Retinal Detachment
A retinal detachment is a serious event in which the retina is pulled away from its normal position and the tissue underneath it. The retina cannot operate in this abnormal position, vision becomes blurred. Permanent vision loss can occur if a retinal detachment is not repaired immediately, and if untreated, blindness may occur.
Causes
There are several things that may cause a retinal detachment. As people age, the vitreous may move away from the retina. This usually does not cause any problems, but if the vitreous pulls off of the retina hard enough, the retina will tear. If fluid then passes through the tear, the retina will be lifted up from the back of the eye.
Injuries to the face or eyes may cause the retina to detach. Also, people who are very nearsighted have longer eyes than normal. This elongation of the eye causes the retina to be more fragile and to detach more easily. Retinal detachments can also occur as a result of LASIK surgery, although this is rare. Cataract surgeries and eye diseases can cause retinal detachments. For example, in diabetic retinopathy, abnormal blood vessels may grow under the retina, causing it to pull away from the back of the eye. A previous retinal detachment in the other eye, glaucoma, and a family history of retinal detachment put you at risk for a retinal detachment.
Treatment
If a retinal tear is present, repair is done either by laser surgery or cryotherapy (freezing). Both of these methods seal the retina back in place, and cause little pain. These treatments can be done in a retina specialist’s office, and usually prevent retinal detachment.
Nearly all retinal detachments must be repaired by some form of surgery. These surgeries are done in a hospital, and you can go home that same day. Laser photocoagulation can be used to reattach a retina. (see laser photocoagulation) Another method of repairing a detached retina is pneumatic retinopexy. (see pneumatic retinopexy) A scleral buckle may also be used. (see scleral buckle)
In this procedure, the vitreous gel is surgically removed. This is done in order to relieve the pulling on the retina, or to make it easier for the retina specialist to work with the retina. Once the vitreous is removed, the retina specialist can use laser photocoagulation to reseal the retina. The vitreous gel is replaced, either with a gas bubble or silicone oil. Your body will gradually replace the vitreous over time.
After retinal reattachment surgery, you will experience some discomfort. Your retina specialist may prescribe you medications and will give you specific directions on your daily activities. You may have to wear a patch over your eye for a short amount of time. If you have a gas bubble in your eye, it is important that you not fly on an airplane or travel to places of high altitude until the gas bubble has disappeared. It is very important that you follow the directions given to you by your retina specialist. As with any surgery, there are risks involved in repairing a detached retina. Among these risks are infection, bleeding, high pressure in the eye, and cataracts. A detached retina that goes untreated will result in permanent vision loss, and possibly blindness. If you follow the post-operative directions carefully, the risks of surgery will be reduced and are less likely to have another retinal detachment. In some cases, a second operation is needed. Many patients find it helpful to get a new pair of glasses a few months after the surgery.
It may take several months after surgery for vision to improve, and it is possible that not all vision will be restored.
Because retina detachments often cause permanent vision loss or blindness if untreated, it is very important that you contact a retina specialist upon any symptoms of retinal detachment.