Types Of Retinal Detachment 

1. Rhegmatogenous Retinal Detachment (Most Common)

This is the most common type of retinal detachment. It occurs when a tear or hole develops in the retina, allowing fluid from the vitreous (the gel-like substance that fills the eye) to seep underneath the retina. This fluid accumulation causes the retina to detach from the underlying tissue. 

Causes and risk factors: 

• Aging (usually over 50 years old) 

• Myopia (nearsightedness) 

• Trauma or eye injury 

• Previous eye surgeries (e.g., cataract surgery) 

• Inherited retinal conditions  

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2. Tractional Retinal Detachment

This type occurs when scar tissue on the retina contracts, pulling the retina away from the underlying tissue. It is often caused by complications from other conditions such as diabetic retinopathy, retinal vein occlusion, or sickle cell disease, where abnormal blood vessels or scar tissue grow on the retina. 

Causes and risk factors: 

• Diabetic retinopathy 

• Retinal vein occlusion 

• Eye trauma or injury 

• Premature birth (in cases of retinopathy of prematurity) 

3. Exudative (Serous) Retinal Detachment 

In exudative retinal detachment, fluid accumulates under the retina due to leakage from blood vessels without any tears or holes. This type does not involve any retinal breaks. It can be caused by a variety of conditions that lead to abnormal fluid production or leakage, such as inflammation, tumours, or vascular issues. 

Causes and risk factors: 

• Age-related macular degeneration (AMD) 

• Retinal vein occlusion 

• Inflammatory diseases (e.g., uveitis) 

• Tumours or other growths behind the eye (e.g., choroidal melanoma) 

Who Is At Risk? 

Retinal detachment is more likely to happen to people between the ages of 40 and 70. As we get older, the vitreous gel in our eyes shrinks and changes texture. This natural process increases the risk of the gel tearing away from the retina. 

If you’re nearsighted, your risk is higher as well. Nearsightedness — particularly if it’s bad enough — can alter the shape of the eye, putting strain on the retina. 

Other eye procedures, such as cataract surgery, also increase risk. If you’ve had any type of eye procedure, your eyes may be even more sensitive. Eye injuries can damage the retina over time.  

Your family history has an outsized influence. If someone in your family has experienced retinal detachment, it’s smart to watch for symptoms yourself. The risk is even higher if a close relative has had it. If you’ve had a retinal detachment in one eye, it’s more likely to happen in the other.  

Symptoms And Early Signs 

Do you ever see those little floaters in your vision? They’re little dots or squiggly lines that float around your vision. A sudden increase in these floaters is a huge red flag. It’s something you want to keep an eye on, especially if you start seeing flashes of light. These flashes may occur in one or both eyes and can indicate something is wrong. If you see a dark shadow or a “curtain” in your field of vision, make an appointment with your optometrist. This is a very clear signal that you must pay attention to. 

Initially, the changes in your vision may be mild. If the detachment increases in size, those changes will be much more evident. That’s why prompt recognition is so important. The sooner you catch these symptoms, the better the chances are of getting effective treatment. 

Diagnosis Methods 

1. Slit Lamp Examinations 

They’re extremely important for detecting retinal detachment. The eye doctor uses a slit lamp to get a close look at your retina. It’s like looking into your eye with a microscope to try to find tears or detachment. The slit lamp throws a beam of light into your eye, so the doctor can see tiny details.  

2. Direct And Indirect Ophthalmoscopy 

Your eye doctor uses tools to view your retina. Direct ophthalmoscopy is when they look straight into your eye, and indirect is when they use a lens. Both ways help them check the retina’s condition, and it’s super thorough. 

Before any eye exam, you’ll receive some dilating eye drops. These drops make your pupils bigger, like a portal, and make it easier for your eye doctor to see all the tiny details of your eyes.  

3. Diagnostic Imaging Tools  

Optos or Optomap — is an instrument that takes an ultra-wide field image of 200 degree of the retina. You sit in front of the instrument and in just a few minutes, your optometrist gets a detailed view of your retina. This image helps the optometrist be able to pick off any small breaks and tears found in the retina so further treatment can be done immediately.  

If there’s any opacity or if the view is cloudy, ocular ultrasound comes in handy. If something’s blocking the view, it helps to visualize the retina past this opacity. In cases where there’s been trauma, CT scans can be used. These scans provide another way to look at the eye when things appear slightly off. 

During your visit, your optometrist may ask questions to learn more about symptoms or history. If they don’t find a retinal tear, they may ask you to return in several weeks. Keeping an eye on things is key because catching a retinal detachment early can prevent vision loss. The success rate for diagnosing retinal detachment is approximately 90 percent. Sometimes, one procedure isn’t enough, and more might be needed to fix things. You may be advised to skip jarring activities to help your eyes heal properly post-surgery.  

Treatment Options For Retinal Detachment 

The treatment for retinal detachment depends on the type of detachment (rhegmatogenous, tractional, or exudative), the extent of the detachment, and the specific circumstances of the individual patient. Here are the main treatment options for retinal detachment: 

1. Laser Therapy (Laser Retinopexy) 

Laser treatment is used primarily to treat retinal tears or holes that have not yet progressed to a full detachment. It works by creating small burns around the retinal tear or hole, which helps to seal the retina to the underlying tissue, preventing further detachment. 

2. Cryotherapy (Freezing Treatment) 

Cryotherapy uses extreme cold to create a scar around a retinal tear or hole. Like laser therapy, it helps seal the tear and prevent fluid from getting underneath the retina, causing further detachment. 

3. Pneumatic Retinopexy 

Pneumatic retinopexy is a less invasive procedure that involves injecting a small gas bubble into the vitreous cavity of the eye. The gas bubble pushes the retina back into place, and the retina adheres to the underlying tissue as the gas bubble gradually dissipates. 

4. Scleral Buckling Surgery 

Scleral buckling is a surgical procedure used for more extensive retinal detachments. It involves placing a silicone band (buckle) around the outside of the eye to gently push the sclera (the white part of the eye) toward the retina. This helps to close the tear or hole and allow the retina to reattach. 

5. Vitrectomy 

Vitrectomy is a more invasive surgical procedure where the vitreous gel (the clear, jelly-like substance filling the eye) is removed. The surgeon then repositions the retina and may use a gas or silicone oil bubble to hold the retina in place during the healing process. 

6. Silicone Oil or Gas Injection 

In cases of more severe retinal detachment or complex cases, a gas bubble or silicone oil may be injected into the eye after vitrectomy or scleral buckling. The gas bubble temporarily holds the retina in place as it heals, while silicone oil may be used if the retina does not reattach after the initial surgery. 

7. Observation (for Exudative Retinal Detachment) 

Exudative retinal detachments, which do not involve a tear or hole but instead are caused by fluid accumulation underneath the retina (due to conditions like age-related macular degeneration, retinal vein occlusion, or inflammatory diseases), may not require immediate surgical intervention. Treatment focuses on addressing the underlying cause. 

How To Prevent Retinal Detachment? 

To reduce the risk of retinal detachment, take the following steps: 

1. Get Regular Eye Exams– Visit an eye doctor regularly for comprehensive exams, especially if you’re over 40 or have risk factors like diabetes or a family history of eye issues.
2. Protect Your Eyes from Injury– Wear protective eyewear during activities that could cause eye trauma, such as sports or work with machinery. 
3. Manage Health Conditions- Control conditions like diabetes and hypertension, which can increase retinal risk. Regular eye checks are crucial for those with these conditions. 
4. Know the Warning Signs- Seek immediate medical help if you notice flashes of light, floaters, or a shadow over your vision, as these could signal retinal problems. 
5. Wear Sunglasses- Protect your eyes from UV rays, which can contribute to eye damage over time. 
6. Monitor Age-Related Changes– Be aware of natural aging effects on the retina and report any vision changes promptly to your eye doctor. 

If you’re experiencing symptoms such as flashes of light, floaters, or a sudden decrease in vision, don’t wait—consult an optometrist. Book an appointment with Dr. D’Orio Eyecare today to get the care you need. Visit drdorioeyecare.com/book-appointment or call us at 416-656-2020 for our Toronto location, or 416-661-5555 for our North York location. Your vision deserves the best! 

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1. Related To Genetics

Macular degeneration is not a disease that will affect everyone. In fact, it often develops because of one’s genetics being passed down from a previous generation. There have been over 30 genes identified as being risk factors for this eye disorder. While having a family history of macular degeneration does not guarantee that you will develop the condition, you should keep an eye out for its warning signs… if your parents or grandparents suffer from it, you are three to four times more likely to develop the condition.

2. Early Warning Signs

As macular degeneration can become quite serious, it is important to be aware of its early warning signs to seek timely treatment. You may notice, for example, that you need more light while reading, especially in low-light conditions. Or it may present as your central vision appearing dark or “whited out” in a specific location. You may also notice that your vision has become blurrier in general. If you notice that you are suffering from any of these symptoms, it is important to visit your optometrist immediately. While some symptoms may be related to a less serious eye condition, only your eye doctor will be able to fully diagnose your eye disorder and set you on a proper course of treatment.

3. Often Age-Related

Macular degeneration is an eye disease that generally affects those over 50 years of age. This is because sometimes as the eyes age, tissues in the macula start to thin. This thinning causes a loss of cells that are essential for vision, leading to a decreased vision in the affected part of the eye. However, just because you are under 50 does not mean you shouldn’t be wary of early symptoms! Macular degeneration has been known to affect those under 50, and can even affect children, known as Juvenile Macular Degeneration, or Stargardt Disease.

4. Two Types of Macular Degeneration

There are two different types of macular degeneration: dry and wet.

Dry macular degeneration appears first and begins to slowly progress over time. It is characterized by the presence of small deposits within the retina, known as drusen. As the drusen grow and multiply, they can begin to affect the vision, causing a dimming or distortion. In advanced dry macular degeneration, the light-sensitive layer of cells in the macula can atrophy, causing the development of blind spots. In some cases, it may not be noticeable without an eye examination… until it becomes more advanced.

When dry macular degeneration is left undetected, it will likely progress into wet macular degeneration, a serious condition that can escalate rapidly. Wet macular degeneration causes the growth of small, abnormal blood vessels to grow within the eye, which leak blood or fluid into the macula, leading to hemorrhage or swelling. The onset of it can be sudden, causing severe damage to vision within days, and being accompanied by sudden loss of vision.

5. Detection And Prevention Is Key

Macular degeneration is not curable, and so it is important that it is detected early to prevent further vision deterioration. Unfortunately, symptoms such as blurry vision or trouble with close work can be confused with other, less serious, conditions. It is important to visit your eye doctor regularly to ensure early detection of this disease.

Currently, there is no course of treatment for early onset dry macular degeneration, but preventative measures can be used to slow the disease. Adapting the lifestyle to include exercising, avoiding smoking, and eating a nutritious diet like leafy greens and fish can help to slow the disease’s progression.

While not curable, wet macular degeneration can be treated. It can be treated with an anti-VEGF injection, which prevents the growth of additional abnormal blood vessels, and could allow a patient to regain some of their vision. The second course of treatment is Photodynamic therapy, which involves a precise laser treatment on the abnormal blood vessels. Laser surgery is another method that is sometimes used for treatment of wet macular degeneration and is more commonly used when blood vessel growth is limited to a compact area that can be targeted, as well as when it is not located near the centre of the macula. This course of treatment will leave a scar, resulting in a blind spot on one’s field of vision.

If you suspect a Macular Degeneration diagnosis or have any other eye or vision concerns, it is important to see your optometrist. Many people do not visit the optometrist until the condition has progressed, and they may have already permanently lost some of their vision. If you feel you may have experienced a deterioration in your vision, contact the experts at Dr D’Orio eyecare. To book an appointment at Dr D’Orio Eyecare, visit https://drdorioeyecare.com/book-appointment/ or call us at 416 656 2020 for our Toronto location, or 416 661 5555 for our North York location.

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