Retinal Detachments

Retinal Holes, Retinal Tears

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Duke retinal specialists diagnose and correct retinal holes and tears as early as possible, before the small breaks lead to retinal detachment, which may require immediate surgery. Our retinal specialists are on call to respond immediately to emergencies, and our dedicated eye operating rooms are always available to treat retinal detachments. We also have the advanced training, skill, and expertise to treat complex problems such as abnormal scar tissue known as proliferative vitreoretinopathy (PVR) that can sometimes arise following retinal detachment. Our goal is to accurately and quickly diagnose your retinal condition to maximize your visual outcome.

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Seeking Care for Retinal Detachments

New floaters and flashes may be a sign of a retinal tear or detachment, especially if they suddenly increase in frequency or are accompanied by a dark curtain or any loss of vision. If you experience these symptoms or are at risk for retinal detachment due to nearsightedness, family history, genetic predisposition, a previous history of retinal detachment, a history of any eye surgery, or a serious eye injury, you need to be seen by an eye specialist immediately. Our subspecialty trained retinal doctors can quickly determine the severity of your condition and recommend the most appropriate treatment.

Our retinal specialists are also experts in treating other common conditions, such as vitreomacular traction, which occurs when the vitreous gel in your eye pulls on your retina, leading to a macular traction or hole. The resulting retinal swelling or break and decreased vision require advanced care from our subspecialists, who have additional training in retinal diseases.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Treatments for Retinal Detachments


A high-intensity beam of light energy is focused on the retina to weld together a retinal tear. This is a common treatment for small retinal tears.


A freezing probe seals the retinal tear then secures the retina to the eye wall. This outpatient procedure is performed on the outside of the eye and can prevent a retinal hole or tear from progressing to a retinal detachment. This is performed when your doctor does not have a clear enough view of the retina to perform a laser treatment.

Pneumatic Retinopexy

During this office-based procedure, a gas bubble is injected into your eye. Your head and body are positioned so that the bubble pushes the retina back into position against the wall of the eye. The procedure is often followed by laser treatment or cryotherapy, which seals off the retinal break. Maintaining the appropriate position in the days following the procedure secures the retina in its place and is important to the success of the procedure. Most small retinal detachments can be managed with these procedures.

Scleral Buckle

A flexible silicone band is sewn around the eye in the operating room to secure the retina in place. Retinal laser treatment or cryotherapy is often performed as well to close the hole causing retinal detachment. The scleral buckle procedure may also be performed in combination with vitrectomy surgery.


The vitreous gel -- the clear, jelly-like substance that fills the center of your eye behind the lens -- is surgically removed through tiny incisions. This may be performed in combination with other retinal detachment procedures, as it gives your eye surgeon better access to the back of your eye. The vitreous gel will be replaced with fluid, gas, or an oil bubble according to your eye’s specific needs.

Gas or Silicone Oil Tamponade

Vitrectomy surgery for repairing a retinal detachment often requires injection of gas or a liquid polymer known as silicone oil. These substances help keep the repaired retina in place and reduce risk of retinal detachment happening again. After gas injection, you will likely be required to remain face down for a few weeks after the surgery. There are also restrictions on air travel. Silicone oil may be removed six to 12 months after surgery. This procedure may be combined with cataract extraction and lens placement surgery.

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A lighted instrument with a special lens provides your doctor with a 3D view of the inside or your eye. Careful ophthalmoscopy is the most important way to detect retinal tears, holes, and detachments. Your pupils will be dilated before ophthalmoscopy to allow for an adequate view of your retina.


Special ultra-wide-field photographs of the back part of the eye can help your doctor see retinal tears or detachments.

Optical Coherence Tomography (OCT)

High-resolution scans provide detailed information that can help your doctor assess damage to the retina. 


Noninvasive sound waves travel through the eye. They bounce off your retina and other parts of your eye to create images that help your doctor detect retinal tears, holes, or detachment. Ultrasound is useful when your doctor cannot see the back of your eye or your retina clearly via an ophthalmoscopy because of a cataract or a vitreous hemorrhage.

Pioneers and Experts in Retinal Detachment Repair

Latest Advances in Retinal Imaging
We are one of the few centers in the U.S. to use optical coherence tomography (OCT) imaging in the operating room. The technology lets us visualize the layers of the eye with greater detail and identify subtleties and patterns that guide our treatment recommendations. Intraoperative OCT imaging allows for advanced surgical techniques like gene therapy delivery for genetic retinal disease. Our researchers and doctors are pioneers in this intraoperative imaging technology. They are also national leaders in using surgical microscope integrated OCT and interpreting the results.

High-Volume Referral Center
As a premier retina center, our providers have advanced training and skill in handling complex retinal detachments such as recurrent retinal detachments with proliferative vitreoretinopathy. As a result, we receive a high volume of referrals from other doctors. We are frequently called upon to help people who have recurrent retinal detachments or other complex problems following previous surgeries elsewhere.

Retinal Surgery Pioneers
The field of retinal surgery was pioneered at Duke by Robert Machemer, MD, the former chair of our ophthalmology department. Many of our senior surgeons trained under Dr. Machemer, who is widely considered to be the “father of vitreoretinal surgery.” Vitreoretinal refers to treatment of the retina, macula, and vitreous -- the gel and fluid that fill the eye.

Compassionate, Supportive Environment
We offer patient support services, including educational materials and programs, a low vision rehabilitation program, and a dedicated social worker to help you and your loved ones manage your condition and maximize your quality of life.

Best Eye Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our ophthalmology program is ranked seventh in the nation and is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 12/14/2023 by