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). When detachment occurs, fluid accumulates in the space left between the two layers and the detached retina cannot function or nourish itself properly. If left untreated, retinal detachment can eventually lead to a complete loss of eye function (blindness).
|Diagram of a normal eye|
|Diagram showing a retinal detachment|
What causes it?
Retinal detachment can occur as a complication following damage caused by the vitreous gel, which fills the eyeball, exerting traction on a fragile area of the retina. Other causes include:
- Serious inflammation
- Myopic macular hole in patients with high myopia
- Complications resulting from previous eye surgery
- Ocular trauma
- Diabetic retinopathy
If the patient has previously suffered from a detached retina or there is a family history, the disorder may reappear. It is therefore advisable to have regular check-ups with the ophthalmologist.
How can it be prevented?
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. It 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.
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
|Vision in a healthy eye|
|Vision with symptoms of retinal detachment|
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
- Are there any safety considerations when performing an angiography?
- Can a patient do sport or exercise physically after vitrectomy?
- Is it counterproductive for the patient to have an angiography when undergoing eye treatment?
- What are the symptoms of a detached retina and should it be treated as an emergency?
- What is angiography?
- What is the difference between indocyanine green and fluorescein angiography?
- What position should a patient with intraocular gas keep his head in?
- What position should a post-operative retina patient sleep in?
- What should a post-operative vitrectomy patient not do?
- When are patients with intraocular gas able to fly?
- Why is angiography useful?
- Can I fly after retinal detachment surgery?