Retinal Detachment

 

Retinal Detachment

Definition

A detached retina is a serious and sight-threatening event, occurring when the retina becomes separated from its underlying supportive tissue. The retina cannot function when these layers are detached.

Source : All About Vision 

 

Organ

This disease affects the retina.

 

Symptoms

Symptoms include a sudden or gradual increase in either the number of floaters, which are little “cobwebs” or specks that float about in your field of vision, and/or light flashes in the eye. Another symptom is the appearance of a curtain over the field of vision. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.

Source : NEI 

 

Causes

The most common cause of retinal detachment is tiny breaks developing inside the retina.

The breaks allow the fluid found between the retina and the lens of the eye to leak underneath the retina.

A build-up of fluid can cause the retina to pull away from the blood vessels that supply it with blood. Without a constant blood supply, the nerve cells inside the retina will die.

These breaks are thought to develop due to:

  • a posterior vitreous detachment (PVD) – which is a normal ageing phenomenon when the gel of the eye pulls off from the retina
  • thinning of the retina

Very short-sighted people have the greatest risk of developing age-related retinal detachment (though the risk is still very small) because they are often born with a thinner than normal retina in the first place.

Previous eye surgery, such as cataract removal, may also make the retina more vulnerable to damage.

In some cases, a tear can develop if the eye is suddenly injured, such as by a punch to the face. 

Source : NHS

 

Evolution

Without treatment, sight in the affected eye will start to deteriorate. Most people describe this as a shadow or "black curtain" spreading across their vision.

Retinal detachment usually only occurs in one eye. If your eye is affected, there is an up to one in 10 chance that retinal detachment will happen in your other eye.

Source : NHS 

 

Prevention

Make sure you see an eye doctor immediately if you develop new floaters, flashing lights or any change in your vision.  Early is always better than later in treating retinal tears, detachments and other serious issues. 

Getting an eye exam can flag early changes in your eyes that you may not have noticed. Treating those changes can help.

You should get your eyes checked once a year, or more often if you have conditions such as diabetes that make you more likely to have eye disease. Regular eye exams are also important if you are very nearsighted, as nearsightedness makes retinal detachment more likely.

If you have diabetes or high blood pressure, keeping those conditions under control will help the blood vessels in your retina, which is good for your eyes. 

Source : WebMD

 

Diagnosis

Your ophthalmologist can diagnose retinal tear or retinal detachment during an eye examination where he or she dilates (widens) the pupils of your eyes. An ultrasound of the eye may also be performed to get additional detail of the retina.

Only after careful examination can your ophthalmologist tell whether a retinal tear or early retinal detachment is present.

Some retinal detachments are found during a routine eye examination. That is why it is so important to have regular eye exams.

Source : AAO 

 

Treatment

Surgery is required to repair a detached retina. The procedure is usually performed by a retinal specialist — an ophthalmologist who has undergone advanced training in the medical and surgical treatment of retinal disorders.

Generally, the sooner the retina is reattached, the better the chances that vision can be restored.

Surgical procedures used to treat a retinal detachment include:

Scleral buckling surgery. This is the most common retinal detachment surgery, and consists of attaching a small band of silicone or plastic to the outside of the eye (sclera). This band compresses (buckles) the eye inward, reducing the pulling (traction) of the retina and thereby allowing the retina to reattach to the interior wall of the eye.

The scleral buckle is attached to the posterior portion of the eye and is invisible after surgery.

Scleral buckling surgery often is combined with one of the following procedures to fuse the retina to its underlying supporting tissue (called the retinal pigment epithelium, or RPE).

Vitrectomy. In this procedure, the clear jelly-like fluid is removed from the posterior chamber of the eye (vitreous body) and replaced with clear silicone oil to push the detached portion of the retina back onto the RPE.

Pneumatic retinopexy. In this procedure, the surgeon injects a small bubble of gas into the vitreous body to push the detached portion of the retina onto the RPE.

If the detachment is caused by a tear in the retina, the surgeon usually uses a laser or a freezing probe to "spot weld" the retina firmly onto the RPE and underlying tissues and thereby seal the tear. If a laser is used, this is called laser photocoagulation; use of a freezing probe is called cryopexy.

Surgical reattachment of the retina isn't always successful. The odds for success depend on the location, cause, and extent of the retinal detachment, along with other factors.

Also, successful reattachment of the retina doesn't guarantee normal vision. Generally, visual outcomes are better after surgery if the detachment is limited to the peripheral retina and the macula is not affected.

Source : All About Vision 

 

Images

  Slit lamp photograph showing retinal detachment

 Slit lamp photograph showing retinal detachment in Von Hippel-Lindau disease EDA08

SourceBy National Eye Institute/National Institutes of Health [Public domain], via Wikimedia Commons

 

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