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Retinal Detachment

Having a retinal detachment (or retinal separation) means that a part of the retina -- which lines the inside back wall of the eyeball -- has been lifted from its normal position. The retina is like the film in a camera. Millions of light-sensitive retinal cells receive optical image bits, instantly "develop" them, and send them on to the brain to be seen. The retina is vital for seeing; if any area is detached some vision is lost.

A detached retina is a serious condition that can lead to severe visual impairment or even total blindness in the affected eye. Any new detachment is always considered an emergency. Though the detachment often begins in a small area, it almost never stays small. As it gets larger, vision loss increases.

A retina can detach at any age, but it is more common in midlife and later, and in those who are extremely nearsighted. It affects men more than women, and Caucasians more than blacks. Heredity may also play a part, since it tends to run in families.

What Causes a Retinal Detachment?

A detachment is almost always caused by small tears or holes that form in the retina. These usually result from aging changes in the vitreous, a gel-like substance that fills the eye's interior and helps maintain its round shape. The vitreous contains millions of fine fibers that are attached over the entire surface of the retina. As we age the vitreous slowly shrinks and eventually pulls free from the retina (a vitreous detachment). This pulling sometimes creates one or more tears in the retina. Most tears do no harm, but if vitreous fluid seeps through one, the retina will begin to separate from the back wall of the eye.

A much less frequent cause of retinal tears is a blow or injury to the eye. And rarely, a retinal detachment is not caused by a retinal break, but by traction. Traction detachments are associated with some eye condition that produced intraocular hemorrhage or inflammation, with the formation of retinal surface membranes, such as in severe diabetes and retinopathy of prematurity.