Retinal detachment

Retinal detachment is a separation of the layers of the retina from the inner surface of the eye. The detached retina fails to fulfill its function, that is why vision becomes blurry. Retinal detachment is a serious problem. Failure to start treatment immediately can result in loss of vision in the affected eye.

What is a retinal detachment?

Retinal detachment is a separation of the layers of the retina from the inner surface of the eye. The detached retina fails to fulfill its function, that is why vision becomes blurry. Retinal detachment is a serious problem. Failure to start treatment immediately can result in loss of vision in the affected eye.

Why causes the retina detachment?

With age, the vitreous decreases in size. When the eye moves, the vitreous moves relative to the retina and does not cause problems. However, in some people, the vitreous does not detach from the retina and can cause retinal ruptures. As a result, through the rupture, the liquid enters under the retina, and it detaches from the inner surface of the eye.

Terms

Retina is a layer of nerve cells, located on the inner surface of the eye. The retina senses light and sends signals to the brain, with images formed out of these signals in the brain.

Vitreous  is a transparent gel filling the eye cavity from the inside.

«Spots» in front of the eyes are small clumps of cells or certain substances in the vitreous which appear as small moving dots, lines, or clouds in the field of vision.

Who is at increased risk of retinal detachment?

Risk factors for developing retinal detachment:

  •  myopia (poorly seeing distant objects without glasses)
  •  surgery for cataracts, glaucoma, or previous eye surgery;
  •  using medications for glaucoma which constrict the pupil (pilocarpine, etc.)
  • serious eye injury;
  • tear or detachment of the retina in the second eye;
  • retinal detachment in close relatives;
  • weak points on the retina (they can be detected by an ophthalmologist during examination).

Early symptoms of retinal detachment

In case of retinal detachment, you should immediately see an ophthalmologist, otherwise you can lose vision in the affected eye. See your ophthalmologist immediately if you notice any of these symptoms.

  • Sudden flashes in front of the eye. Sometimes patients have glints in the eye, as if from a blow to the eye.
  • Seeing numerous spots in front of the eye – dots, lines or spirals.
  • A shadow at the periphery of the field of vision.
  •  Part of the field of vision is obscured by a grey veil.

How is retinal detachment diagnosed?

The ophthalmologist will examine the retina with a special lens after dilating the pupil with eye drops.

How is retinal detachment treated?

Retinal detachment is subject to surgical treatment. Here are some of the surgical procedures to be performed in case of retinal detachment.

Pneumatic retinopexy. The ophthalmologist inserts a bubble of gas into the eye. The bubble presses the retina against the inner surface of the eye to snap it back into place. After this surgery, your doctor will ask you to keep your head in a certain position for several days for the bubble to stays in the right place. Gradually, as the retina adheres, the bubble will dissolve, and the eye will fill with its own intraocular fluid.
Vitrectomy.The ophthalmologist removes the vitreous, which tightens the retina. Instead of the vitreous, a bubble of medical air, gas, or silicone oil is injected into the eye. This bubble presses the retina against the inner surface of the eye for the retina to adhere. If a bubble of silicone oil is injected into the eye, it is necessary to remove it a few months. If a bubble of medical air or gas is injected into the eye, you are prohibited to fly by air, climb to a great height and to dive, because during a rapid climb, the gas bubble increases in size and leads to a higher intraocular pressure. For some time, you should to keep your head in a certain position for the bubble to press the retina to the inner surface of the eye.
Extrascleral buckling. A small seal (tape) made of rubber or soft plastic is sutured to the outside of the eye, which presses on the eye and promote adherence of the detached retina. Usually, this buckling is left in the eye, as it is not visible to people around.

 What complications can there be after retinal detachment surgery?Each operation can lead to complications, but if you do not treat retinal detachment, you can quickly and permanently lose your vision. The ophthalmologist will inform you of possible postoperative complications, as well as of the predicted result which the operation can bring.

What to expect after surgery?

  • You will feel some discomfort for several hours after the operation. You will be given painkillers.
  • Rest more and avoid excessive activities for several weeks after surgery. The ophthalmologist will explain when you will be able to go in for sports, drive a car and start other activities.
  • After the surgery, the eye will be covered with a sterile bandage. Do not remove this bandage without your doctor’s permission.
  • If a bubble of gas or silicone oil is injected into the eye, you need to keep your head in a certain position for a while – usually for 1 or 2 weeks. The doctor will explain in what position the head should be kept. Be sure to follow these guidelines for the retina to adhere.
  • For several weeks after the surgery, you will see spots and flashes in front of your eyes.
  • Improvement in visual acuity usually begins four weeks after surgery. Stabilization of visual acuity may occur only in a few months. Visual acuity after surgery will depend on the extent of damaging cells of the detached retina.

 Summary

Retinal detachment is the separation of the layers of the retina from the inner surface of the eye. Retinal detachment is accompanied by numerous spots and flashes in front of the eye or shadows at the periphery of the field of vision. Part of the field of vision can be obscured by a grey veil. If you notice any of these symptoms, see your ophthalmologist immediately.
To return the detached retina to its place, surgical treatment is used.
A bubble of gas or silicone oil may be injected into the eyes and press the retina against the inner surface of the eye. In order for the retina to adhere, you should follow the instructions of the ophthalmologist after the operation.

For eye diseases or decreased visual acuity, be sure to consult an ophthalmologist. The doctor will make every effort to preserve or restore your vision.

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