What is a retinal detachment?

The retina is the inner layer at the back of your eye. The retina captures the light coming into your eye and sends this information to your brain.

Sometimes the retina can peel off (detach), usually because of a tear. This causes your vision to be blurred or a shadow to develop in your vision.

What are the benefits of surgery?

The aim is to prevent your vision from getting worse and your retina from detaching again.

Are there any alternatives to surgery?

Sometimes the tear or hole can be treated without any surgery, by using a laser, with freezing treatment or by injecting gas into your eye.

What will happen if I decide not to have the operation?

More of the retina will usually detach, causing your vision to get worse. If the macula becomes detached and you leave it untreated for too long, you are likely to lose the vision in your eye permanently.

What does the operation involve?

Various anaesthetic techniques are possible, including a general anaesthetic or a local anaesthetic that is injected around your eye to numb it. The operation usually takes about 90 minutes.

Your surgeon can repair any tears or holes using a laser or by freezing treatment.

Retinal detachment surgery can involve one or more of the following techniques:

• Removing the jelly part of your eye and replacing it with air, gas or silicone oil to help keep the retina in place (vitrectomy).
• Stitching a small piece of silicone rubber (scleral buckle) onto the surface of your eye to press the wall of your eye inwards and keep the retina in place.
• Injecting a bubble of gas into your eye to float the retina back into place, and the following day using freezing treatment or a laser to fix the position (pneumatic retinopexy).

How can I prepare myself for the operation?

Keeping in the same position

Before the operation your surgeon may ask you to keep in a certain position such as lying flat on one side. This may help to prevent more of the fluid from collecting under the retina and making the problem worse.

If the operation is performed under a local anaesthetic, you will need to lie still and flat during the operation. If you cannot lie still and flat, let your surgeon know.

Your face will be covered with a cloth to allow your surgeon to work on a clean surface. Air will be blown gently towards your nose. If you are claustrophobic (afraid of being in small spaces), let your surgeon know.

Lifestyle changes

If you smoke, stopping smoking will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you.

Some complications can be serious.

General complications of any operation

• Bleeding on the outside of your eye during or after the operation.
• Infection, which may cause blurred vision or even permanent loss of vision.
• Allergic reaction to the equipment, materials or medication.
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Heavy bleeding inside your eye during surgery, which may cause permanent loss of vision.
• Reduced vision.
• Raised pressure in your eye.
• The retina becoming detached again. The risk depends on how severe the detachment is and the type of surgery you need.
• Development of a cataract. This is when the natural lens within the eye becomes cloudy causing blurred vision.
• Double vision. This usually gets better but sometimes you may need another operation. Double vision may be permanent.
• Inflammation in your other eye.

Consequences of this procedure

• Pain.

How soon will I recover?

You are expected to go home the same day.

Regular exercise should improve your long-term health. It is important to keep still for the first few days. Before you start exercising, ask the healthcare team or your GP for advice.

Do not swim or lift anything heavy until you have checked with your surgeon.

Most people make a good recovery.

Your surgeon will tell you if new glasses will improve your vision, or if you need surgery to remove a cataract.

Summary

A retinal detachment is a common problem where the inner layer at the back of your eye peels off. Retinal detachment surgery should prevent your vision from getting worse.

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