Retina Detachment

What is Retina Detachment?

Retinal detachment is a serious eye condition. The retina, the layer of tissue on the back of the eye, is removed from the tissues that support it. Sudden changes, including floaters, flashing lights and the presence of shadow inthe peripheral vision, are signs that this may be the case. A retinal detachment needs treatment as soon as possible.

Before Treatment

If your retina detaches or torn, you will experience many floaters or dark spots, flashing lights, blurry or distorted vision.

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After treatment

If treated immediately, there should be no loss of vision and your vision will be clear again.

Retinal detachment is a serious eye condition that affects your vision and can lead to blindness if left untreated. It occurs in a layer of tissue called the retina that covers the back of the eye. It involves the removal of the retina from the tissues that support it. Symptoms include flashing lights, floatersor seeing a shadow in your vision.

You may experience warning signs such as those before the retina comes off, as in the case of a retina tear. Retinal detachment often occurs spontaneously or suddenly. Risk factors include age, myopia, history of eye surgeries or trauma, and family history of retinal detachments.

Call your ophthalmologist or go to the emergency department immediately if you think you have a detached retina.

The retina senses the light and sends signals to the brain so that we can see. When the retina detaches, it cannot do its job. Your vision may become blurred. And you may permanently lose vision if the detachment is not repaired. Immediate treatment can save your eyesight.

The risk of retinal detachment increases as you age. You are also at higher risk if you have or had:

  • Eye injury
  • Family history of retinal detachment
  • Intraocular surgery (any surgery involving the eye, such as cataract surgery)

The presence of certain eye diseases also increases the risk of retinal detachment:

  • Significant myopia
  • Posterior vitreous detachment, where the vitreous pulls away from the retina
  • Lattice degeneration
  • History of retinal tears or detachments in the other eye

If you are at high risk of retinal detachment, talk to your ophthalmologist.

Retinal detachment is rare for people who do not have any of the risk factors listed here.

The three causes of retinal detachment are:

Rhegmatogenous:The most common cause of retinal detachment occurs when there is a small tearin your retina. The ocular fluid called vitreous can travel through the tear and collect behind the retina. It then pushes the retina away, detaching it from the back of your eye. This type of detachmentusuallyoccursasyouget older.As the vitreous shrinks and thins with age, itpullson the retina, tearing it apart.

Tractional: Scar tissue in the retina can pull it away from the back of the eye. Diabetes is a common cause of these retinal detachments. Prolonged high blood sugar can damage the blood vessels in your eye, and this can lead to scar tissue formation. Scars and traction areas can become larger, pulling and detaching the retina from the back of the eye.

Exudative: Fluid accumulates behind the retina, even though there is no retinal tear. As the fluid collects, it pushes your retina away. The main causes of fluid accumulation are the leakage of blood vessels or swelling behind the eye, which can occur from causes such as uveitis (eye inflammation).

Retina Detachment - eye clinic

Some people do not notice any symptoms of retinal detachment, while others do. It depends on the severity – if a larger part of the retina is detached, you are more likely to experience symptoms.

Symptoms of retinal detachment may appear suddenly and include:

  • Seeing flashes of light.
  • Seeing floaters — flecks, threads, dark spots and squiggly lines that drift across your vision. (Seeingsome here and there is normal and there is no need to worry.)
  • Blurring of your peripheral vision.
  • Darkening or shadow that covers part of your vision.

Retinal detachment is usually painless. But it is a serious problem that can threaten your eyesight. Contact yourophthalmologist if you notice any symptoms.

You need an ophthalmological examination to diagnose retinal detachment. Your ophthalmologistwill do fundoscopy to check your retina. They will put drops in your eyes. The drops dilate or widen the pupil. After a few minutes, yourophthalmologist can carefully examine the retina.

Your ophthalmologist may recommend other tests after dilated eye exam:

  • Optical Coherence Tomography (OCT): Youget dilating eyeThenyousitinfrontoftheOCTmachine.

Eye (Ocular) ultrasound:You will not need dilating drops for this examination. You sit in a chair and rest your head on a support so that it stays still. Your ophthalmologist gently places an organ on the front of your eye to scan it. Then you sit with closed eyes. Your ophthalmologist puts gel on your eyelids. With your eyes closed, you move your eyes as your doctor scans them with the same instrument.

Your ophthalmologistwill discuss with you the treatment options.You may need a combination of treatments for best results.

Treatments include:

Laser (thermal) treatment or cryopexy (freezing). Sometimes, your ophthalmologist will diagnose a retinal tear before the retina begins to detach. Your ophthalmologist uses a medical laser or a freezing tool to seal the tear. These devices create a scar that holds the retina in place.

Pneumatic retinopexy: Your ophthalmologistmay recommend this approach if the detachment is not so extensive. During pneumatic retinopexy:

  • Your vitreoretinal specialist injects a small gas bubble into the vitreous, the fluid into the eye
  • The bubble presses on the retina, closing the tear
  • You may need laser or cryopexy to seal the tear
  • The fluid collected under the retinalgets re-absorbed from the body. The retina can now stick to the eye wall like it should. Eventually, the gas bubble also gets reabsorbed.

After surgery, your vitreoretinal surgeon will recommend that you keep your head still for a few days to promote healing. You also may be told not to lieonyourback.

Scleral buckle (Scleral buckle). During this procedure:

  • Your surgeon surgically places a silicone tape around the eye
  • The band holds the retina in place and stays there permanently
  • The detached retina begins to heal
  • Laser or cryopexy is used to seal the tear

Vitrectomy.  During a vitrectomy, your vitreoretinal surgeon:

  • Surgically removes the vitreous
  • Places a bubble of air, gas or oil in the eye to push the retina back into place

If your surgeon uses an oil bubble, will removeit a few months later. Gas and air bubbles get reabsorbed.

If you have a gas bubble, you may need to avoid activities at certain altitudes. Changing altitude can increase the size of the gas bubble and the pressure in your eye. You should avoid flying and traveling at high altitudes. Your surgeon will tell you when you can start these activities again.

After retinal detachment surgery, you may have some discomfort. It can last for a few weeks. Your surgeon will discuss painkiller and other forms of relief. You will also need to relax your activities for a few weeks. Talk to yoursurgeon about when you can exercise, drive and return to your normal activities.

Other things you can expect after surgery:

  • Eye patch: Wear the eye patch for as long as your surgeon tells you it is necessary
  • Head position: If your surgeon put a gas bubblein your eye, follow the instructions for the position of your head. Your surgeon will let you know in what position your head should be in and how long you will keep it there to help heal the eye
  • Eye drops: Your surgeon will guide you how to use the drops to help your eye heal
  • Improved vision: About four to six weeks after surgery, you will begin to notice that your vision improves. It may take a few months to notice the full effects
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