RETINAL DETACHMENT
The retina is the innermost layer of the eye that receives and transmits images that have passed through and been focused by the lens and cornea. The retina, like a film in a camera, is responsible for creating the images that one sees. When the retina detaches, it is lifted or pulled away from its normal position. If not promptly treated, retinal detachment can cause permanent vision loss.
WHAT ARE THE SYMPTOMS OF RETINAL DETACHMENT?
- The sudden onset of light flashes and floaters.
- A slow enlarging of a dark curtain or shadow, usually beginning in the periphery and slowly moving to central vision, could signify the start of detachment.
WHO IS AT A RISK FOR RETINAL DETACHMENT?
- People with a high minus number (Myopia).
- People with a family history of retinal detachment.
- People with a history of eye injury.
- People with thinning of the retina (lattice degeneration) or other degenerative retinal conditions.
WHAT ARE THE TREATMENT OPTIONS FOR RETINAL DETACHMENT?
Treatment is aimed at closing retinal tears to facilitate reattachment of the retina. If detected early retinal holes can be sealed by Laser. Since the retina gets most of its blood supply from vessels in the wall of the eye, if it becomes detached, it does not get enough oxygen, and cells in the retina suffer and begin to die. Hence the prompt treatment is important. There are different surgical procedures which repair a detached retina, which is a separation of the retina from its normal position lining the back of the eye.
PNEUMATIC RETINOPEXY
The retina is reattached by injection of expansile gas into the vitreous cavity (a procedure that can be performed under local anesthesia as an office procedure or in the operation theater) followed by careful positioning of the head.
Once the retina is reattached, the retinal tear can be sealed by laser photocoagulation or cryotherapy (this can be done before gas injection).
SCLERAL BUCKLE
This surgery is generally performed in the operating room. A piece of silicone elastic plastic or sponge is sewn onto the outer wall of the eyeball (sclera) to create an indentation or buckle effect inside the eye.
The buckle is positioned so that it pushes in on the retina, effectively closing the break. This buckle counteracts the forces that are pulling the retina away from its normal position, and it is meant to stay in place forever.
VITRECTOMY
In more complicated forms of retinal detachments, Vitrectomy surgery may be necessary. The vitreous jelly is removed, as well as any scar tissue or blood that may have accumulated. The vitreous is then replaced with special fluid or a gas bubble.
WHAT ARE CHANCES OF VISUAL RECOVERY FOLLOWING RETINAL DETACHMENT SURGERY?
Approximately 90% of common retinal detachments can be initially repaired with one or a combination of the above procedures. Improvement of vision in the operated eye takes weeks to months. Blurred vision is to be expected for a while.
About 10 to 15% of patients with retinal detachment will require repeat surgery.
