Retinal Detachment

Retinal Detachment

A Retinal Detachment is a painless but sight site threatening eye problem that is considered a medical emergency. A detached retina occurs when the retina lifts away from the underlaying layers of tissue in the back of the eye. RETINAL DETACHMENT The retina is unable to function when detached, resulting in blurry vision. As we get older, the vitreous gel in our eyes starts to shrink and get thinner allowing it to move around and pull on the retina. Usually this occurs without a problem, but sometimes the vitreous may stick to the retina and pull hard enough to tear it. When that happens, fluid can pass through the tear and lift or detach the retina.
Retinal Detachment Risks

Patients who have one or more of the following are at greater risk for detached retina:

  • Are nearsighted and need glasses to see far away
  • Have had eye surgery such as cataract surgery
  • Have had a serious eye injury
  • Have had a retinal tear or detachment in the other eye
  • Have family members who had retinal detachment
  • Have weakened areas in their retina from thinning or degeneration
Retinal Detachment Symptoms

A Retinal Detachment can cause a number of symptoms and warning signs that occur often before the actual detachment happens. The key to preserving vision is to recognize these warning signs and symptoms and scheduling quick diagnosis and treatment. Warning signs and symptoms of Retinal Detachment may include:

  • Flashes of light that may occur in your field of vision toward the outermost periphery.
  • A sudden increase in the number of floaters in your vision and possibly even a ring of floaters or “hairs” in your vision-sometimes this is accompanied by “specks” or a “cobweb”.
  • A sense of a “shadow” in your peripheral vision that may progress toward the center of your vision.
  • A sensation of a “curtain” or a “veil” being drawn over your vision.
  • Straight lines, such as the edge of a door or walls, appear to be curved or appear as a “bubble”.
  • In extreme cases of retinal detachment you may experience a loss of central vision.
Types of Retinal Detachment

There are three main types of retinal detachment:

Rhegmatogenous Retinal Detachment is the most common type that occurs as a result of a break-usually a tear or hole-in the retina that permits fluid to pass into the space underneath the retina. Tears or holes in the retina may actually occur without causing any symptoms to occur. Therefore, it is important that you have routine eye examinations, especially if you are nearsighted or myopic, or if you play contact sports and might be subjected to eye trauma. If you are nearsighted or myopic, you may be more prone to peripheral retinal degenerations, such as lattice degeneration, which may increase your risk of retinal detachment making regular eye examinations an even more important part of your routine health care. Rhegmatogenous Retinal Detachment is the most common type of retinal detachment.

Exudative Retinal Detachment may occur due to inflammation, injury or a Retinal Vascular Disease that causes fluid accumulation underneath the retina without the presence of a retinal hole or retinal tear.

Tractional Retinal Detachment may occur when fibrous or fibrovascular scar tissue has been formed on the retina as a result of an injury, inflammatory disease or the presence of neovascularization, such as in Diabetic Retinopathy. The scar tissue actually pulls the Retina free from the underlying pigment layer it is normally attached to, causing a Retinal Detachment.

Retinal Detachment Treatment

Our retina specialist will perform a detailed eye exam, including a careful examination of the peripheral retina. This may include pushing on the outside of the eye, called scleral depression, to view the far most peripheral retina to identify any retinal breaks that will need to be treated. Retinal imaging is sometimes performed to document the extent of the detached retina. The goal of the examination is to determine the extent of the retinal detachment, and therefore the most suitable treatment. The goal of the treatment is to re-attach the retina to its original insertion, seal the holes and reinstate the retina function. Several methods exist in order to achieve that:

Laser Surgery-When a single tear or hole is found, and the retinal detachment is localized to a small area, our retina specialist may choose to weld the retina with a focal laser treatment in the office, in order to prevent the retinal detachment from spreading.

Pneumatic Retinopexy-When the retinal detachment is located in the superior part of the retina, and is associated with a single tear or hole, our retina specialist may consider injecting the eye with an inert gas bubble to push against the detached retina, so it will adhere to the wall of the eye. The tear itself may be sealed with freezing therapy at the time of gas injection, or few days later with laser in the office.

Vitrectomy-In certain cases, when the retinal detachment is more advanced, surgery is indicated. This procedure is done in the operating room. The retina specialist will insert special instruments into the eye, remove the vitreous gel from the eye and reinflate the eye to allow for retina adherence. The retinal tear is then sealed with either laser or a freezing probe.

Scleral Buckle-in this type of surgery, a silicone band is wrapped around the eye globe, depressing the outer wall of the eye closer to the retinal tear, thereby allowing the retina to reattach. The tear is then treated with a freezing probe, to allow for permanent sealing.