Retinal tears or detachment

I feel some parts of my vision are blocked. Oh no, is it retinal detachment?

Sudden onset or increase in the number of floaters, flashes and appearance of a curtain over the field of vision may be the warning signs of a retinal problem such as retinal tear or detachment. A retinal detachment is a medical emergency. Anyone experiencing its symptoms should see an eye doctor immediately.

 

What happens in retinal detachment?

The retina is the light sensitive tissue that lines the inside of the eye and is responsible for maintaining proper vision. It works like the film of a camera, where visual images are converted into electrical impulses before they are sent to the brain via the optic nerve. Retinal detachment occurs when the retinal tissue is separated from the inside wall of the eye. If not treated promptly, retinal detachment can lead to permanent vision loss.

How does it happen?

There are three different types of retinal detachment:

RhegmatogenousTractionalExudative
This is the most common type of retinal detachment. It occurs when fluid gets underneath the retina through areas of untreated retinal tears hence separating it from the underlying layer that nourishes the retina.
This type of detachment occurs when there is a scar tissue on the surface of the retina that contracts and pulls the retina away from its underlying layer.
In this case, fluid leaks into the area underneath the retina without the presence of any retinal tears or breaks. It is mostly caused by inflammatory disorders, injury or trauma to the eye or presence of vascular abnormalities.

Who gets retinal detachment?

Retinal detachment can occur at any age, though you are more likely to develop the condition if you:

  • Are short-sighted 
  • Have history of injury or trauma to the eye
  • Have family history of retinal detachment

What can be done?

The commonest type of retinal detachment is caused by first having retinal tear. That is why if we want to catch the problem at an early stage before it develops into a full blown detachment, consult an eye doctor urgently when you see floaters. Retinal tears can be silent and are picked up during an eye screening. The treatment is so much simpler for a retinal tear. 

Small retinal tears are treated with laser procedure or a freeze treatment called retinal cryotherapy. The laser procedure is usually performed in the clinic to seal the area around the tear back into its place. As it takes about two weeks for the treatment to seal the tear, the risk of retinal detachment still exists during this period. Your doctor will arrange for a review visit after 2 weeks to ensure that the laser burns on the retina are healing well.

If your retina has already detached, your eye doctor will perform surgical procedures that may include one or more of the following:

  1. Scleral buckling that involves the use of a tiny synthetic band that is tightened around the eyeball to gently push the wall of the eye against the detached retina.
  2. Vitrectomy is the surgical removal of the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain its round shape. It is often performed in combination with injection of gas bubble or silicone oil into the eye to push the retina back against the inside wall of the eye. You will be required to stay in a certain posture following the injection to position the gas bubble right at the detached retina. You will not be allowed to travel in an airplane until the gas bubble disappears. Air travel is permissible with silicone oil. Your eye doctor will explain which is the better option for you.

In all the procedures, either laser treatment or retinal cryotherapy will be performed to seal the area around the retinal tears. The EyeClinic has its own treatment room where laser procedures can be performed on the same day.

Will my vision improve after the surgery?

Over 90 percent of retinal detachments can be successfully treated. Sometimes a second treatment is needed if scarring occurs as part of the healing process, leading to a re-detachment.

The visual outcome is not always predictable. The earlier the diagnosis and intervention, the better the visual outcome. The final visual result may not be known for up to several months following surgery. It is important to note that under the best of circumstances and after multiple attempts at repair, treatment may sometimes fails and vision may eventually be lost.

That is why it is important to contact an eye doctor immediately if you ever notice a sudden or gradual increase in the number of floaters, flashes or a dark curtain over the field of vision. Early treatment saves sight.

All short-sighted people should have a dilated eye exam to check their retina once a year.  Retinal tears can be silent and are picked up during an eye screening. 

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