What it is
The retina is the thin, light-sensitive layer lining the back of the eye. A detachment is when it lifts away from the wall of the eye — a little like wallpaper peeling off. The lifted part stops sending pictures to the brain, so vision is lost in that area. It is an emergency: the sooner it is repaired, the better the chance of saving sight.
Warning signs — be seen the same day
- A sudden shower of new floaters
- Flashes of light, like lightning at the edge of vision
- A dark curtain or shadow spreading across your sight
- A sudden drop in vision
Who is more at risk
- A high minus number (short-sight / myopia)
- A previous eye injury or eye surgery
- A detachment in the other eye or in the family
- Weak spots in the retina, such as lattice degeneration
How it is diagnosed
A careful dilated examination of the retina, supported where needed by an ultrasound or OCT scan to map exactly where and how far the retina has lifted.
How it is treated
Almost always with surgery — sealing the tear (with laser or freezing) and settling the retina back into place using techniques such as vitrectomy or a scleral buckle, sometimes with a gas bubble. The right method depends on your particular eye.
What it is
Long-standing high blood sugar quietly damages the tiny blood vessels of the retina, making them leak or close off. In the early stages there are often no symptoms at all — which is exactly why regular screening matters, before vision is affected.
The main stages
- Non-proliferative (early) — leaking vessels, small haemorrhages and swelling
- Proliferative (advanced) — new, fragile vessels grow and can bleed inside the eye
- Diabetic macular oedema — swelling at the centre of vision, the commonest cause of blurring
Risk factors
- How long you have had diabetes
- Poorly controlled blood sugar
- High blood pressure and cholesterol
- Kidney disease, and pregnancy
How it is diagnosed
A dilated retinal examination, an OCT scan to measure swelling, and where needed an angiography to map leaking and closed vessels.
Management
The foundation is good control of sugar, blood pressure and cholesterol. Depending on the stage, treatment may add laser, intravitreal injections, or surgery. Importantly, not every finding needs treatment — some are simply monitored closely.
What it is
The macula is the small central part of the retina that gives sharp, straight-ahead vision — for reading, faces and fine detail. In age-related macular degeneration (AMD) the macula wears out over time, blurring or distorting the centre of vision while the surrounding (side) vision is usually preserved.
The two types
- Dry AMD — commoner and gradual; thinning of the macula with tiny deposits called drusen
- Wet AMD — less common but faster; abnormal leaky vessels grow and bleed, causing sudden distortion. This type is treatable with injections
Risk factors
- Age over 50
- Smoking — the single biggest changeable risk
- Family history
- High blood pressure and a diet low in leafy greens
How it is diagnosed
A simple Amsler grid check at home (straight lines start to look wavy), together with OCT and OCT-angiography scans that can detect fluid or new vessels very early — often before you notice a change.
Management
For wet AMD, anti-VEGF injections dry the leak and preserve vision. For dry AMD, the emphasis is monitoring, not smoking, and certain vitamin formulations that may slow progression. Any new wavy lines or a fresh blur in the centre should be checked promptly.
What it is
A small gap that opens at the very centre of the macula, usually because the jelly inside the eye (the vitreous) tugs on it with age. It causes a blurred or missing spot in the centre and bent, distorted lines — while side vision stays normal.
Symptoms
- A grey or blind spot in the middle of vision
- Straight lines that appear bent or wavy
- Difficulty reading fine print
Who is more at risk
- Age — most common in the 60s and 70s
- Slightly more common in women
- High short-sight, or a previous eye injury
How it is diagnosed
An OCT scan shows the hole clearly and measures its size — which helps decide the best treatment and the likely outcome.
Management
Most macular holes are repaired with keyhole surgery (vitrectomy) and a gas bubble that gently holds the hole closed while it heals; you may need to keep your head in a certain position for a few days. In general, the earlier a hole is closed, the better the visual recovery.
What it is
A medicine delivered as a tiny injection into the jelly of the eye, placing the drug exactly where it is needed at the retina. The commonest are anti-VEGF drugs, which switch off abnormal leakage and swelling.
When it is needed
- Wet macular degeneration
- Diabetic macular oedema
- Blocked retinal veins (vein occlusion)
- Other causes of macular swelling or leakage
What to expect
The eye is numbed and thoroughly cleaned. The injection itself takes only seconds and is usually painless. It is an outpatient procedure — you go home the same day. Often a short course is needed, with the retina rechecked on OCT each visit to guide the next step.
Afterwards & safety
Mild grittiness or a small red patch on the white of the eye can occur and settles on its own. Serious problems are rare. Contact us urgently if the eye becomes very painful or red, or if vision drops. Injections are advised only when the scan shows they will genuinely help.
What it is
A focused beam of light used to seal, spot-weld or calm parts of the retina. It is a precise, in-clinic treatment — no cut and no stitch.
When it is needed
- To seal a retinal tear or weak area, preventing a detachment
- To treat leaking or abnormal vessels in diabetes and vein occlusions
- For certain peripheral retinal problems
What to expect
The eye is numbed with drops and you sit at a machine similar to the one used for examination. You may see bright flashes and feel small pin-pricks. It usually takes just a few minutes.
Afterwards
Vision may be blurred for a short while and the eye a little light-sensitive; most people return to normal activities quickly. Laser is generally about protecting the vision you have rather than sharpening it — its value is in preventing further loss.
What it is
Keyhole surgery performed inside the eye. Through three tiny openings, the jelly (vitreous) is removed and the retina is worked on directly — to peel membranes, close holes, repair detachments or clear blood.
When it is needed
- Retinal detachment
- Macular hole, or macular pucker (a fine membrane)
- Advanced diabetic retinopathy with bleeding or traction
- A vitreous haemorrhage that will not clear, and some injuries or infections
What to expect
Usually carried out under local anaesthesia as a day-care procedure. A gas bubble or, occasionally, silicone oil may be placed to support the retina; if a gas bubble is used you may need to hold a particular head position for a few days and must avoid air travel until it clears.
Recovery
Vision is blurred at first and improves gradually over weeks as the eye settles. You will use drops and attend review visits. The exact recovery depends on the reason the surgery was needed.
