Causes of retinal detachment

Photo of a patient having his eyes examined

Retinal detachment is usually caused by tears or holes in the , often resulting from eye surgery or age-related changes in the eye. Nearsightedness can also be a cause.

Retinal detachment is a rare eye disease. The is made up of lots of and forms the inner lining of the eye. It lies loosely on top of another layer that supplies the with nutrients.

Image: Healthy eye

The detaches from the layer below if fluid gets through a tear and under the . The typical signs of retinal detachment are flashes of light, shady areas or dark patches in your vision. Permanent vision loss can often be avoided if it is spotted early and operated on.

What causes tears and holes in the retina?

The eye is filled by the vitreous body. It is made of a gel-like fluid. Its structure changes as we get older: It shrinks and gets runnier. It can then gradually detach from the , something experts call posterior vitreous detachment. That’s normal and generally harmless.

But the shrinking vitreous body is sometimes still connected to the in some spots. It then pulls on it, which can cause the to tear.

Other risk factors for retinal tears or holes are:

  • Eye surgery, like for cataracts or near or farsightedness
  • Severe nearsightedness. The eyeball is then too long, meaning the is under tension and tears more quickly.
  • Eye injuries, perhaps due to an accident or a blow to the eye

How exactly does a tear or hole cause retinal detachment?

Not all tears and holes in the cause retinal detachment. That only happens when the vitreous body detaches from the , becomes runnier, and then gets under the through a tear. That usually happens over several days or weeks. The is then separated from the layer below, meaning it no longer gets enough nutrients and is damaged. Signs of that can be seeing dark patches or bright flashes of light in the affected eye.

Illustration: Eye with detached retina caused by a tear

What other causes of retinal detachment are there?

What is known as retinal traction detachment is much less common. Scars can form on the as a result of diseases or inflammations of the eye. For instance, diabetes can cause blood vessel damage which reduces circulation in the . To balance that out, the body creates new, but less stable vessels which can scar or cause bleeding (diabetic retinopathy). The scars shrink over time, causing them to pull on the , which can make it detach.

In exudative retinal detachment, which is also rare, fluid collects beneath the without it being torn. That can cause it to detach. Possible causes include:

  • Fluid from tumors or inflammations in the eye
  • Blood leaking from damaged blood vessels, perhaps due to certain vascular eye diseases like diabetic retinopathy
  • Eye diseases such as age-related macular degeneration (AMD)

Sometimes, several combined causes can lead to detached .

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IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

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Created on November 12, 2024

Next planned update: 2027

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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