What Is Retinal Detachment?
Retinal detachment is a condition that occurs when the light-sensitive layer of tissue located at the back of the eye, known as the retina, separates from the surrounding tissue.
Retinal detachment is a serious situation that can lead to permanent vision damage if not treated right away, and it is often the case that your retina will have to be reattached with emergency surgery. This condition commonly occurs in patients over the age of 60, but it can also occur if you are severely near-sighted, have a family history of retinal detachment, have sustained an eye injury, or have had surgery to remove cataracts.
Types Of Retinal Detachment
Rhegmatogenous retinal detachment is the most common, and occurs as a result of a tear in your retina. Once a tear is present, fluid in your eye can seep underneath, the pressure of which can cause it to separate. Vitreous is a naturally occurring jelly-like fluid found inside your eye, and when this and your retina become stuck tightly together, it can lead to retinal detachment. Exudative retinal detachment occurs when the blood vessels found underneath the retina start to leak fluid. As this can build up, it can push your retina off the back of your eye. This could happen for a number of reasons, but it primarily occurs as a result of severe inflammation in your eye.
Warning Signs and Symptoms
Although retinal detachment can lead to permanent vision damage, most people will be made aware of it before it reaches this stage.
This is because there are a number of warning signs, such as the sudden onset of blurred or distorted vision, or the appearance of floaters or a network of floaters that can resemble a cobweb appearing in your line of vision. You may also experience short bursts of light (lasting no longer than a second) in the affected eye. Without treatment, your vision will begin to deteriorate, and you will be aware that something is wrong.
What Are The Causes?
Retinal detachment is most commonly caused by tiny tears or breaks that develop in the retina.
These breaks enable fluid between the retina and the lens to leak and seep underneath the retina, and this build-up can pull the retina away. Breaks can be caused by posterior vitreous detachment (PVD), which occurs when the vitreous gel in the eye pulls away from the retina. Thinning of the retina with age can also cause retinal detachment, and those who are very near-sighted may be at higher risk of experiencing this condition. Trauma to the eye, previous eye surgery, and diabetic retinopathy can also lead to retinal detachment.
Diagnosis Of Retinal Detachment
A GP or optometrist will be able to diagnose retinal detachment, and to do so, they will examine your symptoms and test your vision. Tests will include looking into the back of your eyes with an ophthalmoscope, and if they suspect retinal detachment is present or your retina is at risk of detaching, you will be immediately referred to an ophthalmologist. You may then have to undergo further tests such as an ultrasound to confirm a diagnosis. As you will not be able to drive, you should make arrangements to travel to your appointment as soon as possible.
How Is It Treated?
Surgery is required to reattach your retina to your eye.
There are three surgical procedures that can achieve this, and which is used will depend on the severity of your condition, how large an area is affected, and how soon you have sought treatment. One procedure is called a Vitrectomy, during which the vitreous fluid found at the back of your eye is removed, and replaced with a gas bubble that will temporarily hold your retina in place during the healing process. During scleral buckle surgery, an ophthalmologist will attach synthetic material to the outside layer of your eye to apply pressure, which will cause the inside wall of your eye to indent. In doing so, it will push against the detached retina to place it into a position that can help it reattach. The area around this hole will then be closed using a laser or cryotherapy.
Pneumatic retinopexy is a procedure during which a small gas bubble can be injected into your vitreous over the site of the area of detachment. The bubble will press the retina back into place, and the hole will again be sealed using either cryotherapy or a laser. This procedure will be possible only if the retinal detachment occurs over just a small area.
Recovery and Aftercare
Following the procedure, you will be provided with corticosteroid eye drops to reduce inflammation, along with antibiotics to fight infection.
If your procedure involved fitting a gas bubble, you may be asked to assume a position during which your head is kept face down, a recovery procedure known as posturing. This keeps the gas bubble in place and applies the appropriate amount of pressure, and you may need to do this for up to 10 days following the operation. During this period, or as long as the gas is present in your eye, you may experienced blurred vision. This will dissipate as the gas is reabsorbed into your eye, and it’s important to note that you won’t be able to travel via airplane during your recovery period. This is because changes in the air pressure will affect gas bubble and increase the pressure bing applied, which can damage your eye.
If the retinal detachment has affected your central vision, it may take up to a year for your vision to be fully restored to normal. If you have had a minor case of retinal detachment, a full recovery could take place in as little as six months, while in serious cases, your vision may never return to normal.