Retinal Detachment:

Retinal detachment is separation of the retina from the underlying layers that line the inner wall of the eye. Through the retinal tear, liquid from the vitreous may pass through the tear, and detach the retina. As the fluid accumulates, more and more of the retina detach. Detached retina loses its function; hence the person with retinal detachment loses vision suddenly or gradually. more…

Although anyone can develop a retinal detachment, some people are at a high risk. Myopic patients (nearsighted people), those who have ‘weak areas’ in the retina, known as lattice degeneration, those who have had significant eye injuries, and those with a family history of retinal detachment are at higher risk of retinal detachment. Retinal detachment can also occur following cataract surgery.

Retinal Detachment is an emergency; Earlier the treatment better the vision.

What is Retina?

The retina is a thin sheet of light sensitive nerve tissue lining the inner aspect of the eye. The light that enters the eye passes through the cornea and lens and is focused on the retina. It is this layer of the eye that turns into light into the visual signal transmitted to the brain, allowing one to see. If the retina is damaged, spectacles alone cannot improve one’s vision.

What is Vitreous?

The vitreous is a clear jelly-like material that fills most of the space inside the eye. As we age, the vitreous often liquefies and the gel structure may collapse.

What is a Retinal Tear?

In most people, the vitreous gel separates from the retina easily without any problems. In some people, the gel may be strongly adherent to the retina and when gel separates it may tear the retina as well. When this happens, one may perceive “flashes of light” even if there is no light in the room or even if the eye is closed.

What causes retinal detachment?

The vitreous-a gel like material is present is maximum areas of eye. Meanwhile, the presences of retinal tear allow gel from vitreous space to pass through the hole and flow between the retina and the back wall of the eye. As a result the retina detaches from its underlying layer of support tissue at the back of the eye. The detached area of the retina will not function properly and if not treated initially the whole retina will peel off and the person may lose his/her vision.

Why do Retinal detachments occur?

Retinal detachment can occur for a number of reasons, some of these reasons include:

Shrinkage of the vitreous: The gel-like material that is present inside the maximum area of eye that may generate tugging on the retina and a retinal tear, leading to a retinal detachment.
Injury
Advanced diabetes
High Myopia

SYMPTOMS :

Most people notice floaters and flashes before the retina detaches. As the detachment increases a gradually enlarging dark shadow engulfs vision. It may appear as a curtain or a shade drawn slowly across the field of vision. Central retina is the area that helps one see fine detail also allowing one to read small print. When retinal detachment progresses to involve the central retina, the reading ability is lost. In complete retinal detachment, one may just see light and no other details.

TREATMENTS:

Retinal tears with minimal or no detachment can be treated on an out-patient basis using laser therapy or cryopexy (freezing) procedures. These treatments decrease the risk of a retinal detachment. Retinal detachment may rarely occur even after these treatments; it is hence essential that the patient is on regular follow-up after the treatment.

Once the retina is detached, surgery to reposition the separated retina is required. Scleral buckling or vitrectomy operation will be necessary to reattach the retina. Surgical treatment of retinal detachment requires admission to the hospital and a day’s stay. The patient may be allowed to go home in the evening. Surgery is usually performed under local anesthesia, by making the eye and area around it numb by giving an injection.

In Scleral buckling surgery, a flexible silicone rubber piece is sewn to the sclera (white of the eye) to close the hole. This surgery is performed on the outer wall of the eye.

Vitrectomy is performed by placing three micro incisions on the white of the eye and is performed within the eye ball.

An oil or gas may be placed within the eye to close the hole. If oil is placed inside the eye for reattaching the retina a minor surgery will be required 4-6 months later for removing the oil.

A simple technique of injection a gas bubble and doing laser or cryopexy may reattach the retina in a small group of patients. This technique is called Pneumoretinopexy.

FAQs :
Will I get my vision back if I have detached retina?

Retinal detachment is serious problem that needs early, highly specialized treatment. Despite surgery, one out of 10 people on an average may develop recurrence of the disease necessitating re-operation.

Retina being nerve tissue, some loss of function always occurs after retinal detachment. After successful attachment of the retina, vision will improve but not to normal levels. Visual recovery varies and depends on factors such as how soon after the detachment operation is performed and whether the central retina is detached or not, among others.

Article by
Sankara Eye care.