Protecting Your Vision from Retinal Tears and Detachments
Retinal Detachment and Floaters Treatment in Singapore
Retinal detachment is a serious, sight-threatening emergency. Without prompt intervention, it can lead to permanent and irreversible vision loss. Dr Bobby Cheng provide comprehensive evaluation and treatment for retinal detachment and floaters in Singapore, combining advanced diagnostic imaging with timely, personalised care to protect your sight.
Medically reviewed by Dr Bobby Cheng
Senior Consultant Ophthalmologist
MBBS (Singapore) | MMed (Ophthalmology, Gold Medal) | FRCS (Edinburgh) | FAMS
What Are Floaters and Retinal Detachment?
Floaters are small, shadow-like shapes such as dots, threads, or cobwebs that drift across your field of vision particularly against bright backgrounds. They develop as the vitreous gel inside the eye naturally liquefies and shrinks as part of the natural ageing process, creating tiny clumps that cast shadows on the retina.
In most cases, floaters are a harmless and common occurrence. However, as the vitreous contracts, it can exert traction on the retina and in some cases, this pulling force is strong enough to cause a retinal tear. If left undetected, fluid can seep through the tear and accumulate beneath the retina, causing it to lift away from the back of the eye. This is known as a retinal detachment – a serious, sight-threatening emergency that requires immediate treatment to prevent permanent and irreversible vision loss.
Symptoms to Watch For
While occasional floaters are rarely a cause for concern, certain symptoms should never be ignored. Seek urgent eye assessment if you experience any of the following:
A sudden increase in floaters
Particularly if new floaters appear abruptly or in greater number than before
Flashes of light
Often described as lightning streaks, flickering, or camera flashes, typically more noticeable in dim lighting
A curtain, shadow, or dark patch over part of your vision
A partial or spreading obstruction across your visual field, which may indicate the retina is beginning to detach
Sudden loss or blurring of vision
Any unexplained, rapid change in visual clarity warrants immediate attention
How Retinal Detachment Is Diagnosed
When symptoms such as sudden floaters, flashes of light, or a shadow across your vision are reported, a thorough and urgent retinal assessment is carried out. Early and accurate diagnosis is critical — the sooner a retinal tear or detachment is identified, the greater the likelihood of preserving full vision.
Diagnosis of retinal detachment typically involves:
Dilating eye drops are administered to widen the pupils, enabling your specialist to directly visualise the peripheral retina and vitreous in full detail. This examination is essential for identifying retinal tears, holes, or areas where the retina has begun to lift.
A non-invasive, high-resolution imaging technique that produces precise cross-sectional images of the retina. OCT is particularly valuable in detecting subtle retinal changes, assessing the extent of fluid beneath the retina, and monitoring treatment response over time.
High-resolution photographs of the retina provide a comprehensive visual record of any tears, holes, or detachment. These images are used to guide treatment planning and serve as a baseline for future comparison during follow-up visits.
Retinal tears and detachments require urgent care to prevent permanent vision loss.
If you notice sudden floaters, flashes, or vision loss, seek medical attention without delay. Early treatment provides the best chance of preserving vision.
Treatment Options for Retinal Tears and Detachment
Retinal Tears
When a retinal tear is identified early — before detachment has occurred — it can often be treated effectively in day surgery setting with a short, minimally invasive procedure.
Laser photocoagulation is the most commonly used treatment for retinal tears. A precisely focused laser beam is directed around the tear, creating a series of small controlled burns that stimulate the formation of scar tissue. This scar tissue acts as a natural seal, securing the edges of the tear and preventing fluid from tracking underneath the retina. The procedure is performed under anaesthetic eye drops, is generally well tolerated, and requires minimal recovery time.
Cryotherapy offers an effective alternative or complement to laser treatment, particularly for tears located in the peripheral retina that are more difficult to access with a laser. A specialised freezing probe is applied to the external surface of the eye over the affected area. The extreme cold induces a controlled inflammatory response that generates scar tissue, firmly bonding the retina back to the underlying eye wall and preventing fluid entry.
Both procedures are highly effective in preventing the progression from retinal tear to retinal detachment — provided treatment is carried out promptly.
Retinal Detachment
When the retina has already detached, surgery is necessary to reattach it and restore vision. The most appropriate procedure depends on the size, location, and complexity of the detachment.
A gas bubble is injected into the vitreous cavity of the eye. The bubble rises and gently presses against the detached retina, pushing it back into its correct position against the eye wall. Laser or cryotherapy is then applied to seal the underlying tear. Patients are typically required to maintain a specific head position for several days following the procedure to keep the bubble in contact with the tear site. Pneumatic retinopexy is best suited to small, uncomplicated detachments in the upper portion of the retina.
A soft silicone band is sutured around the outer surface of the eye, gently indenting the eye wall inward. This reduces the traction forces pulling on the retina and brings the eye wall closer to the detached retina, facilitating reattachment. The buckle remains in place permanently but is not visible externally. This technique is commonly used for more widespread or complex detachments, particularly in younger patients.
Vitrectomy is the most widely performed surgery for retinal detachment today. The vitreous gel is carefully removed from inside the eye and replaced with either a gas bubble or silicone oil to support the retina during healing. Laser or cryotherapy is then used to seal the retinal tear. The gas bubble dissolves naturally over several weeks, while silicone oil — used in more complex cases — may need to be removed in a separate procedure at a later stage. Vitrectomy provides excellent intraoperative visualisation, making it particularly well suited to advanced or complicated detachments.
After Surgery: What to Expect
Recovery following retinal detachment surgery varies depending on the procedure performed and the complexity of the detachment. It is important to have realistic expectations and follow your specialist’s post-operative instructions closely.
Vision may take several weeks to months to stabilise after surgery. The extent of visual recovery depends on factors such as whether the macula was involved in the detachment and how long the retina was detached prior to treatment.
Vitrectomy and gas bubble procedures can accelerate the development of cataracts in some patients. If this occurs, cataract surgery may be recommended at a later stage once the retina has fully healed.
If a gas bubble has been used, strict head positioning — such as face-down or side-lying — may be required for several days following surgery to ensure the bubble remains in contact with the treated area of retina.
Patients with a gas bubble in the eye must avoid air travel and travel to high-altitude destinations until the bubble has completely dissolved. Changes in cabin pressure can cause the gas to expand, raising intraocular pressure to dangerous levels.
Recovery and Follow-Up
Visual recovery after retinal detachment surgery is a gradual process, and outcomes vary from patient to patient. The degree of recovery depends largely on how much of the retina was affected and how long it remained detached before treatment was received.
Many patients regain useful, functional vision following surgery — however, it is important to understand that complete restoration of pre-detachment visual clarity may not always be achievable, particularly if the macula was involved.
Regular follow-up with Dr Bobby Cheng is an essential part of post-operative care. Scheduled reviews allow him to monitor the healing retina, identify and manage any complications early, and take steps to reduce the risk of recurrence in the treated or fellow eye.
Frequently Asked Questions About Retinal Detachment and Floaters
Not always. The majority of floaters are a normal, age-related result of changes to the vitreous gel and are entirely harmless. However, a sudden increase in floaters — especially when accompanied by flashes of light or a shadow across your vision — may indicate a retinal tear and should be assessed by an eye specialist promptly.
Yes, if left untreated. A retinal detachment is a sight-threatening emergency, and without timely surgical intervention, it can result in permanent vision loss. The sooner treatment is received, the greater the chance of preserving useful vision.
No. All procedures are carried out under monitored sedation or general anaesthesia, ensuring patient comfort throughout. Patients may experience a sensation of mild pressure during the procedure, but pain is not expected. Any post-operative discomfort is generally well managed with prescribed medication.
Recovery timelines vary depending on the type of surgery performed and the complexity of the detachment. Vision may take several weeks to months to stabilise. Dr Bobby Cheng will provide detailed post-operative instructions, including any head positioning requirements if a gas bubble has been used.