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Retinal Detachment

Retinal detachment is serious as well as vision damaging. It occurs when the retina – the lining of the back of the eye – separates from its supportive tissue. The retina cannot function detached. Unless it is reattached quickly, the patient’s vision will suffer. Eyesight loss may result. The retina converts light rays to impulses that travel through the optic nerve to our brain, which in turn are interpreted as the images we see. A detached retina makes this functioning impossible.

What Are The Signs and Symptoms of Retinal Detachment?

You may be experiencing a retinal detachment if you suddenly notice spots, floaters and flashes of light. The Journal of the American Medical Association reports that one in seven people with sudden onset of flashes and floaters will have a retinal tear or detachment.

Other symptoms may include blurry vision, poor vision or a shadowy curtain coming down from the top of or across the eye from the side. These symptoms can happen gradually as the retina slowly tears away from the tissue, or very suddenly if the retina detaches immediately.

No pain is felt with retinal detachment. Experiencing any of the above symptoms requires an immediate consultation with your eye doctor. Fast treatment increases the chances of regaining loss of vision.

Causes of Retinal Detachment?

Sudden injury or shock to the eye or face can be a cause of a detached retina, as well as high nearsightedness. Extremely nearsighted people have long-stretched eyeballs and therefore much thinner retinas which could be prone to tearing.

In rare cases, retinal detachment occurs after LASIK surgery in very nearsighted individuals. In one study of over 1,500 LASIK patients, only four suffered from retinal detachment. In those patient cases their pre-LASIK prescriptions ranged from -8.00 D to -27.50 D.

Cataract surgery, eye diseases, tumors, and other systemic diseases like diabetes or sickle cell may also cause retinal detachments. New blood vessels growing under the retina which may occur with diabetic retinopathy, may separate the retina from its support tissue.

Retinal Tears or Detachment Treatments

Surgery is the only effective treatment for a torn or detached retina. The procedure your doctor selects may depend on the severity and location of the tear.

Laser surgery – Photocoagulation, is typically selected for retinal breaks and tears that have not yet become retinal detachments. The surgeon directs a laser beam into your eye through the pupil to “weld” the damaged retina to its supporting tissue. Photocoagulation requires no surgical incision and causes the least irritation to the eye compared to other treatments.

Cryopexy, the surgeon applies a freeze probe to the outer surface of the eye over the area of defective retina. The scarring that occurs from the freezing reattaches the retina to its support tissue.

Pneumatic retinopexy is generally used to treat a retinal detachment in the upper half of the retina. The surgeon injects an expandable gas bubble into the eye, positioning the bubble on the torn or detached retina. As the gas bubble expands, it pushes the detached retina against its tissue base. The surgeon then may use laser photocoagulation or cryopexy to firmly reattach the retina to the tissue. The body absorbs the gas bubble after a while and precautions are advised by your doctor until that happens.

Another process of pneumatic retinopexy uses an injection of silicone oil rather than expandable gas to press the detached retina against its support tissue. In this alternative procedure, the silicone oil must be removed from the eye after the retina is reattached.

Scleral buckling is a very common surgery used to treat a retinal detachment. The surgeon places a soft silicone band around the eye, indenting the outside of the eye toward the detached retina. The band is sutured against the tough outer white coating of the eye (the sclera). The surgeon drains all fluid between the retina and its support tissue, and reattaches the retina with laser photocoagulation or cryopexy.

In about 90% of cases, detached retinas are successfully reattached with surgery. However, be aware of the risks. Your vision may not necessarily return to normal. Patients who have the best results from retinal detachment surgery are those who seek attention immediately upon noticing any symptoms. Also much easier to repair are detachments that do not involve the central retina (the macula).