely care can lower the risk of retinal detachment or support better recovery if surgery is needed.

• Have regular eye check-ups, especially if you are short-sighted or have had eye surgery.
• Protect your eyes from injury by wearing protective eyewear during risky activities.
• Seek medical help immediately if you notice early symptoms such as floaters, flashes, or shadows.
• Follow the doctor’s advice carefully after surgery to support healing.
• Avoid heavy lifting, straining, or sudden movements during recovery.
• Keep your head in the position advised by the doctor if a gas bubble is used in the eye.
• Working and driving should be avoided during recovery.

If you suspect retinal detachment, consult an ophthalmologist (eye specialist) right away. In emergencies, go directly to a hospital eye department.