Eye Retinal Detachment

 

Eye retinal detachment is an emergency that occurs when the retina, a light-sensitive membrane situated at the back of the eye, separates from its normal position.

 

The lens of the eye focuses an image on the retina when light passes through it. The retina is a thin layer of tissue that receives images and sends them as electric signals through the optic nerve to the brain.

 

So, when the retina separates from its normal position, it renders deprived of oxygen and nourishment. This may lead to retinal detachment surgery for treatment. As the retinal cells are cut off from the blood vessels that provide oxygen, the risk of partial or permanent vision loss increases. If it is not treated immediately, it may lead to severe consequences.

 

Symptoms of Retinal Detachment

 

Though there is no significant pain associated with this situation, various symptoms occur before or in the advanced stages:

 

• Blurred vision

• The sudden appearance of floaters or tiny specks or strings drifting through the field of vision

• Partial vision loss that occurs as a curtain has pulled across your field of vision, with a shadowing effect

• Photopsia: Sudden flashes of light in the eyes

• Gradual reduction of side or peripheral vision

 

Symptoms occur rapidly and, if not addressed or treated immediately, may lead to eye surgery for retinal detachment. The risk of vision loss also increases with time if the symptoms are overlooked.

 

Types or Causes of Retinal Detachment

 

Whether this condition is caused by a tear, scar tissue, or disease, the types differ with the state of the retina.

 

Majorly, there are three types of Retinal Detachment:

 

1. Rhegmatogenous 

 

It is the most common type of retinal detachment caused by a hole or a tear in the retina, making the fluid slip through the opening and collect underneath the retina, consequently pulling the retina away from the underlying tissues. The regions where the retina detaches lose their supply of blood and cease to work, causing loss of vision.

 

Aging is the most common cause of rhegmatogenous detachment. Vitreous, a gel-like substance that fills the inside of the eye may change in consistency or render more liquid with age. Usually, this gel-like substance separates from the surface of the retina without any complications and this condition is termed posterior vitreous detachment (PVD). The common complication of this separation is a tear.

 

Vitreous may tug on the retina with sufficient force to create a retinal tear when it separates or peels off the retina. If immediate measures are not taken, the liquid vitreous can pass through the tear and settle behind the space of the retina, causing detachment.

 

2. Tractional

 

This type of retinal detachment is typically observed in people who have poorly controlled diabetes or people suffering from diabetes mellitus (which mainly affects the retinal vascular system).

 

In tractional retinal detachment, the scar tissue grows or contracts on the retina’s surface, causing the retina to pull away from the back of the eye.

 

The retinal vascular damage leads to scar tissue accumulation resulting in detachment of the retina.

 

3. Exudative

 

This type of retinal detachment is not caused by any tears or holes in the retina. In this, fluid accumulates beneath the retina.

 

The main causes are:

 

• Age-related macular degeneration

• An inflammatory disorder that leads to the accumulation of fluid behind the retina

• Injury or wound to the eye

• Tumors

• Cancer behind the retina

 

Are you at risk of retinal detachment?

 

It is usual for anyone to experience retinal detachment but a few factors can highly increase being at risk:

 

• Anybody with a family history of retinal detachment

• A severe injury or wound in the past

• If someone has been through eye surgeries such as cataract surgery

• Diagnosed with eye conditions or diseases

• Aging (greater risk if the person is above the age of 50)

• Extreme myopia (Not able to see objects situated farther from the eye)

• Diagnosed previously with retinal detachment

 

Some eye-related conditions or diseases also put you at a higher risk:

 

• Diabetic Retinopathy (a diabetic complication that affects the blood vessels in the retina)

• Lattice degeneration (the thinning of the retina)

• Retinoschisis (the separation of the retina into two layers)

• Posterior vitreous detachment (gel-like material in the center of the eye pulls or separates away from the retina)

How is Retinal Detachment diagnosed?

 

This condition is diagnosed through an eye exam. The eye specialist will use dilated eye exam to check the retina. Initially, eye drops are put in the eyes. These drops dilate the pupils or widen them. The doctor will be able to get a close look after a few minutes.

 

The eye specialist or ophthalmologist may prescribe other tests after the dilated eye exam. These tests are non-invasive and painless. They help the doctors provide more detail and information for the further course of treatment. Some of the tests which are mostly recommended are:

 

• Optical coherence tomography (OCT): Firstly, the pupils are dilated for this imaging. Secondly, the patient is required to sit in front of the OCT machine, where your head is placed on a support to stay still. Lastly, the machine scans your eye but does not touch it.
• Eye (ocular) ultrasound: This test does not use drops for dilating the eye but the doctor may use drops that numb the eyes to diminish the discomfort. The patient sits on a chair and rests the head on a support to remain still. The doctor gently positions the instrument in front of the eye for scanning. Then, the patient is instructed to close their eyes. The eye specialist puts gel on the eyelids. To scan the eyes with the instrument, the patient needs to move the eyes keeping them closed.

 

What is the treatment for retinal detachment?

 

In minor cases of retinal detachment or tears of the retina, a simple procedure in the eye specialist’s office may suffice. But, in most cases, surgery becomes a necessity to repair the detached retina.

 

Laser surgery (photocoagulation) and freezing (cryopexy) are the most usual treatment options for the tears in the retina.

 

• Photocoagulation: It is performed with a laser in case there exists a hole or tear in the retina but the retina is still attached. The laser burns around the tear site and results in scarring, which in consequence affixes the retina to the back of the eye.
• Cryopexy: It is a procedure that means freezing with intense cold. In this treatment, the doctor applies a freezing probe outside of the eye in the region over the retinal tear site and the eventual scarring will hold the retina in the normal place.

 

Eye Surgery for Retinal Detachment

 

In case, a larger part of the retina is detached, doctors usually recommend Retinal Detachment Surgery to move the retina back in place.

 

The three most typically prescribed surgeries are retinopexy, scleral buckling, and vitrectomy.

 

1. Pneumatic retinopexy

 

Medical professionals conduct this procedure to mend minor detachments. The doctor may perform it in the office itself. Firstly, the doctor uses medicine to numb the eyes to reduce or diminish discomfort. The steps thereafter are:

 

• They use a tiny needle to extract a small amount of fluid.

• Formation of petite bubbles in the eye by injecting a small amount of air.

• Lastly, the doctor waits for the retina to shift back into place and repairs any holes or tears with laser surgery or freezing.

 

The air bubble in the eye won’t cause any problems and will dissipate naturally over time. However, after the surgery, it’s advisable to take certain precautions to ensure the eye fully heals.

 

To minimize strain on the body, experts recommend avoiding activities such as engaging in vigorous exercise, lifting heavy objects, or traveling by air for a short period. The patient needs to keep following up with the doctor to make sure the eye is healing correctly.

 

2. Scleral bulking

 

In more severe cases of retinal detachment, doctors perform scleral bulking. The doctor will typically give the patients anesthesia for this surgery so they can sleep and do not feel any discomfort during the entire procedure. Next:

 

• The doctor will place a small and flexible band around the sclera (white portion of the eye).

• The band then pushes the sides of the eye and toward the retina so it will reattach.

• The band remains permanently after the surgery.

• Lastly, to repair any holes or tears, laser surgery or freezing might be provided.

 

The retinal detachment surgery is very simple and not painful, so the doctor may discharge the patient the same day. Although, due to the induced anesthesia, someone might have to drive the patient home.

 

Some precautions are necessary to make sure the eye heals properly:

 

• Wearing an eye patch for at least a day after surgery.

• Avoidance of heavy lifting or intense exercise.

• Follow-ups with the eye specialist.

 

3. Vitrectomy

 

An eye surgery for retinal detachment, suitable for larger tears, typically takes place in an outpatient surgery center. The patient will be under anesthesia to proceed through the following steps:

 

• The doctor will make a small incision in the sclera of the eye.

• Insert a microscope to examine the eye’s interior.

• Next, the doctor will correct abnormalities, such as scar tissue or vitreous.

• Inject a gas bubble concurrently to reposition the retina.

• Finally, perform freezing or laser treatment to mend tears or holes.

 

After the surgery, the patient may experience slight discomfort and should refrain from vigorous exercise.

 

Prevention from Retinal Detachment Surgery

 

There are no known ways to prevent retinal detachment condition or surgery but a person can take a few precautionary measures:

 

• Getting eye dilation exams regularly

• Wearing a protective eye shield while playing sports

• Controlling levels of blood sugar

 

These conditions might worsen the normal functioning of the eye and may result in severe consequences. But, don’t worry if you have such conditions. At ASG Eye Hospitals, we take pride in providing the best solutions for eye care to people irrespective of their awareness, knowledge, and financial levels. The most optimal retinal detachment surgery at ASG encompasses state-of-the-art equipment and highly experienced doctors.

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