What is retinal detachment?
Retinal detachment is an eye disorder caused by the spontaneous detachment of the neurosensory retina (inner layer of the retina) from the pigment epithelium (outer layer).
It is also a serious eye disease, which can result in total vision loss if it is not treated in time. Choosing the most appropriate technique for each case is essential for the success of the treatment.
How can retinal detachment be prevented?
At-risk population should undergo eye examinations at least once a year.
It is important for patients in the high-risk group to undergo regular eye check-ups at least once a year.
In the event of a sudden appearance or increase of floaters, light flashes or any of the above symptoms, the patient should visit the ophthalmologist as a matter of urgency.
It is essential to diagnose the condition as quickly as possible, since prognosis is greatly improved if the macula or central area of the retina does not detach.
t is advisable to perform preventive laser treatment as soon as tears have appeared on the retina and before detachment has taken place.
Preventive laser treatment is also advisable for high-risk patients with peripheral retinal degenerative lesions that can eventually lead to a tear.
Retinal detachment Symptoms
As the condition does not cause pain and in many cases does not result in initial vision loss, it is important to be aware of the symptoms, even if they appear to be harmless. Typical symptoms and which usually appear succesively include:
- Floaters (black spots that move as the eye moves). They are caused by changes in the vitreous
- Light flashes. A highly significant symptom as it shows that traction is being exerted on the retina. They usually occur when the tear has already taken place
- Black curtain across a part of the visual field. This occurs when retinal detachment has already taken place. Patients should see the ophthalmologist immediately
- Distorted images followed by a significant decrease in visual acuity. This symptom occurs if the central area of the retina (macula) is damaged
Various surgical techniques exist, depending on the degree and stage of detachment.
- Laser photocoagulation. A laser is used to make controlled burns around the detached area. These burns eventually heal and seal the retinal tear, preventing the vitreous from seeping between the layers
- Vitrectomy. Vitrectomy consists of removing the vitreous from the inside of the eye. The retina is subsequently reattached using heavy liquids and lasered from inside the eye
- Scleral buckling. A solid silicone band is positioned around the outermost layer of the eye wall (the sclera) to maintain external pressure on the eyeball, enabling the tear to close
- Drainage of liquid. It is occasionally necessary to drain subretinal fluid through the sclera in conjunction with other retinal surgery. This is usually carried out at the end of the operation by injecting gas or air into the eye to keep the retina in place
Angiography is a technique used to delineate retinal or choroidal cases. Different contrasts are used, usually sodium fluorescein or indocyanine green. The scan is also useful for the diagnosis of other retinal diseases, such as pigment epithelium. In general, angiography is used to study many retinal diseases and their diagnosis.
Indocyanine green angiography is a technique used in some cases of AMD and serves to define the neovessels and, occasionally, to diagnose other diseases. Fluorescein angiography is the standard technique for studying blood vessel diseases and the retina in general.
It is a diagnostic technique to determine pathological and abnormal structures in the blood vessels and the different layers of the retina. It can be used in cases of macular degeneration, diabetic retinopathy, vasculopathy and many other macular disorders.
It is not counterproductive for any eye treatment.
Yes, after any eye operation, although it is advisable to wait several days for the scars to heal. It normally takes ten to twelve days to return to a normal life. It is always best to consult the doctor to find out about the risk factors.
The symptoms of a detached retina are the presence of flashes of light (photopsia) or objects floating in the vitreous humour and, occasionally, a progressive shadow and loss of vision. It is important to contact your ophthalmologist as quickly as possible. It is not an emergency, but it needs to be operated on as soon as possible by a surgeon.
In general, the patient can lead a normal life, unless there is gas inside the eye, in which case the patient should heed the advice of his doctor. Flying above 600–800 m and travelling over high mountain passes, either by train or car, should be avoided. If such needs arise, the ophthalmologist should be consulted.
The head should normally be tilted forward so that the gas does not contact the front of the eye, but the surface of the back of the eye. The length of time that the head should be kept in this position depends on the quantity of gas given.
If there is no gas or silicone oil, the patient can sleep in any position. If there is no covering element (gas or silicone oil), the patient’s position is unimportant.
When they have very little gas, i.e. one fifth or less in the eyeball, they can travel by air without a problem. If, however, they have a larger amount, they cannot fly, because the change in air pressure makes the gas bubble expand, which can cause ocular hypertension and damage the optic nerve.
IMO Institute of Ocular Microsurgery
GPS navigator coordinates:
41º 24’ 38” N – 02º 07’ 29” E
Exit 7 of the Ronda de Dalt (mountain side). The clinic has a car park with more than 200 parking spaces.
Autobus H2: Rotonda de Bellesguard, parada 1540
Autobus 196: Josep Maria Lladó-Bellesguard, parada 3191
Autobuses H2, 123, 196: Ronda de Dalt – Bellesguard, parada 0071