Choroidal Detachment

Choroidal detachment occurs when fluid or blood collects between the choroid and the sclera, the tough outer wall of the eye. This separation can change eye pressure and affect vision. It may happen after eye surgery or an injury, or because of inflammation, very low eye pressure, or another eye problem. Although it can affect anyone, it is more likely in people with certain eye conditions or recent eye procedures.

Symptoms vary with the cause and size of the detachment. Some small choroidals cause few noticeable symptoms and are found during a routine or follow-up eye examination. Others can cause vision changes, discomfort, or sensitivity to light.

Choroidal detachment develops when fluid accumulates in the suprachoroidal space, the area between the choroid and sclera. The fluid pushes the choroid away from the sclera. Bleeding into this space can cause a hemorrhagic choroidal detachment, sometimes called choroidal hemorrhage or choroidal bleeding.

Common triggers

Possible triggers include recent eye surgery, an eye injury, inflammation inside the eye, very low eye pressure, medication effects, and bleeding disorders. A hemorrhagic choroidal detachment may be associated with trauma, surgery, blood-thinning medicines, or abnormal blood vessels, but the cause varies from person to person.

Risk depends on the underlying cause, and having a risk factor does not mean that someone will definitely develop choroidal detachment. An ophthalmologist considers a person’s eye history, medical conditions, medicines, and recent procedures when assessing risk.

Complications are more likely when the detachment is extensive, hemorrhagic, recurrent, or left untreated. Possible problems involve vision, eye pressure, the retina, or the position of the choroid. Some cases resolve without lasting damage when the cause is treated appropriately and follow-up is maintained.

An ophthalmologist reviews symptoms, recent surgery or injury, medicines, and medical conditions before examining the eye. The clinician may also measure eye pressure and assess vision to understand how the choroidal detachment is affecting the eye.

Tests used to confirm the diagnosis

A dilated eye examination allows the ophthalmologist to inspect the retina and choroid. Ocular ultrasound can show the choroid when blood, swelling, pain, or another problem limits the view inside the eye. Optical coherence tomography may provide detailed images when helpful, and additional tests may look for inflammation, bleeding, or another underlying disease.

Choroidal detachment treatment depends on whether the cause is low eye pressure, inflammation, bleeding, trauma, or a postoperative problem. An ophthalmologist may monitor the eye, treat the underlying cause, drain fluid or blood, or repair an associated wound or eye complication.

Observation and treatment of the underlying cause

Small or uncomplicated detachments may improve with close follow-up and treatment of the trigger. The ophthalmologist may adjust pressure-lowering medicines when appropriate, treat inflammation, or manage another medical problem causing the choroidal effusion. Examinations help confirm that the fluid is resolving and that eye pressure and vision remain safe.

Procedures and surgery

Persistent, extensive, or hemorrhagic choroidal detachments may require a procedure to drain fluid or blood and reform the eye. Surgery may also repair an injury, address a wound from a previous procedure, or treat retinal or other surgical complications. Recovery and follow-up vary according to the cause, the amount of choroidal bleeding, the presence of kissing choroidals, and the eye’s response to treatment.

Many cases improve when the underlying cause is corrected, but recovery may be slower or less complete after severe bleeding, retinal involvement, prolonged low eye pressure, recurrent disease, or other eye damage. A hemorrhagic choroidal detachment may have a different outlook from a small fluid-related detachment.

Factors that influence recovery

Important factors include the type and size of the detachment, its cause, how quickly treatment begins, baseline vision, and the response to treatment. Scheduled eye examinations are important for checking resolution, eye pressure, retinal health, and possible recurrence. An ophthalmologist can provide the most accurate outlook for an individual case.

Contact an ophthalmologist promptly for new blurred vision, eye pain, redness, visual shadows, or symptoms after eye surgery, injections, or trauma. These symptoms can have several causes, including choroidal bleeding, and should not be assessed only at home.