Retinal detachment guide

02/10/2022
02/10/2022

Icon editWhat is retinal detachment?

To understand the disease of the retina, you must first understand what the retina is. The retina is a layer of nerve cells that lines the back wall inside the eye that senses light and sends signals to the brain so a person can see.

What is retinal detachment?The retina is attached to the back of the eyes by a clear gel called the vitreous body. This gel is located inside the eyeballs and maintains a round shape. Sometimes, the vitreous body in the eyeball may begin to shrink or become smaller. It causes the eyeball to change its shape, pulling the retina.

However, retinal detachment occurs when the vitreous pulls on the retina so much that it pulls away from the eyeball. Also, if the fluid gets between the eyeball and the retina, it can cause a detachment.

A detached retina can no longer do its job of sending light signals to the brain, which can lead to altered or permanent loss of vision.

Icon microscopeDiagnostic tests

Retinal detachment is a relatively rare but severe eye condition that affects vision and can lead to blindness if left untreated. The disease has many causes, but ageing or eye injury is the most common.

The retinal disease does not cause eye pain or a headache but changes eyesight. For instance, the most common warning sign is sudden flies in the eyes. It may look like a waterfall of floating objects sliding into view. The patient may also experience:

  • Flashes of light in one or both eyes;
  • A shadowy veil over your field of vision;
  • Decreased peripheral (lateral) vision;
  • Sudden blurred vision.

Symptoms of retinal disease often appear quickly. However, if the condition is not treated immediately, a large portion of the retina can detach, increasing the risk of permanent vision loss or blindness.

An eye examination is required to effectively diagnose retinal detachment. First, the ophthalmologist examines the retina, having expanded the vision. For this, special eye drops are used to dilate the pupil. A few minutes after the application, the eye doctor can examine the fundus carefully.

For a more precise and detailed examination, the doctor may recommend other tests:

  • Optical coherence tomography - the eye is scanned by using special equipment.
  • Ultrasound examination of the eyes - ultrasonic waves and a unique device help to scan the inner structures of the eye.

It is essential to understand that retinal disease does not go away unaided. Therefore, diagnosis and further treatment are critical to maintain or restore the vision. With rapid action, the treatment of retinal detachment is predominantly successful. However, vision may take some time to recover, and partial damage may be permanent in severe cases.

Icon doctorTreatment methods

Almost all patients with retinal problems require surgery to return to normal life. The surgery is usually carried out on an outpatient basis, and patients can return home the same day. Without the operation, the retina may lose its ability to function, possibly leading to complete loss of vision. The surgical method used to restore a retinal detachment depends on its nature. The main types of surgery are scleral buckle, pneumatic retinopexy, and vitrectomy.

Scleral buckle - The doctor applies a tiny, flexible bandage to the white part of the eye, called the sclera. Then, the tape uses gentle pressure to the sides of the eye, which helps the retina reattach. The application will remain on the eye after the operation forever.

Pneumatic retinopexy - used for a small tear that is easy to close. The ophthalmologist injects a tiny bubble of gas into the vitreous. The bubble presses on the upper part of the retina, closing the gap. Sometimes you will need to keep your head in a specific position for several days for the bubble to stay in the right place.

Vitrectomy is used for large tears and is usually performed on an outpatient basis. During the operation, the following steps are taken:

  • a small incision is made in the sclera of the eye;
  • the vitreous body is surgically removed;
  • a bubble of air, gas or oil is placed in the eye, with the help of which the retina returns to its place.

The procedure is generally painless and may cause some discomfort. On the same day, the patient can leave the hospital. An eye patch and avoiding strenuous activities will be required for a few days.

Icon plusNew treatments options

The goal of treating a retinal detachment is to reattach the retina to the back of the eye and seal the breaks or holes that caused the detachment. To eliminate the disease, doctors can use several more approaches:

Laser surgery (photocoagulation) is the most advanced procedure. This surgery is designed to repair the retina and treat the underlying cause of the detachment. Used when the reason is a problem with the vitreous body in the eyeball. The laser burns through the tear, leaving scars that attach the retina to the back of the eye.

Another option is cryopexy (freezing with extreme cold). For this treatment, the eye doctor will place a freezing probe on the patient's eye over the site of the retinal tear, and the resulting scarring will help hold the retina in place.

The bionic retinal implant is the last word or a technical breakthrough in ophthalmology. The procedure involves surgically inserting a 2mm microchip under the centre of the retina and putting on a pair of special video glasses connected to a computer on the belt. The chip transmits the visual data recorded by the glasses to a computer that uses artificial intelligence algorithms to process it and then instructs the glasses to focus on the main subject. The glasses transmit this data to a chip, which converts it into an electrical signal. This signal then travels through the cells of the eye and optical cells to the brain, where it is interpreted as if it was a natural vision.

Icon chartStatistics and prognosis

In most specialized eye centres offered by AiroMedical specialists, about nine out of ten retinal detachments are successfully treated with a single operation. In other cases, repeated retina detachment occurs, and a second operation is required. The final success rate is over 95%.

How to choose the type of treatment? Only an examination by an experienced ophthalmologist and an assessment of the retinal tear will give recommendations and help make the right choice. Very often, treatments can be combined. For example, laser surgery or cryopexy may be used in addition to pneumatic retinopexy, scleral buckling, or vitrectomy. It is also possible to combine scleral filling and vitrectomy.

Whether vision returns depends not only on the success or failure of the operation but also on the detachment's duration, extent, and location. For example, suppose the macula (the part of the retina responsible for central vision) is detached. In that case, it is unlikely that full vision will ever return, even if a successful operation.

However, the most valuable thing is to know and remember that retinal detachment does not heal on its own. Therefore, it is essential to get medical attention as soon as possible so that the patient has the best chance of maintaining their vision. If you have any symptoms of this condition, complete a form with AiroMedical.

References:

  1. NIH: Surgery for Retinal Detachment
  2. WebMD: Retinal Detachment
  3. Healthline Media: What Causes Peripheral Vision Loss, or Tunnel Vision?
  4. Health Navigator: Retinal detachment
  5. The Foundation of the American Society of Retina Specialists: Retinal Detachment