Most Retinal Detachments occur following a retinal tear that allows fluid to move between the retina and the eye wall. In the area where the retina is detached, vision is lost. Retinal detachments are more common in the elderly, nearsighted people, individuals who have had eye surgery, or those who have experienced eye trauma. Retinal detachments often run in families.
Symptoms
Symptoms of retinal detachment may include flashes, floaters, or a dark curtain that causes loss of peripheral or central vision. Individuals who experience any of these conditions should consult with an eye doctor immediately. If a retinal detachment is discovered, surgical repair is critical to prevent permanent loss of vision.
Treatment
The techniques used to repair a retinal detachment include scleral buckling, vitrectomy, or pneumatic retinopexy. More than one technique may be used during a procedure. Depending upon the nature of the retinal detachment, the eye physician will determine the best repair methodology. Surgery is out-patient, meaning no overnight stay, usually performed using local anesthesia.
Scleral Buckling is a surgical procedure in which a piece of soft silicone material is sewn against the outside wall of the eye, creating an indentation which closes the retinal defect that caused the detachment. The surgeon may also drain accumulated fluid behind the retina. Laser or freezing therapy is then used to seal the retina back into place once it is reattached. The scleral buckle stays in place permanently and does not harm the eye.
Vitrectomy surgery involves the use of microscopic cutting instruments to remove the vitreous gel and any scar tissue present inside the eye. The fluid that created the retinal detachment is then drained through the existing retinal tear, thereby reattaching 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 visual function. The gas bubble is slowly absorbed, while the vitreous cavity fills with fluid normally produced by the eye.
Pneumatic Retinopexy is a technique where a gas bubble inserted into the vitreous cavity closes the retinal tear and pushes the detached retina back into position. A laser or freezing therapy is then used to seal the retina to the eye wall. A 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, while the vitreous cavity fills with fluid that is normally produced by the eye.
Prognosis
Using advanced equipment and modern techniques, the majority of retinal detachments can be successfully repaired. Visual improvement may be immediate or might take many months. The amount of vision recovered is variable, depending on many factors. Because the duration of a retinal detachment is a critical aspect in visual recovery, urgent evaluation is recommended.