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Causes
By Mayo Clinic staff
Retinal detachment can occur as a result of:
- Trauma
- Advanced diabetes
- An inflammatory disorder, such as sarcoidosis or cytomegalovirus retinitis
- Sagging or shrinkage of the jelly-like vitreous that fills the inside of your eye
How retinal detachment occurs
Retinal detachment occurs when vitreous liquid (vitreous humor) leaks through a retinal tear and accumulates underneath the retina. Leakage can also occur through tiny holes where the retina has thinned due to aging or other retinal disorders. Less commonly, fluid can leak directly underneath the retina, without a tear or break.
As liquid collects underneath it, the retina can peel away from the underlying layer of blood vessels (choroid). Over time these detached areas may expand, like wallpaper that, once torn, slowly peels off a wall. The areas where the retina is detached lose their blood supply and stop functioning, so you lose vision.
Posterior vitreous detachment
As you age, your vitreous may change in consistency and shrink or become more liquid. Eventually, the vitreous may sag and separate from the surface of the retina — a common condition called posterior vitreous detachment (PVD), or vitreous collapse. This occurs to some extent in most people's eyes as they age.
PVD usually doesn't cause serious problems, but it can cause visual symptoms. If the vitreous pulls on the retina as it shifts and sags, you may see flashes of sparkling lights (photopsia) when your eyes are closed or when you're in a darkened room. The shifting or sagging vitreous may also make new or different floaters appear in your field of vision. These spots, specks, hairs and strings are actually the shadows cast on the retina by small clumps of gel, fibers and cells floating in the vitreous.
If the sagging vitreous pulls too strongly, the retina can tear, leaving what looks like a small, jagged flap. Most retinal tears caused by PVD lead to retinal detachment if left untreated. Detachments that go undetected and untreated can progress and eventually involve the entire retina, causing complete loss of vision in the affected eye.
- Retinal detachment. National Eye Institute. http://www.nei.nih.gov/health/retinaldetach/index.asp. Accessed Oct. 1, 2008.
- Wilkinson CP. Rhegmatogenous retinal detachment. In: Yanoff M, et al. Ophthalmology. 2nd ed. St. Louis, Mo.: Mosby, Inc.; 2004:982-988.
- Arroyo JG. Retinal tear and detachment. http://www.uptodate.com/home/index.html. Accessed Oct. 1, 2008.
- Kang HK, et al. Management of retinal detachment: A guide for non-ophthalmologists. British Medical Journal. 2008;336:1235-1240.
- Posterior vitreous detachment, retinal breaks, and lattice degeneration. San Francisco, Ca.: American Academy of Ophthalmology. http://one.aao.org/asset.axd?id=01c2221b-554a-4ebb-bff9-dd8e17f84008. Accessed Oct. 3, 2008.
- Fletcher EC, et al. Retina. In: Riordan-Eva P, et al. Vaughan & Asbury's General Ophthalmology. 17th ed. United States of America: The McGraw-Hill Companies, Inc.; 2008. http://www.accessmedicine.com/content.aspx?aid=3088798. Accessed Oct. 1, 2008.
