Green Eye Up Close - Retinal Detachment

There are a lot of different eye conditions that people can experience today. One of the more serious conditions is retinal detachment. There are a number of different reasons why this can occur, and if this happens to you, you may be a bit worried. However, in this blog post, we will help you to understand everything you need to know about retinal detachment. This not only includes how it happens but also what treatment options are available to you. 

What is retinal detachment?

The retina is required for you to see properly. It is a thin layer of nerve cells that lines the inside of the eye and is sensitive to light. Retinal detachment tends to occur as part of the natural ageing process, although there are other retinal detachment causes. This is when your retina has one or more holes that allow the vitreous to pass underneath it and lift off. If this condition is not treated, it can result in blindness in the affected eye, which is why retinal detachment surgery is a must.  

What causes retinal detachment? 

There are three distinct causes of retinal detachment, which are as follows:

  • Exudative – Exudative detachment does not occur due to a break or a tear. Common causes include Coats’ disease, cancer behind your retina, and an inflammatory condition that results in fluid that will accumulate behind your retina. 
  • Tractional – This type of retinal detachment occurs when the scar tissue that is on the retina surface contracts, which causes the retina to pull away from the back of your eye. This tends to affect people with diabetes mellitus, and is one of the less common types of detachment. 
  • Rhegmatogenous – This condition occurs when there is a hole or tear in the retina, which allows fluid from within your eye to slip through it and reach behind your retina. This results in the retina separating from the retinal pigment epithelium – this is the membrane that will provide nourishment and oxygen for your retina. This is the most common form of retinal detachment. 

There are various different factors that could make you at a heightened risk of retinal detachment. This includes:

  • Diabetes mellitus
  • Complications from cataract-removal surgery
  • Prior history of retinal detachment
  • Being over 50-years-old
  • Trauma to your eye
  • A family history of retinal detachment 
  • Extreme nearsightedness
  • Posterior vitreous detachment 

Symptoms of retinal detachment 

The following are warning signs that you could be experiencing retinal detachment:

  • The blurring of your vision or distortion of vision, even when you are wearing your glasses this would occur
  • Sudden short flashes of light in the affected eye, which don’t last any longer than a second
  • A cobweb effect of many small floaters – other people have reported a large, single black floater, which has the appearance of a housefly
  • The sudden appearance of floaters – black streaks, specks, or dots, which float across your field of vision

If you notice any of the symptoms of retinal detachment that have been mentioned above, it is important to see a doctor as soon as possible. If retinal detachment is not seen to, it can result in complete loss of vision in the affected eye.

If your GP suspects that you are suffering from retinal detachment, it is highly likely you will be referred to an ophthalmologist that day. The specialist will use a slit lamp and ophthalmoscope (a magnifying glass connected to a light) to study the back of your eye. If there is a poor view of the retina, they may use an ultrasound to figure out whether or not you have a retinal detachment. 

Retinal detachment treatment 

It is vital that retinal detachment is treated as quickly as possible due to the risk of losing some or all of your vision in the affected eye will increase the longer you leave it. There is only one form of retinal detachment treatment, and this is surgery. Prior to the surgery, you will need to avoid eating and drinking for six hours, and you will be given general/local anesthetic. There are three types of retinal detachment surgery, as explained below:

Pneumatic retinopexy 

Pneumatic retinopexy is a procedure that tends to be used when the detachment is relatively uncomplicated and small. It involves a small bubble of gas being injected into the eye, which presses the retina back into place. To keep the retina in the right place, laser treatment or freezing is often used to generate scar tissue. Over the following weeks, the bubble will slowly be absorbed into the eye. If you require any other type of operation that demands general anesthetic, you need to tell your doctors about the gas bubble in your eye. 

Scleral buckling

This involves using fine sponge or silicone rubber bands that are stitched onto the sclera, which is the outside white of the eye. They will be stitched onto the area where the retina has detached. The bands enable the torn retina to lie against the eye’s wall, as they act like a buckle, pressing the sclera towards the middle of the eye. Laser treatment or freezing is then utilized to scar the tissue around the retina. This makes a seal between the wall of the eye and the retina to close up the hole or tear.

Vitrectomy 

This is the most popular type of retinal detachment surgery. It works by getting rid of the fluid that is inside the eye and replacing it with a silicone or gas bubble. This will hold the retina in position from inside. This option is usually recommended if the fluid in front of the eye is unusually dense and thick and is, therefore, pulling the retina away from the blood vessels underneath. To close the wound, the surgeon will use small dissolving stitches. In some cases, the surgery can be performed without stitches. This is something your ophthalmologist will advise on. 

Retinal detachment surgery recovery

There are several possible side effects following surgery, including:

  • Discomfort – If you experience any discomfort it is advisable to take paracetamol or a similar pain reliever. However, do not exceed the dose stated on the packaging.
  • Fluid leak
  • Itching, sticky eyelids
  • Bruising – You may experience slight bruising around the eyes, especially if you have undergone a scleral buckle procedure. 

The hardest part of the recovery process is posturing. However, it is also the most important. You need to sit or lie in a position that will keep your face down. This is so the silicone or gas bubble floats up and presses the retina into position. This is something your ophthalmologist will advise on.

You also need to avoid the following during retinal detachment recovery:

  • Rubbing your eye
  • Driving
  • Getting soapy water into your eye while washing your hair
  • Strenuous exercise 

In most cases, it will take about two-to-six weeks for your eyes to heal. It is normal for your vision to be very blurred immediately after surgery if a gas bubble has been used. If you have an increase of redness of the eye, loss of vision, or a lot of pain, you need to see a doctor as soon as possible.

Are there any risks?

As is the case with all surgeries, there are risks that you need to be aware of. Let’s take a look at some of the more serious, albeit rare, side effects that can occur:

  • Unsuccessful surgery – Every patient is different, and so retinal detachment surgery is not always a success. 
  • Cataracts 
  • Allergies to the medication that has been used
  • Double vision
  • Inflammation inside the eye
  • High pressure inside the eye
  • Bruising of the eyelids or the eye

There is a five to ten per cent risk that you will need further surgery. If you fall into this category, it means that you will have developed scar tissue or another retinal hole. The former tends to occur when the eye tries to naturally heal the damage, which ends up being a hindrance rather than a help. This can result in second surgery being required.

Hopefully, you now have a better understanding of retinal detachment. If you are worried that you may be suffering from this condition, it is imperative to book an appointment with a doctor as soon as possible. While you may be feeling worried, it is important to know that there are a number of treatment options out there, and the sooner you act, the better. We hope this guide has helped to shed light on the options that are available to you and give you all of the details you need.

 

Eye Conditions: Retinal Detachment

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