19 Jul Retinal Detachments Can Blind
The natural history of a retinal detachment is blindness. “Natural history” of a disease is the same as the usual outcome. So, the usual outcome of a retinal detachment is complete blindness if eye surgery is not performed.
Retinal Detachments Only Become Larger
Retinal tears and holes cause a retinal detachment. A small amount of fluid goes through the tear and gets underneath the retina causing the detachment. With time the amount of fluid increases underneath the retina, and so, too, the size of the retinal detachment enlarges.
Always Lose Side Vision First
Because all tears and holes occur in the peripheral retina (the portion of the retina giving us peripheral, or side, vision), you always lose your side, or peripheral vision, first. As the detachment grows, the macula becomes detached and central vision will eventually be lost. The initial goal of retinal detachment surgery is to fix the detachment before the central eyesight is affected. By doing so, you minimize the risk of permanent loss of your central.
We usually try to operate within days.
When the macula (central portion of the retina responsible for reading, etc.) detaches, there can be permanent loss of eyesight despite successful surgery.
Rods and Cones
The retina is a laminated tissue. It has several layers. The rods and cones are underneath the top layer. Loss of vision from a detachment is due to the physical separation of the rods and cones (aka photoreceptors) from the layer beneath them.
Retinal Detachment Surgery Prevents Blindness
There are several ways to fix a retinal detachment. These are outlined in the overview of retinal detachments. The goal of any retinal detachment surgery is to prevent blindness by reattaching the retina and, if possible, fix the eye before central vision is affected.
Longstanding Retinal Detachments
Chronic, or longstanding, retinal detachments are those unfortunate eyes that were never diagnosed or operated upon. In general, eye surgery doesn’t always work to restore sight in these cases. Permanent damage to the rods and cones occurs with time, and, despite success in reattaching the retina, vision does not return.
By chronic, I’d say conditions lasting months to years.
Losing the Eye Can Happen
In extreme cases of retinal detachments that never get repaired, the eye can start to die and shrink. This condition, phthisis bulbi, occurs when the retina has not been attached for years (generally). While it doesn’t always occur, it can be extremely disfiguring and can be a psychological nightmare.
What Does This Mean? Because the outcome of a retinal detachment is so grim, surgery is almost always recommended. If the natural history is blindness, that is, the chance of going blind is 100%. Though there are risks of eye surgery (blindness), the chances are small. Thus, there really isn’t much to lose by operating.
AndrewPosted at 08:45h, 22 July
I have been trying to get a clear answer regarding AMD as I now have been seeing grey spot ONLY at night when I go to bed when it is dark. During the day I am ok…How far along am I with AMD?. I was told I have a tremendous amount of Drusens around the retina but not specifically the Macular area. I am only 44 yrs old an is very concern about my future ability to work, etc…
KarmaPosted at 04:37h, 01 December
my son lost left eye sight. i took the hospital and doctor told me there is some mass like substances, he is only 2 and 9 months old. I request your good self to give me some advice on this. I doubt it is retina attached or something like that. Is there any possible to gain the sight again. i am worried a lot
Randall V. Wong, M.D.Posted at 06:41h, 07 December
There are so many possibilities that I can’t really comment constructively without examining your child.
April AndersonPosted at 16:20h, 07 January
I am the typical patient that has waited too long to see a physician regarding my symptoms. I have had floaters that have slowly gotten larger over a few years time. One time a few years ago I remember right after getting out of a tanning bed, I noticed that everything went grey or blacked out for a minute. Very scary to say the least, but my vision was fine again within a few seconds. Now, very slowly, what I thought were floaters have now been getting much larger. If I look into the light sky or even a computer screen, I can see some of these floaters in my field of vision. At dark it does not seem to bother me much. However, today I walked outside to and the sunlight hit my eye just right and I saw nothing but squiggly lines in my entire line of vision in this one eye. When I turned away, the problem went away, but if I turn back and the sun hit it just right, the lines returned. I started doing some research on the fact and realize that I may indeed have a detached retina in one or both eyes. Is this what this appears to be to you? How long can you go with symptoms like this before you may lose sight in one or more eyes? When I first noticed some of these symptoms, it has been several years, and just seemed to progressively gotten worse. I really did not realize just how bad it may actually be until I went outside today and saw the squiggly lines. Just some thoughts on this situation would be much appreciated. I am very scared about it ! Our local hospital is a joke and I would never go there to have a procedure done. Is this type of thing done in the office, or is a hospital visit needed.
Thanks for all of your help- any thoughts or ideas are much appreciated.
Randall V. Wong, M.D.Posted at 03:46h, 08 January
Obviously, I can’t tell if you’ve new or old floaters, but it sounds as though you’ve got new symptoms. Regardless, please get checked out. You don’t want to have a retinal detachment and not now about it!
buddyPosted at 17:13h, 24 January
Dr i have a retinile detachment and i can not afford a surgery what will happen to my eye
Randall V. Wong, M.D.Posted at 04:22h, 02 February
Retinal detachments can lead to complete blindness. The longer the retina is detached, the worse the prognosis.
Best of luck.
nauman javedPosted at 01:18h, 30 January
my elder brother lost eye sight of both eyes due to retinal detachment in 1999. After getting both eyes operated, he regained eyesight of one eye while the other is dis-functional. The functioning of the left eye was further reduced when it was revealed that he suffers glucoma and that glucoma has affected his vision adversely.. now he can barely undertake his routine activities due to reduced vision. he says he is able to see through sides of his eye and not through centre.. Can his eyesight be regained at least for one eye??
Randall V. Wong, M.D.Posted at 05:12h, 02 February
I am going to err on the conservative…both glaucoma and retinal detachment can lead to permanent loss of vision.
I can’t really be specific because I have not examined your brother.
AmiPosted at 18:21h, 24 March
Dear Dr Randy,
My boyfriend had a retinal detachment in his right eye last August 2011. Unfortunately, after a vitrectomy and even a scleral buckle, he never regained his vision. He is extremely near sighted in both eye. He has glaucoma and the detachment was due to lattice degeneration. If I’m not mistaken his grade is 1400 in his left eye.
I have read about extreme High probability of a detachment to the fellow eye within 2-5 years. If this happens, he will be completely blind.
I would like to know if there’s anything that we can do right now to prevent this from happening. Do you have any suggestions for us? Can laser be performed to the good eye as a preventive measure?
Also, is there any truth that eye transplant can be done in cases of retinal detachment? (Ex. Bionic eye )
Thank you very much.
Randall V. Wong, M.D.Posted at 09:07h, 01 April
In my estimation, he has 10% chance of detaching in his good eye. No reason to think he’ll go blind. First eye probably detached too long and perhaps a complicated situation.
Nothing on bionic eyes. There is a retinal implant which is still experimental…but it may, at best, allow a completely blind person navigate a sidewalk.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Zita StephensPosted at 16:47h, 25 April
Hi Dr, Wong…
PLEASE TAKE THE TIME TO READ THIS ANS RESPOND>.>>>>>>>
My husband James had retinal detachments in both eyes in 1994(cause unknown alttho he had bad nearsightedness ). He has since had about 10 surgeries. Dr. William Mieler performed his earlier surgeries. He had the gas treatment done initially(sorry if I don’t know the correct terminology) and the retina would re detach so they did the silicone oil treatment on both eyes which actually allowed the retina to stay flat. The left eye had so many tears that the Dr. didn’t feel comfortable going back in. the right eye was the healthier eye.
Over the years the silicone oil caused calcium deposits on the cornea…in 2003 and 2004 he had corneal scrapings…which calcium deposits only returned. In 2005 his Dr., Dr. Rubenstein…at Rush Medical Center in Chicago, performed a corneal transplant using a human donor cornea. We were so excited because his vision returned..he could tell what time it was on the microwave and could see using his magnifier. 6 months later..he started to “reject” the donor cornea…and his symptoms returned,( cloudy murky white vision). The Dr. then informed him of a prosthetic corneal transplant. Said the chances for rejection were lower. He got the prosthetic corneal surgery and he never saw again. Vascularized tissue began to form on the back of the eye so now he is completely blind in the right eye with the left of course, having not been touched in years from the multiple tears has no sight either.
I believe that if he can get the prosthetic cornea taken off, maybe he will be able to get some form of vision again, light perception,etc. The doctor can’t even see what condition the retina is in because of the vascularized tissue. I have read info on the bionic eye but it doesn’t seem like it’s currently for patients with retinal detachments, in fact I’ve heard one of the negative effects is retinal detachments. We are looking for some glimmer of hope. Would you recommend removing the prosthetic cornea so that we can see the condition of the retina? and maybe if another human donor transplant may work? My husband has been living with this since his teenage years and he now has been really talking about options which he really never has…I guess previously he’s resigned himself to the fact that” it is what it is”. He now has expressed wanting a different set of eyes to look at him. The Dr. who performed the last surgery to remove the vascularized tissue basically just told him that he should just live with his condition. If that is the case, it would have been nice to hear why. Your input and professional thoughts are greatly appreciated. Should we continue to try options…or could there be hope for the left eye? Thanks in advance Dr. Wong.
Randall V. Wong, M.D.Posted at 15:51h, 11 May
I think the best idea is to have a second opinion as you suggested. I’d first seek the opinion of a corneal specialist as she’d be the first to consider if a second graft could be possible.
She’d also be the person to determine if there is any visual hope at all.
All the best.
Randall V. Wong, M.D.
aliPosted at 04:09h, 05 May
my relative got complete blind cos of retinal detachment when he was 1. now he is 2 yrs old. was wondering can it be repaired?
Randall V. Wong, M.D.Posted at 18:20h, 12 May
I am wondering if your relative has a retinal detachment from retinopathy of prematurity.
Randall V. Wong, M.D.
MarissaPosted at 15:00h, 09 May
Hi Dr.Wong, I just have an eye exam for my new floaters. My ophthalmologist said that I don’t have any retinal tear. It really bothers me. Do you have any suggestions or any treatment for floaters?
Randall V. Wong, M.D.Posted at 08:36h, 10 May
If the floaters are really bothering you, you might consider vitrectomy. There are not magic pills or drops.
I have a separate website for the treatment of floaters.
Let me know if you have questions.
samdupPosted at 02:11h, 05 June
Dear Dr Wong,its been really wonderful to see all the suggestions u have given to retina detachment patients.I too had a same problems on both of my eyes but luckily i got early operation in Aiims new delhi since two years back ,now i can see with my right with the help of glass but my left eye is still cloudy , i am really worried about it,so i would like to request u to suggest me .Will my left eye regained vision bacl,why it became cloudy after surgery? Why my both eyes r burnimg,
Is there any spl ointment to control burning? what r the foods i have to avoid eating? Is there any chance of redatachment?Your answers and suggestions are highly appreciated. THanks
Randall V. Wong, M.D.Posted at 23:29h, 09 June
There are drops and ointments that may help, but you’ve got to ask your own doctor because I am unable to examine you from way over here.
Nicholas VerheydenPosted at 06:11h, 13 September
How long is a long standing detachment able to be fixed, with or without vision?
My friend adopted a boy with ROP (they’re infertile and believe children with disabilities should be adopted) who’d had surgery on his left eye and regained some vision but his right eye had a retinal Tear so the doctor, didn’t operate. a few months ago (now age 6) he got a cataract in his left eye and during evaluation the doctor said the retina in the right eye was detached and scarred but didn’t look completely dead yet and operated to prevent Phthisis. the surgery worked and he actually regained Light Perception in that eye.
LP after 6 years, that seemed astounding but is there a limit where the Retina can’t even stick back on at all?
Randall Wong, M.D.Posted at 11:17h, 23 September
Hard question because I don’t know when it’s really too late to attempt operating on a detached retina. ROP detachments are more difficult than adult retinas.
All the best,
Clarissa MoorePosted at 03:29h, 16 November
Hello! My name is Clarissa Moore. Last year my daughter had retinal detachment surgery. Everything went well. Her doctor said that it’s hereditary. I have been in and out of the optometry office when I was a child. Not ever finding out why I lost the sight in my right eye. To make a long story short out of years of going to the doctor she asked me did I have my eye scraped for retinal detachment surgery. I told her no I did not know I had a retinal detachment. I have been blind in my right eye for years. Would surgery be to late for me? I sometimes have sharp pains in my right eye. Thank you, Clarissa Moore
Randall Wong, M.D.Posted at 19:23h, 20 August
Sorry for the untimely reply. Somehow I lost your question.
Prognosis for your right eye seems poor as most cases of long standing decreased vision not due to cataract.