It starts small as a speck drifting across your vision, a flicker of light at the edge of your sight. Annoying, but harmless, right? Not always. Those so-called “floaters” and flashes can sometimes be the first warning of retinal detachment — a silent but severe eye emergency that can rob you of your vision in days if left untreated.
WORDS LIM TECK CHOON
 FEATURED EXPERTDR PEH KHAIK KEE Consultant Ophthalmologist and Vitreoretinal Surgeon Sunway Medical Centre |
The retina is a thin, light-sensitive layer at the back of the eye.
- Retinal detachment happens when the retina peels away from its normal position. Think of it as the film in a camera coming loose.
- While it is painless, it can lead to permanent blindness if left untreated.
Dr Peh Khaik Kee explains that:
- As we age, the clear gel inside our eyes —called the vitreous — begins to shrink and pull away from the retina.
- This can cause a small tear to happen, which allows fluid to slip behind the tear and “lift” the retina off the wall of the eye.
As the retina detaches further, the light-sensing cells on the retina are cut off from their source of oxygen and nutrients.
- If this continues, those cells will die — which will lead to vision loss and eventually blindness.
- Once the retinal cells are gone, no surgery can bring them back. This is why vision loss caused by retinal detachment is irreversible.
FLOATER: AN EARLY WARNING SIGN TO WATCH OUT FOR
Floaters are drifting specks or cobwebs in your vision.
- They are often harmless, and only 5% to 10% of such cases are caused by retinal detachment.
- However, a sudden increase in floaters, especially with flashes of light, should be a reason to see an eye specialist.
HOW THE EYE SPECIALIST DETECT A RETINAL DETACHMENT
The only way to be sure is with a dilated eye exam.
- Special eyedrops will be given to the patient to dilate their pupils.
- This allows the eye specialist or ophthalmologist to later examine the back of the retina more clearly.
- Follow-up visits for the next few months are necessary to detect formation of new tears in the retina.
TREATMENT
If the Retinal Tear Is Caught Early
The tear can be sealed using a quick and painless procedure called laser photocoagulation.
- This is a simple, clinic-based treatment used when the retina has a small tear but has not detached yet.
- A focused laser beam will be directed to create tiny burns around the tear.
- These burns form scar tissue that “welds” or “glues” the retina back to the underlying tissue, sealing the gap so fluid can no longer slip behind it and cause further detachment.
The whole thing takes just a few minutes.
It is painless, but there may be mild stinging or flashes of light in the eye.
If Retinal Detachment Has Occurred
Surgery will be necessary.
There are two main types of surgery that can be considered:
- Vitrectomy, where the gel-like vitreous in the eye is removed and replaced with gas to push the retina back in place.
- Scleral buckling, which gently increases the space in the eye wall to relieve tension on the retina.
During the recovery period, patients may need to lie face-down for several hours daily for 1 to 2 weeks to keep the retina in place.
IN CONCLUSION
Dr Peh points out that early detection and treatment make all the difference between going for a painless procedure and undergoing surgery.
Hence, it is recommended to see an eye specialist as soon as one experiences any unusual change in their vision.
| This article is part of our series on eyesight and eye health. |
