Detached Retina (Retinal Detachment)

What is retinal detachment?

Retinal detachment is a condition that occurs when the retina, a tissue layer located at the back of the eye, separates from the tissues supporting it. This painless yet severe eye problem affects eyesight and can cause blindness.

The retina is responsible for sensing light and sending signals to the brain to enable vision. However, when it detaches from the tissues supporting it, blood supply is lost. Blood vessels in these tissues transport oxygen and nutrients to the retina.

You should contact an eye specialist or visit the emergency room immediately if you notice the following:

• Light flashes

• An increase in eye floaters

• Shadows in your vision

Since these symptoms could indicate a detached retina, do not wait till you experience pain. Your eye doctor will recommend starting treatment immediately.

Types of retinal detachment

The three forms of retinal detachment are:

• Rhegmatogenous: This is the most prevalent type of retinal detachment that typically occurs with age. A slight tear in the retina allows vitreous humor (gel-like fluid) to move through the rip and accumulate behind the retina. This pushes away the retina, separating it from the rear of the eye. As a person becomes older, the vitreous tend to thin and shrink, pulling on the retina and tearing it off.
• Tractional: This form of detached retina occurs when the scar tissue on the retina pulls it away from the back of the eye. The main cause of this condition is diabetes. Prolonged high blood sugar periods can damage the eye’s blood vessels, leading to scar tissue. These scars and traction or pulling areas can enlarge, detaching the retina from the rear of the eye.
• Exudative: Develops when fluid accumulates at the back of the retina without retinal tear. Fluid build-up pushes the retina away from the tissue that supports it. The common causes of fluid collection are swelling at the back of the eye or leakage of the blood vessels, often due to conditions such as uveitis.

What Are The Symptoms of Retinal Detachment?

Althoughsome individuals may experiencedetached retina symptoms, others do not notice any. The severity, however, depends on how large the area of the retina is detached.

Retinal detachment symptoms can occur suddenly and may include the following:

• Seeing light flashes (photopsia)

• Seeing many floaters, which are flecks, dark spots, threads, and squiggly lines drifting across the vision. It is, however, normal to occasionally see a few floaters, and this shouldn’t be a concern.

• Darkening of the side or peripheral vision

• Darkening or developing a shadow that covers part of the vision

 

What are The Causes of And Risk Factors for Retinal Detachment?

Some of the risk factors associated with retinal detachment are:

• Eye injury

• Aging

• A previous detached retina or family history of the condition

• Prior eye surgery

In addition, having particular eye problems increases the risks of a detached retina. They include:

• Severe near sightedness.

• Posterior vitreous detachment (pulling away the vitreous fluid in the centre of the eye from the retina).

• Conditions affecting the choroid or retina, including lattice degeneration (retina thinning) and diabetes-related retinopathy.

• Particular inherited eye conditions.

• Detachments or retinal tears history in the other eye.

Generally, it’s important to see a doctor if you think you have increased risks of developing retinal detachment. This will help establish an eye test schedule and receive advice on steps to take in order to protect your overall eye health.

What are the complications of this condition?

Retinal detachment is a serious problem that might lead to vision loss. Without immediate treatment, irreversible blindness can occur within a few days.

Diagnosis

How do healthcare providers diagnose retinal detachment?

To diagnose a detached retina, the eye doctor will first conduct an eye test and examine the retina using a dilated eye exam. Eye drops will be administered in the eyes to widen or dilate the pupil. Aftera few minutes, the physician will closely inspect the retina for any signs of detachment.

Following a dilated eye exam, other diagnostic tests may be recommended. These include non-invasive tests that usually don’t hurt. Instead, they provide a more detailed view, enabling the doctor to clearly see the retina.

These tests are:

• Optical coherence tomography (OCT): This imaging test involves widening the eyes using eye drops. The procedure is conducted while you sit facing the OCT machine with your head resting on a support. The machine then scans your eyes without touching them.
• Fundus imaging: This test involves taking wide-angle pictures of the retina while dilated.
• Eye (ocular) ultrasound: This procedure doesn’t require dilating eye drops. Instead, numbing drops may be used to make you feel comfortable during the scan. While sitting in a chair with your head resting on a support, the doctor will gently place a tool against the front of the eye for scanning. After that, you will close your eyes while seated as the gel is applied to the eyelids. You will then be asked to move your eyeball with your eyes closed as the provider scans them using the same device.
• Computed tomography (CT scan): This is an imaging test that combines a computer and X-rays to create detailed images. It is usually recommended if there is a potential penetrating eye damage or a trauma history.

Treatment

How do you treat retinal detachment?

The eye care specialist will inform you of the available treatment options for detached retina. For a better outcome, a combination of treatments may be necessary. They include:

• Laser therapy or cryopexy

• Scleral buckle

• Pneumatic (gas bubble) retinopexy

• Vitrectomy

• Laser (thermal) therapy or cryopexy (freezing)

In some cases, the doctor will detect a retinal tear even before the eye retina begins to pull away. Freezing equipment or a medical laser can be used to close the tear by creating a scar holding the retina in position.

Pneumatic retinopexy

This method may be recommended for the ideal candidates.Generally, the pneumatic retinopexy procedure involves the following steps:

1. Injecting a small gas bubble into the eye

2. The bubble pressing against the retina to seal the tear

3. Using a laser or cryopexy (freezing) to close the tear

4. The body reabsorbing the fluid accumulated under the retina, allowing the retina to stick to the eye wall properly. The body eventually takes up the gas bubble as well.

Following the surgery, keeping your head calm for several days is important to aid recovery. Your doctor may also specify a particular position for lying down or sleeping.

While these post-surgery recommendations might be uncomfortable or bothersome, they are particularly essential for long-term benefits.

Scleral buckle

In scleral buckle surgery, the medical provider performs the following:

1. Surgically placing a buckle (sponge) or a silicone band around the eye.

2. The band keeps the retina in position and permanently remains there. It won’t, however, be visible.

3. Sealing the tear using a cryopexy or a laser.

4. Injecting a gas bubble or draining the fluid beneath the retina to aid reattachment.

Vitrectomy

During this procedure, the medical provider will:

1. Surgically remove the vitreous.

2. Sealing all the retinal holes or tears using a freezing or laser.

3. Placing a bubble of gas, oil, or air in the eye to help shove the retina back in position.

If an oil bubble is used, the provider will remove it after some months. On the other hand, gas and air bubbles are naturally absorbed by the body.

If a gas bubble is used, you may need to refrain from activities at particular altitudes, as altitude changes can expand the bubble and increase eye pressure. This thus means avoiding flying or traveling to higher altitudes until your provider gives clearance.

Prevention

While preventing rhegmatogenous retinal detachment may be impossible, you can reduce your risk with the following steps:

• Getting routine eye care: Frequent eye exams are vital in protecting overall eye health. This is especially if you are nearsighted. Having myopia tends to increase the risk of retinal detachment. Dilated exams to detect small retinal tears should also be included during regular eye tests.

• Staying safe: Always consider using safety goggles or protective eyewear when engaging in sports or other high-risk activities.

• Getting immediate treatment: If you experience symptoms of a detached retina, seek immediate medical attention from your eye care physician or visit the emergency room.

• Maintaining overall health: Managing chronic conditions, eating a balanced diet, and exercising regularly are important for your overall health.

Preventing diabetes-related tractional retinal detachment is possible if you improve your blood pressure and blood glucose levels.

Coping and Support

A detached retina can lead to total vision loss. Based on the extent of eyesight loss, this can significantly impact your lifestyle. Here are thus some of the useful strategies to help you adjust and cope with impaired vision:

• Getting glasses: You can optimize the remaining vision using glasses tailored to your needs. Consider safety lenses to help protect the other better-seeing eye.
• Brightening your home: Ensure your home is well-lit to enhance reading as well as other activities.
• Making your home safer: Remove throw rugs and use coloured tape on the corners of your steps. You can also install motion-activated lighting.
• Enlisting the assistance of others: Inform friends and family about your vision condition so they can assist you.
• Using technology: Utilize digital talking books as well as computer screen readers to assist you in reading well. Also, keep up with new advancements in technology.
• Exploring transportation options: Look into vans, shuttles, volunteer driving networks, or even ride shares available for persons with impaired vision.
• Connecting with others: Join an online network, find support groups, and use the available resources for individuals with vision impairment.

Questions to Ask Your Eye Care Provider

If you have or are at risk of getting a detached retina, consider asking your provider the following questions:

• Which detached retina treatment option is suitable for me?

• Will I require surgery?

• How can I effectively protect my eye health following surgery?

• How frequently should I undergo eye exams?

• What else can I do to minimize my risk of detached retina?

Outlook for Retinal Detachment

Retinal detachment condition is painless yet serious. Therefore, you should seek immediate care by calling your eye doctor or going to the ER if you notice symptoms of a detached retina, like light flashes, a surge in eye floaters, or darkened vision. You will require some form of surgery to repair the detached retina. Delaying treatment, even for a few days, might result in permanent eyesight loss.

Post-surgery, you should keep caring and protecting your vision by adhering to the surgeon’s advice.