What is retinal detachment?
The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. When the retina detaches, it is lifted or pulled from its normal position. If not treated soon, retinal detachment can cause permanent loss of vision
What are the different types of retinal detachment?
There are three different types of retinal detachment:
Rhegmatogenous Retinal Detachment —A tear or break in the retina allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. This is the most common type of retinal detachment.
Tractional Retinal Detachment—In this type of detachment, scar tissue on the retinal surface contracts and causes the retina to separate from the RPE. This type of detachment is less common.
Exudative Retinal Detachment—Frequently caused by retinal diseases, including inflammatory disorders and injury/trauma to the eye. In this type, fluid leaks into the area underneath the retina, but there are no tears or breaks in the retina.
Causes and Risk Factors
Who is at risk for retinal detachment?
A retinal detachment can occur at any age, but it is more common in people over age 40. A retinal detachment is also more likely to occur in people who:
→ Are extremely nearsighted/myopic (people with minus numbers to help them see distant objects)
→ Have had a retinal detachment in the other eye
→ Have a family history of retinal detachment
→ Have had cataract surgery
→ Have other eye diseases or disorders, such as lattice degeneration, retinoschisis, uveitis or degenerative myopia
→ Have had an eye injury
Symptoms and Detection
What are the symptoms of retinal detachment?
Symptoms include a sudden increase in either the number of floaters, which are little “cobwebs” or specks that float about in your field of vision, and/or light flashes in the eye.
Another symptom is the appearance of a curtain over the field of vision.
A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional/VitreoRetinal specialist immediately.
Treatment
How is retinal detachment treated?
Conditions predisposing to retinal detachment like small holes and tears are treated with laser treatment. These procedures are usually performed in the doctor’s Outpatient Department. During laser tiny burns are made around the hole to “weld” the retina back into place.
Retinal detachments are treated with surgery that may require the patient to stay in the hospital. In some cases, a scleral buckle, a synthetic band, is attached to the outside of the eyeball to gently push the wall of the eye against the detached retina. If necessary, a vitrectomy may also be performed. During a vitrectomy, the doctor makes a tiny incision in the sclera (white of the eye). Next, a small instrument is placed into the eye to remove the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain a round shape. Silicone oil/Gas is often injected to into the eye to replace the vitreous and reattach the retina; the oil/gas pushes the retina back against the wall of the eye. During the healing process, the eye makes fluid that gradually replaces the gas and fills the eye. Silicone oil, however, does require to be removed at a later date by a small surgery. With all these procedures, either laser or cryopexy is used to “weld” the retina back in place. Many patients are instructed maintain a prone (upside down) position for a few days after the surgery so as to get the maximum benefit of the oil/gas that is injected.
With modern therapy, over 90 percent of those with a retinal detachment can be successfully treated, although sometimes a second treatment is needed. However, the visual outcome is not always predictable. The final visual result may not be known for up to several months following surgery. Visual results are best if the retinal detachment is repaired before the macula (the central area of the retina responsible for fine, detailed vision) detaches. That is why it is important to contact an ophthalmologist preferably a retinal surgeon immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over the field of vision.
