Retinal Detachment, Surgery and Treatment

There are three main types: rhegmatogenous, tractional, and exudative. Rhegmatogenous is the most common, caused by a tear in the retina.

There are many causes of retinal detachment but the most common cause is a retinal hole or tear. This allows fluid in the eye to go underneath the retina causing it to come off.

A person may experience a sudden appearance of floaters, flashes of light, or ‘cobweb-like’ shapes in their field of vision. If these symptoms were already present, there might be a noticeable increase—either sudden or gradual—in their number or intensity. Additionally, some individuals may notice a sensation of a “curtain” or shadow descending over part of their vision. This shadow can spread and may eventually lead to a loss of central vision.

Retinal detachment occurs in approximately 1 out of every 10,000 to 15,000 individuals. Risk factors for retinal detachment include aging, trauma, severe myopia, family history of retinal detachment, and previous eye surgery.

If you are at risk for retinal detachment, it may be advisable to avoid activities that involve sudden or forceful eye movements, such as contact sports or roller coaster rides. Regular eye check-ups can help detect retinal tears or breaks early, and timely laser treatment can lower the risk of progression to retinal detachment.

If you do not treat a retinal detachment, yes, it can lead to permanent vision loss, including complete blindness in the affected eye.

Here’s why:

• The retina is essential for vision—it converts light into signals sent to the brain.
• When it detaches, it no longer receives oxygen and nutrients from the underlying layers.
• Without prompt treatment, the retinal cells begin to degenerate and die, making the damage irreversible.
• The longer the retina stays detached, the greater the risk of permanent vision loss.

Key Points:

• Early treatment—usually through surgery or laser therapy—offers the best chance of restoring vision or preventing further loss.
• Delaying treatment significantly decreases the likelihood of a good visual outcome.

If you suspect a retinal detachment or are experiencing symptoms (like flashes, floaters, or a shadow over your vision), it’s important to see an eye specialist immediately — this is considered a medical emergency.

There are several methods available to repair a retinal detachment. The choice of treatment depends on the type and severity of the detachment. A retinal specialist will determine the most appropriate approach, and in some cases, a combination of techniques may be used to improve surgical outcomes and increase the success rate.
Treatment options include laser surgery, cryopexy, pneumatic retinopexy, and scleral buckle surgery, depending on the type and severity.

Surgical treatments for retinal detachment are successful in over 90% of cases in terms of reattaching the retina to the eye wall. However, more complex cases may require a combination of techniques or multiple surgeries for optimal results.

Vision recovery varies depending on several factors, with the most important being whether the macula - the most sensitive part of the retina - was detached, the severity of the detachment, duration of detachment, and any co-existing eye problems. Some patients regain full vision, while others may experience partial recovery. Early treatment improves outcomes. The longer the retina stays detached, the greater the risk of permanent vision loss.

Before Your Operation
Before your operation your doctor or nurse will take a detailed medical history, including any medications you are currently taking. Please prepare your list of medications. You may also need to undergo tests such as blood work and an ECG to ensure you are medically fit for the procedure.

If cataract removal is planned as part of your surgery, additional measurements will be taken to determine the correct lens implant needed for successful visual outcomes.

At this appointment, we will also explain the surgical procedure in detail and answer any questions you may have. Additionally, we will review your medications and provide guidance on whether any need to be stopped prior to surgery, particularly blood thinners and medications used to manage diabetes.

What to Expect on the Day of Surgery
You will receive specific instructions about when to stop eating and drinking before your operation. Depending on the scheduled time of your surgery, you will be asked to arrive either early in the morning (for morning procedures) or later in the morning (for afternoon procedures).
In most cases, an overnight stay in the hospital is required, so we recommend bringing a small overnight bag with toiletries and a change of clothes.

Please be aware that retinal detachment surgery may sometimes need to be performed as an emergency, depending on the urgency of your condition.

You will receive specific instructions about when to stop eating and drinking before your operation. Depending on the scheduled time of your surgery, you will be asked to arrive either early in the morning (for morning procedures) or later in the morning (for afternoon procedures).

In most cases, an overnight stay in the hospital is required, so we recommend bringing a small overnight bag with toiletries and a change of clothes.

Please be aware that retinal detachment surgery may sometimes need to be performed as an emergency, depending on the urgency of your condition.

After your surgery, your operated eye will be covered with a protective plastic shield held in place with tape. The following day, a nurse will remove the shield, gently clean your eye, and administer the prescribed eye drops. You and your family members will also be shown how to correctly apply the eye drops and given guidance on proper eye care at home.

You may experience some temporary side effects from the local anaesthetic, such as numbness on one side of your face, a mild headache, or double vision. These effects usually wear off within 1 to 2 days.

It’s normal to have some redness, swelling, drooping of the eyelid, and a gritty or irritated feeling in the eye for up to 4 weeks after surgery. Mild discomfort can usually be managed with pain relief medication. However, if you experience severe pain—especially if it’s accompanied by headache or vomiting—seek medical attention immediately.

Your vision will likely be blurred after surgery, particularly if a gas or oil bubble was used inside the eye. Vision will gradually improve as the gas is absorbed or after the oil is removed. The final level of vision depends on the condition and recovery of your retina.

After your surgery, you will need to remain in the recovery area for 1 to 2 hours until you are fully awake and stable. Depending on the type of surgery performed, the type of anaesthesia used, and your overall medical condition, an overnight hospital stay may be recommended.

As your vision will be temporarily blurred in the operated eye, we strongly advise arranging for someone to accompany you and assist you in getting home safely.

You may need to maintain a specific head position following surgery, especially if a gas bubble or silicone oil has been placed inside the eye. Proper positioning is crucial to support the healing process and improve the outcome of your surgery.

Important Guidelines:

• Follow the positioning instructions provided by your surgeon carefully.
• You must maintain this position continuously, except during meals and toilet breaks.
• To help keep your head in the correct position, you can rent a vitrectomy pillow or use rolled-up bath towels for support.
• A drinking straw can help you stay hydrated without needing to change your head position.
• Your surgeon will let you know how long you need to maintain this posture.
• Do not travel by air unless your surgeon has cleared you to do so, as altitude changes can affect the gas inside the eye.

To promote healing and prevent complications after your eye surgery, please follow these care instructions carefully:

• Use eye drops exactly as prescribed by your doctor.
• Maintain the head position recommended by your doctor, especially if gas or oil was used during surgery.
• Clean your eye twice daily using sterile or clean cotton balls slightly moistened with sterile saline or cooled boiled water. Be careful not to let water enter the eye.
• Wear the plastic eye shield while sleeping for at least 2 weeks to protect your eye.
• Washing your hair: You may be advised to avoid washing your hair or to washvery carefully avoiding soap or water from entering the eye.
• Wear protective sunglasses outdoors. These can be used in place of the eye shield during the day to protect your eye from dust, wind, and light.
• Safe activities include watching TV and using a computer. However, if you were advised to maintain a specific head position, you must continue doing so during these activities.
• Limit outdoor exposure and stay at home as much as possible for 4 weeks or as advised by your doctor. If needed, go only to clean and uncrowded places.
• No dietary restrictions are necessary, but eating plenty of fruits and vegetables is encouraged to prevent constipation.

• Avoid coughing or sneezing forcefully for at least 2 weeks.
• Prevent water or soap from entering your eye for 4 weeks. If this happens, rinse your eye by using the prescribed eye drops.
• Refrain from returning to work until cleared by your doctor (typically, a 4-week hospital leave is provided).
• Do not rub or put pressure on your eye for at least 6 weeks.
• Avoid driving for 6 weeks or until your doctor advises it is safe.
• Avoid strenuous physical activities such as jogging, tai-chi, swimming, or badminton for 6 weeks. Light exercises like walking are generally safe.
• Please note that all activity restrictions depend on your doctor’s evaluation and may vary based on your individual condition.

Over the next six weeks, you can expect your eye to become more comfortable, with reduced swelling and redness. Depending on your eye’s condition, your vision should gradually improve over the following 3 to 6 months. Your retinal specialist will slowly reduce your eye drops, and in some cases, stitches (sutures) may be removed.