Retinal Detachment and Retinal Tear Treatment in Jacksonville, Florida
A retinal detachment is the retina peeling away from the wall of the eye. It is painless, it does not get better on its own, and the vision it takes is often not recoverable once the central retina has been off for more than a few days. It is one of the few true emergencies in eye care.
Symptoms — what to watch for
- A sudden shower of new floaters — dots, cobwebs, or what patients often describe as soot or pepper
- Flashes of light, usually in the periphery, often more obvious in a dark room
- A shadow, curtain, or dark veil moving in from the side, above, or below
- A sudden drop in vision in one eye
There is no pain. That is the trap — nothing hurts, so people wait.
The shadow tells you where the detachment is, mirrored: a curtain coming up from below usually means the retina has detached at the top of the eye.
Retinal tears come first
Most detachments begin as a small tear. As the vitreous gel separates from the retina with age — a posterior vitreous detachment — it can pull hard enough in one spot to tear the retina. Fluid then passes through the tear and lifts the retina off the wall behind it.
A tear caught before fluid gets underneath can usually be sealed in the office the same day with laser. That is a fifteen-minute procedure. A detachment is an operating-room repair with weeks of recovery. The difference between those two outcomes is often a matter of days, and it is the single strongest argument for being seen quickly when the symptoms start.
More about flashes and floaters.
Same-day laser for a tear
We perform laser retinopexy in the office on the same visit. The eye is dilated and numbed with drops, and laser is applied in a ring around the tear. The laser creates a scar that welds the retina to the wall over the following one to two weeks, so the tear can no longer let fluid through. Most patients describe it as bright and briefly uncomfortable rather than painful.
Cryotherapy — freezing rather than laser — is used for tears too far forward for the laser to reach.
Who is at higher risk
- Nearsightedness, particularly high myopia — the eye is longer and the retina thinner
- Previous cataract surgery
- A detachment in the other eye, or a family history of one
- Lattice degeneration — a thinning pattern in the peripheral retina
- Eye injury, including injuries years earlier
- Advanced diabetic retinopathy, which causes a different kind of detachment — see diabetic retinopathy
Retinal detachment affects roughly 1 in 10,000 people a year. Being in a higher-risk group is a reason to know the symptoms, not a reason to expect it.
Why the timing matters, and how much
The key question is whether the macula — the small central part of the retina you read and recognise faces with — is still attached.
If the macula is still on, central vision is usually still good, and the aim is to repair before it comes off. Repair within about 24 hours gives better final vision than waiting.
If the macula is already off, central vision has already dropped. The older teaching was that this could safely wait a week. Recent evidence has narrowed that considerably: in a prospective series of 719 macula-off eyes, repair within two days gave significantly better vision at six months than three days or more, and repair within three days was better than four or more. After about day four, further delay made little additional difference.
So days matter, and the first two or three of them matter most. That evidence comes from observational cohorts rather than randomised trials, because no one has randomised patients to a delay.
How a detachment is repaired
Dr. Elkeeb uses all three approaches, and combinations of them, chosen by where the tear is, how much retina is detached, whether the eye still has its natural lens, and how reliably you can position afterwards.
Pneumatic retinopexy
An office procedure. A gas bubble is injected into the eye and the tear is sealed with laser or freezing treatment; you then position your head so the bubble presses the tear closed while the seal forms. It avoids an operation and avoids the cataract that usually follows vitrectomy — but it works only for certain tear locations, and it demands strict positioning.
It is worth being straight about the success rate. The PIVOT randomised trial reported about 81 percent single-procedure success, but that trial had narrow entry criteria, and a 2025 reappraisal of real-world data put single-procedure success closer to 65 to 70 percent. Failure is not a disaster — it means proceeding to surgery — but you should go in knowing the number.
Scleral buckle
A silicone band is placed around the outside of the eye to indent the wall inward and relieve the traction pulling on the tear. The buckle stays permanently. It is particularly useful in younger patients and in eyes that still have their natural lens, because it does not accelerate cataract the way vitrectomy does.
Vitrectomy
The vitreous gel is removed through small incisions, the retina is flattened, the tear is sealed, and the eye is filled with a gas bubble or silicone oil to hold the retina in place while it heals. This is the most commonly used repair and generally has the highest single-operation success rate.
Combined buckle and vitrectomy
Used for complex detachments — multiple tears, tears far forward, or eyes with scar tissue on the retina.
What the results actually look like
The retina is reattached with a single operation in roughly 85 to 90 percent of cases. With further surgery when needed, final reattachment is achieved in something like 95 to 99 percent.
Reattaching the retina and restoring the vision are different things. If the macula was still attached, most patients keep excellent central vision. If the macula was off, vision improves but often does not return to what it was — and the longer it was off, the more that is true. Some distortion frequently remains.
Recovery
- Positioning. If a gas bubble is used, you will be asked to hold a specific head position for a set number of days so the bubble sits against the repair. This is not optional and it is the hardest part of the recovery for most people.
- The bubble. Vision through a gas bubble is very poor — a dark, wobbling line that descends as the bubble absorbs over two to eight weeks depending on the gas used.
- No flying, and no travel to high altitude, while gas is in the eye. Altitude expands the bubble and can raise the pressure in the eye to a dangerous level.
- Cataract. After vitrectomy, cataract progression in an eye that still has its natural lens is the rule rather than the exception, particularly over the age of 50.
- The other eye. Having had a detachment in one eye raises the risk in the other, so the fellow eye is examined and then watched.
What to do if you have these symptoms right now
Call our office. An emergency room cannot repair a retinal detachment, and most emergency rooms do not have a retina specialist available. Calling us gets you to the person who can actually treat it.
Call (904) 666-5050 during business hours and tell our staff you have new flashes, new floaters, or a shadow in your vision. We prioritise these and see urgent cases within 24 hours.
Questions patients ask
Is a retinal detachment painful?
No. That is exactly why it gets ignored. Painlessness is not reassurance here.
Can a detached retina heal on its own?
No. A detachment does not reattach without surgery, and the retina deteriorates the longer it stays off.
Will I get a detachment in my other eye?
The risk is higher than average but most people do not. We examine the fellow eye at your first visit and continue to check it. If you have new symptoms in the other eye at any point, that is a same-day call.
How long until I can drive or go back to work?
It depends on the repair and on whether a gas bubble was used. With gas, useful vision does not return until the bubble has largely absorbed, which can be two to eight weeks. We will give you a realistic timeline for your specific eye rather than a general one.
Why can't this wait until my regular eye doctor can see me?
Because a tear can be sealed in the office today, and a detachment cannot. The window in which that choice exists is measured in days.
Getting seen
We accept urgent referrals and see urgent cases within 24 hours. Call (904) 666-5050. Our office is open 8:00 am to 5:00 pm, Monday to Friday, at 3627 University Blvd S, Suite 605, Jacksonville, FL 32216. Our staff speak English, Arabic, and French.
Dr. Elkeeb operates at HCA Florida Memorial Hospital and Baptist Medical Center Jacksonville.
Referring physicians and optometrists: our referral information is here.
Sources: American Academy of Ophthalmology, Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern; Hillier RJ et al., PIVOT trial, Ophthalmology 2019; reappraisal of pneumatic retinopexy outcomes, Eye 2025; timing of macula-off repair, Ophthalmology Retina 2023; UK primary retinal detachment outcomes cohort, Eye 2023; global incidence meta-analysis, Wien Med Wochenschr 2025.
This page is general information about a medical condition and is not a substitute for examination and advice from your own physician. Do not start, stop, or change any medication based on what you read here.