Retinal Detachment

Overview of Retinal Detachment

The retina is a light-sensitive membrane located behind the eye. The retina is responsible for focusing the image on the lens. When the retina changes the appearance to signals for brain detection, in that way,  people can see objects easily.

Retinal detachment (ankh ka parde ki alehdgi / آنکھ کا پردہ کی علیحدگی)  is a condition in which the light-sensitive retinal layer of tissue (the retina) at the back of the eye pulls away from its normal position. Permanent vision loss may result if the retinal detachment is not treated on time.

Prevalence of Retinal Detachment

Globally, around 33%-44% of people experience retinal detachment due to various causes. 

Doctors Treating Retinal Detachment

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Signs and Symptoms of Retinal Detachment

Retinal detachment is painless. The warning signs of retinal detachment appear until it becomes advanced such as:  

  • The sudden appearance of spots affecting the vision loss
  • Flashes of light in one or both eyes (photopsia)
  • Blurred vision
  • Gradually reduced peripheral vision
  • A curtain-like shadow over the visual field

Types of Retinal Detachment

Retinal detachment comprises three main types, depending on its cause.

1. Rhegmatogenous Retinal Detachment

Rhegmatogenous retinal detachment is one of the most common types of retinal detachment. It is caused by a small tear in the retina. The fluid passes through the hole of the eye and gets back to the retina. This fluid detaches the retina from the retinal pigment epithelium (it provides nourishment and oxygen to the retina).

2. Tractional Retinal Detachment

Tractional retinal detachment starts as the scar tissue on the retina pulls the retina away from the back of the eye.

3. Exudative Retinal Detachment

Exudative retinal detachment results from the accumulation of fluid behind the retina, but there are tears or breaks in the retina. This leads to the retinal detachment.

Causes of Retinal Detachment

Causes of the retinal detachment varies depending upon its types such as: 

1. Causes of Rhegmatogenous Retinal Detachment

As the individual gets older, the risk of rhegmatogenous retinal detachment is higher.Changing the texture and  shrinkage of the vitreous in the eye  begins to form the tears in the retina that pulls from its normal position. Other causes are eye injuries, eye surgery, and nearsightedness.

2. Causes of Tractional Retinal Detachment

One of the most common causes of tractional retinal detachment is diabetes. Because high glucose levels damage the blood vessels and make a hole in the retina. From there, the retina becomes detached.

Other causes of tractional retinal detachment are eye diseases, eye infections, and swelling (inflammation) in the eye.

3. Causes of Exudative Retinal Detachment

The most common causes of exudative retinal detachment are the leakage of blood vessels or cause swelling in the back of the eye.

Other causes of leaking blood vessels and  oedema production in the back of the eye are as follows:

  • Injury or trauma to the eye
  • Age-related macular degeneration (AMD)
  • Eye tumours
  • Diseases cause the inflammation of the eye
  • Coats disease, a rare eye disorder

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Risk Factors of Retinal Detachment

There are the following factors increase the risk of retinal detachment:

  • Aging over age 50
  • History of retinal detachment in one eye
  • Family history of retinal detachment
  • Extreme nearsightedness (myopia)
  • People had a history of eye surgery, such as cataract surgery
  • Severe eye injury
  • Other eye diseases or disorders, including retinoschisis, uveitis, or thinning of the peripheral retina (lattice degeneration)

Possible Complications after Retinal Detachment Surgery

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Prevention

There's no way to reduce the risk of retinal detachment until or unless people wear protective things such as safety goggles during the risky activities.

Another way to protect it is early diagnosis of an eye if people are doing dilated eye exams regularly or test for another eye disease. Early treatment can prevent them from permanent vision loss.

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Diagnosis

Diagnosing the retinal detachment, an ophthalmologist conducts the following ways for the eye examination, which includes:

  • Vision
  • Eye pressure
  • The physical appearance of the eye
  • Ability to see colours

An ophthalmologist may also check whether the retina is functioning properly or not. A doctor also examines the blood flow of the eye particularly in the retina. Additional tests are the ultrasound of eyes to reveal any abnormalities in the eye via images of it.

Treatment of Retinal Detachment | When to Consult a Doctor

Before the retinal tear in the eye progresses to detachment, an eye surgeon may recommend one of the following procedures to protect vision loss and retinal detachment. In this way, retinal detachment repair at its early stage is difficult to preserve at an advanced stage.

  • Laser Surgery (Photocoagulation) - A ophthalmologist targets the laser beam into the eye through the pupil. The laser produces heat around the retinal tear and repairs the retina to underlying tissue.

  • Freezing (Cryopexy)- Firstly numb the area of the eye by injecting the local anaesthetics, the ophthalmologist uses the freezing probe from the outer surface of the eye over the hole. From this, the freezing makes a scar and protects the retina.

Both of these procedures are conducted on an outpatient basis. It means it can be done in the doctor's office. After the procedure, a doctor may advise to avoid some activities that may affect the eyes such as running for some time. 

If the retina has detached from the back of eyes, the following procedures are conducted, depending on the severity of patients

  • Pneumatic Retinopexy- In this procedure, a surgeon injects a bubble of air or gas into the centre part of the eye (the vitreous cavity). This method is done very carefully for targeting the right area. As a surgeon targets the right area, the bubbles automatically push the area of the hole and prevent the fluid flow into space behind the retina. In this way, fluid is collected under the retina and absorbs it by itself. The retina gets back to its normal position (attached to the eyewall). Along with it, cryopexy is also used for repairing the retinal break during the procedure.

After the surgery, a person holds the head in a certain position for several days to keep the bubble in the proper position. The bubble will reabsorb on its own.

  • Scleral Buckling- Firstly a surgeon sutures a piece of silicone material to the white part of the eye (sclera) over the affected area. This procedure indents the wall of the eye and treats the pressure of vitreous pulled by the retina.

If a surgeon detects the several holes in the eye then it will treat by creating a scleral buckle for encircling the entire eye like a belt. The buckle is placed to block vision, and it usually fits in place permanently.

  • Retinal Detachment Vitrectomy- A surgeon eliminates the vitreous along with the tissues that are pulled by the retina. Air, gas or silicone oil is then injected into the vitreous space for flattening the retina. In the end, the air, gas or liquid will absorb in the vitreous space to refill with body fluid. This technique may be used along with a scleral buckling procedure.

After surgery, the improvement of vision may take several months. In some cases, a second surgery is required.

 

In case you exhibit any concerning signs and symptoms for retinal detachment, consult a medical professional as soon as possible.