Retinal Detachment

Retinal detachment is a condition in which a thin layer of tissue at the back of the eye, retina, is pulled away from its normal position.

This prevents the cells of the retina from receiving oxygen and nutrients due to separation from blood vessels that supply the retina. Symptoms include floaters, flashes and reduced vision.

If retinal detachment is left untreated it can lead to permanent blindness.

The signs and symptoms of retinal detachment usually occur when the condition has advanced. They may include:

• Floaters- these are tiny specks that seem to drift through the vision field
• Blurred vision
• Reduced peripheral vision
• A curtain-like shadow over the visual field

Causes of retinal detachment include: 

• a sagging vitreous humour,
• injury to the eye,
• diabetes.

Retinal detachment occurs when vitreous fluid leaks through a hole or tear in the retina and accumulates behind the retina.

Retinal detachments which occur due to tears develop when vitreous collapse and tags on the retina with enough force to produce a tear. This separates the retina from underlying tissues which contain blood vessels.

The areas where the retina is detached loss blood supply and stop functioning, which in turn can lead to loss of vision.

The following tests can be used to diagnose retinal detachment:

• Retinal examination- in which a doctor uses an instrument with a bright light and a special lens (ophthalmoscope) to examine the retina. This device helps doctors to check for any retinal hole, tears or detachments.
• Ultrasonography to check for bleeding in the eye.

Surgery to attach the retina to its normal position is the only treatment that is used for retinal detachment. This surgery is usually performed within days of diagnosis.

Several surgical procedures for retinal detachment can be used. The type of surgery depends on the severity of retinal detachment.

Procedures used include:

• Pneumatic Retinopexy- is a procedure in which a bubble of air or gas is injected into the vitreous humor. The bubble pushes the detached retina against the wall of the eye. This prevents fluid from flowing behind the retina. The fluid that is left behind the retina will later on absorb itself causing the retina to be fixed to the wall of the eye. The bubble will reabsorb on its self within a few days.
• Cryopexy-a procedure where a doctor applies a freezing probe to the outer surface of the retina to cover the tear, is also used.
• Scleral Buckling- a procedure in which a surgeon sews a piece of silicone material to the sclera over the affected area. This procedure relieves some of the force caused by the vitreous humor tagging on the retina. A scleral buckle that encircles the eye may be required for patients with several tears or hole or an extensive detachment.
• Vitrectomy- a procedure in which the vitreous is drained from the eye. Air, gas or liquid can be used to flatten the retina. The air, gas or liquid is eventually absorbed and the vitreous space is filled with body fluid. If silicone oil is used, it may be removed a few months after surgery.

Lifestyle modifications are necessary in order to cope with retinal detachment.

Lifestyle changes can be made to prevent permanent loss of vision. The following can be helpful:

• Getting specifically tailored glasses.
• Using digital talking books and computer screen readers.
• Having proper lifhting especially ehen reading.
• Making the home safer.
• Asking family and friends for help.
• Joining a support group.

Risk factors of developing retinal detachment include:

• Being over 50,
• History of retinal detachment,
• Extreme nearsightedness,
• History of eye surgery or injury,
• History of eye diseases.