Retinal detachment: symptoms and when surgery is necessary

Retinal detachment occurs when a tear forms in the retina, the innermost layer of the eye that enables us to perceive light and transmit signals to the brain for image processing.

Through this retinal tear, fluid from the vitreous body, the gel-like substance that fills the eye, can pass underneath the retina, separating it from the underlying layers that nourish and support it.

This separation rapidly compromises visual function, as the photoreceptors no longer receive adequate nourishment.

The initial symptoms of retinal detachment may appear suddenly and are usually painless. It is therefore important to recognize warning signs such as:

• flashes of light (photopsia);
• sudden increase in floaters (myodesopsia);
• sensation of a shadow or dark curtain covering part of the visual field and progressing toward the center of vision;
• reduced vision, which occurs if the central area of the retina (the macula) is involved.

In the presence of suspicious symptoms, it is essential not to underestimate them and to seek immediate evaluation by an ophthalmologist.

Certain factors increase the likelihood of developing retinal detachment, including:

• high myopia;
• aging;
• ocular trauma;
• previous eye surgery;
• family history of retinal detachment.

Treatment of retinal detachment is surgical and should be performed promptly. The main treatment options include:

• vitrectomy, to remove the vitreous body and reposition the retina using tamponade agents and retinal laser photocoagulation;
• scleral buckle surgery, to close the retinal tear by bringing it closer to the retinal pigment epithelium through external indentation;
• pneumatic retinopexy, a minimally invasive technique reserved for selected cases. It involves injecting a gas tamponade into the vitreous cavity and sealing the retinal tear with cryotherapy or laser treatment.

In selected cases, when retinal tears are identified before detachment occurs, treatment with cryotherapy or laser therapy may also be performed on an outpatient basis without the need for surgery.

Time is a crucial factor: the earlier treatment is performed, the greater the chances of preserving or restoring visual function. If the macula becomes involved, visual recovery may remain partial and limited even after successful surgery.

A prompt examination can make the difference between preserving vision and losing a significant part of visual capacity. In some cases, prevention is possible through regular ophthalmologic examinations, especially in individuals at higher risk.