Retinal detachment treatment
Retinal detachment is a rare and urgent ophthalmic condition that requires immediate treatment to prevent blindness. The signs are flashes of light or dark spots on one or both eyes. The treatment is exclusively surgical and has a high chance of success. Doctors offer retina surgery - a laser operation aiming to restore vision.
The retina makes up the inner lining of the eye - a thin nerve tissue. Retinal detachment occurs when the retina separates from the tissues that support it. This layer is vital for vision because light beams pass through the eyes straight to the retina. Retinal cells convert light into neural impulses that reach the brain and are recognized as images. In ophthalmology, this disease is dangerous because untimely treatment can cause vision loss. In addition, due to detachment, retinal cells do not receive the necessary nutrients and oxygen and die.
Statistics indicate that every year 5-20 people per 100,000 are diagnosed with retinal issues. Also, retinal detachment is a leading cause of blindness.
Ophthalmologists distinguish between several types of retinal detachment, among them:
- Rhegmatogenous - occurs when the retinal breaks. In this case, detachment can appear from several hours to several months.
- Serous or exudative - fluid accumulation in the layer in front of the retina contributes to its separation. Inflammatory processes or tumours might be a reason for this.
- Traction develops due to scars. This type is often related to diabetes, previous surgeries, or premature babies.
- Detachment of retinal pigment epithelium - happens when fluid accumulates under the retinal pigment layer. It may be due to complex eye disorders.
In general, this disease is quite rare. The most common form is rhegmatogenous, which affects one in 10,000 people annually. According to the data, the elderly and people with severe myopia are more likely to suffer from retinal detachment.
It is worth mentioning that a retinal hole is a minor defect within the retina that may precede its complete rupture or detachment. This condition sometimes is an impressive risk factor for retinal detachment.
What is the cause of retinal detachment?
In general, older age is the most common risk factor for retinal separation, but there are other factors:
- Eye injury;
- Genetic propensity;
- Myopia of a high degree;
- Rupture or retina detachment in the other eye;
- Condition after eye surgery (cataract or glaucoma surgery).
According to statistics, 40 to 50% of patients with retinal detachment have myopia, approximately 35% of people undergo surgery to remove the lens before a retinal break occurs, and 10-20% of cases have retinal trauma.
Examples of typical causes of retinal detachment:
- Eye injury;
- Eye tumours;
- Rheumatoid arthritis;
- Physical overexertion;
- Postoperative complications;
- Systemic lupus erythematosus;
- Inflammatory processes of the eye;
- Diabetic retinopathy (damage to the retinal vessels due to long-term diabetes).
Often retinal issues are painless. With a detachment, ophthalmologists divide the symptoms into two stages:
- Initial signs - flashes of light, a distorted picture, dots or flies before the eyes.
- Real symptoms are a blur before the eyes, a sharp deterioration in vision, and eye discomfort.
The retina can be permanently damaged depending on how long this condition lasts. Therefore, the worst case might cause blindness in the affected eye.
Diagnostic tests for a detached retina
Early eye diagnosis in case a doctor suspects retinal detachment can prevent vision loss. Diagnostics are carried out quickly since time is of the essence. It includes ophthalmoscopy, examination using an ophthalmic lens and a special microscope. The method is valuable because a doctor identifies damage and determines the detachment's degree and localization. If the condition is not critical, then ophthalmologists perform other diagnostic options:
- Measurement of eye pressure, its increase may indicate serious diseases.
- Perimetry to determine defects or narrowing of the visual fields.
- Eye ultrasound to identify cataracts or scars, which may be the cause of detachment.
- Optical coherence tomography takes pictures of the retina. Today it is the most accurate imaging method.
Eye doctors always examine both eyes, even if signs of retinal detachment are present in one.
How is retinal detachment treated?
Eye surgery is the method of choice for treating detached retinas and the conditions that precede it (breaks and holes). If gaps or holes occur in the retina that has not yet led to a detachment, these two methods are widely used:
- Laser surgery (so-called photocoagulation). The ophthalmologist conducts a laser beam through the pupil. The heat creates scars that anchor the retina to the underlying tissue.
- Cryopexy (freezing). The nature of the technique is the same as in laser surgery, only this procedure uses low temperature to create scars and fix the retina.
With direct retinal detachment, ophthalmologists offer several types of surgery:
- Pneumatic retinopexy means putting some air or gas into the eye. A doctor uses a laser or freezing to repair a retinal break.
- Scleral buckling - a surgeon sews the silicone material to the injury site. It does not interfere with vision and can remain in the eye forever.
- Vitrectomy - a surgeon removes the accumulated fluid and then fills the space with air, gas, or a particular substance to flatten the retina. Sometimes, a second surgery is required a few months after this procedure to remove the special fluid that the doctor uses during a vitrectomy.
Vision usually improves within a few months after retinal surgery. However, in some cases, a second procedure is necessary. Unfortunately, rarely eye vision couldn't be restored entirely due to too late seeking medical help.
Can I see again after a detached retina?
In general, the prognosis for vision restoration is favourable. A timely surgical cure is successful in 80-90% of cases. Early treatment increases the chances of repairing vision.
Unfortunately, in 10-15% of people with retinal detachment, the same problem happens in the other eye (if it was previously in one eye).
What is the treatment for retinal detachment?
Treatment of retinal detachment is only surgical and contains various methods. It includes pneumatic retinopexy, scleral buckling and vitrectomy.
Can I have retinal detachment surgery abroad?
Yes. Health care abroad has specialized clinics for the treatment of eye diseases. In addition, therapy for retinal detachment is carried out in hospitals with the latest ophthalmological equipment and trained and experienced specialists.
What types of retinal detachment surgeries are used in clinics abroad?
In the treatment of retinal detachment, doctors abroad use several surgical methods: pneumatic retinopexy (gas or air fills the eye and pushes the detached part of the retina back), scleral buckling (a surgeon stitches a bit of silicone over the site of retinal break to the sclera) and vitrectomy (removal of the scrofulous body, so also called eye fluid, filling the space with particular substances that push the retina back into place).
Can I prevent blindness after retinal damage?
Yes. Having an appointment with a doctor as soon as possible helps prevent damage to the retina. The most helpful thing you can do is to seek help from an ophthalmologist within 24 hours of the onset of the first symptoms. Early detection of the problem dramatically reduces the risk of blindness.
What is the success rate of retinal surgery?
The success rate for retinal surgery is approximately 90%. Only 10-15% of cases require a second operation.
Where can I get Retinal detachment treatment?
What are the best clinics for Retinal detachment treatment?
Who are the best doctors for Retinal detachment?
Prof. Dr. med. Mathias Maier from University Hospital rechts der Isar Munich
Dr. med. Detlef Deiermann from Academic Hospital Bundeswehr Berlin
Dr. med. Gerhard Siebenhuner from Centre of Advanced Medicine Frankfurt am Main
Prof. Dr. med. Thomas Kohnen from University Hospital Frankfurt am Main of Goethe-University
Prof. Dr. med. Siegfried Priglinger from University Hospital Ludwig-Maximilians Munich