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There are many different kinds of retinal detachment disorders. The most serious retinal problems requiring surgery are caused by difficulties with the vitreous (a gel-like substance) that is attached to the retina. It is attached the strongest to the retina at the optic nerve, macular area, and the vitreous base. As a person ages, the gel becomes more like fluid and small pockets of fluid form within the gel of the vitreous.
A posterior vitreous detachment (PVD) can be caused from the fluid causing the vitreous to pull on the retina, causing the vitreous to pull free and separate from the retina and optic nerve in the back of the eye. If a person has developed a PVD, flashes of light or large spots in vision may occur, as well as floaters.
When the vitreous pulls away from the retina in an area where it’s weak, it may cause a retinal tear. Lattice degeneration (rare inherited trait) is a condition that weakens the retina. When present, it indicates the retina is thin and is more susceptible to a tear of the retina than an area without lattice degeneration. A vitreous hemorrhage occurs when there is bleeding into the vitreous from a retina tear that occurs across a blood vessel. If there is little bleeding, it’s like walking through a swarm of flies. More bleeding looks like a spider web or a swirling mass of black or red lines, and with a lot of bleeding, vision may reduce significantly or become very dark. A vitreous hemorrhage is more serious than a retina tear.
The retina can tear immediately following a posterior vitreous detachment, or weeks later. If a tear hasn’t developed within eight weeks after a detachment, it’s less likely the retina will do so. Anyone who develops a sudden onset of new floaters or flashing lights of any kind should have a complete retinal evaluation. A retinal tear can result in a detached retina.
With early diagnosis and treatment, detached retinas may be prepared by several options: a gas bubble, scleral buckle or vitrectomy surgery and excellent vision may be restored.
