Most retinal detachments occur following a retinal tear. The retinal tear allows fluid to move between the retina and the eye wall, creating a Retinal Detachment. In the area where the retina is detached, vision is lost. Retinal detachments are more common in the elderly, people who are nearsighted, individuals who have had eye surgery, or those who have experienced eye trauma. Retinal detachments often run in families.
Symptoms of retinal detachment may include flashes, floaters, or a dark curtain causing loss of peripheral or central vision. If you experience any of these symptoms, see your eye doctor immediately. If a retinal detachment is discovered, surgical repair is necessary to prevent permanent loss of vision.
Treatment The techniques used to repair a retinal detachment include scleral buckling, vitrectomy, or pneumatic retinopexy. Sometimes more than one technique is used at the same time. Your physician will determine the best repair technique, depending upon the nature of the retinal detachment. Surgery is outpatient, meaning no overnight stay, and is usually performed using local anesthesia.
Scleral Buckling is a technique in which a piece of soft silicone material is sewn against the outside wall of the eye. This creates an indentation that closes the retinal defect that caused the retinal detachment. The surgeon may also drain the fluid which has accumulated behind the retina. Laser or freezing therapy is used to seal the retina back in place once it is reattached. The scleral buckle stays in place permanently and does not harm the eye.
Vitrectomy Surgery is a technique in which microscopic cutting instruments are used to remove the vitreous gel and any scar tissue which may be present inside the eye. The fluid which created the retinal detachment is then drained through the existing retinal tear, which reattaches the retina. A temporary gas bubble holds the retina in position as laser or freezing treatment seals the retina to the eye wall. Removing the vitreous does not affect the function of the eye. The gas bubble is slowly absorbed and the vitreous cavity is filled by fluid normally produced by the eye.
Pneumatic Retinopexy is a technique in which a temporary gas bubble is inserted into the vitreous cavity and used to close the retinal tear and push the detached retina back into position. After the retina is back in position, laser or freezing therapy is used to seal the retina to the eye wall. The patient’s head position must be strictly maintained for about seven days to keep the bubble in contact with the area of detachment. The gas bubble is slowly absorbed, and the space it occupied in the vitreous cavity is filled by fluid normally produced by the eye.
Using advanced equipment and modern techniques, the majority of retinal detachments can be successfully repaired. Visual improvement may be immediate or may take many months. The amount of vision that is recovered is variable and depends upon many factors. Because the duration of the retinal detachment is an important factor in visual recovery, urgent evaluation is recommended.