RETINAL DETACHMENT

The retina is a thin layer of light sensitive tissue on the back wall of the eye. The light enters the eye and is focused on the retina. The retina transmits the image via the optic nerve to the brain. If the retina is damaged or not in its correct position, a clear picture cannot be produced.

A retinal detachment is a separation of the retina from it attachment to the underlying tissue within the eye. Since the retina can’t work properly under these conditions you could permanently loose vision if the detached retina isn’t repaired promptly.

Type of retinal detachment

Rhegmatogenous retinal Detachment

A break, tear or hole develops in the retina, allowing liquid to pass from the vitreous space into the sub retinal space between the sensory retina and the retinal pigment, epithelium.

Secondary or exudative retinal Detachment

An inflammation vascular abnormalities or tumor cause fluid to built up under the retina (There is no hole, break or tear) resulting in retinal detachment.

Traction retinal detachment –

A separation of the sensory retina from the retina pigment due to contraction of vitroretinal fibroproliferative membrane which pulls away from the pigment epithelium. This main causes are proliferative diabetic retinopathy, injury, inflammation.

Symptoms

Retinal detachment does not hurt pain but warning signs appear much in advance

Flashing light

Flashes are the brief sensation of what appears to be bright lights at the outside edge (periphery) of your vision. These flashes are more common when the eyes move. The flashing lights are caused by the vitreous gel pulling on the retina or a looseness of the vitreous.

Floaters

Floaters are condensation (small solidification) in the gel and frequently described as one or more black moving pots, strands or little flies in your vision. The presence of the floater does not alarm that you have retinal detachment. In particular, if you have any new floater in addition to the sensation of flashing lights than see your doctor urgently.

Vision Loss

You may experience a shadow or curtain that affects any part of the vision than a retinal tear has progressed to detached retina.

Risk Factor

Retinal detachment is more likely to occurs in the people who

  • Are older than 40 years.
  • Are extremely myopic (Near Sightedness) .
  • Have had retinal detachment in the other eye.
  • Have had a family history of retinal detachment.
  • Have had trauma (Injury) in the eye.
  • Have had cataract surgery.
  • Are into sports like boxing, bungee jumping, and other such sports. .
  • Have other eye diseases like retinoschisis, Uveitis, lattice degeneration.

Diagnoses

Retinal Detachment can be diagnosed clinically after the pupils are dilated with an eye drops. In case where the retina cannot be visualized clinically, an ultra sonography of the eye will confirm the diagnoses

Treatment

Cryopexy

Small holes and tear are treated with laser or with a freeze treatment called cryopexy. During laser surgery tiny burns are made around the hole to weld the retina back in place. Cryopexy freezes the area around the hole and helps reattach the retina

Scleral buckling

Sclera buckle, a tiny synthetic band is attached to the outside of the eyeball (sclera) to gently push the wall of the eye against the detached retina. This band is not visible and remains permanently attached. Scleral buckling may be done in addition to laser or freezing treatment to fix retinal break.

Pnematic retinopathy

Pnematic retinopathy involves injecting a gas bubble into vitreous cavity. The bubble pushes the detached part of the retina flat back up against the outer layers

Vitrectomy

Vitrectomy is the surgical procedure is done when the retinal tear/ detachment is large. It involves the removal of the vitreous gel and get the left space filled with gas (C3F8 or SF6) or silicone oil to push the retina back onto the place. The procedure may require special positioning of the patient head so that the gas can rise and better seal the break in the retina.