What is a retinal detachment?
The retina is the thin light-sensitive layer at the back of your eye that gives you the ability to see, much like the film of a camera. In retinal detachment, the light-sensitive layer at the back of the eye separates from the wall of the eye and the underlying blood vessels that supply it with oxygen. Most commonly, this is due to a tear somewhere in the retina that allows the fluid on the inside of the eye to pass through the hole and spread underneath the retina, separating it from the layer underneath. If left untreated, retinal detachment can lead to progressive and permanent loss of vision.
Symptoms of retinal detachment
- Sudden onset of floaters
- Sudden onset of flashing light
- Gradual loss of peripheral vision in the form of a shadow, curtain or cloud (corresponding to the area of retinal detachment)
- Blurred vision
When should you see a doctor urgently?
If you have a sudden and dramatic increase in flashes, floaters or you see a dark curtain in your vision that does not go away, you should see an eye care specialist urgently. Patients at particular risk for retinal tears or retinal detachment are patients that have had surgery to their eyes, are very nearsighted or have had a retinal detachment in their other eye or a close family member.
How are retinal detachments treated?
There are 3 approaches to treating a retinal detachment
- Pneumatic retinopexy
- Scleral buckle surgery
- Vitrectomy surgery
The choice of treatment depends on specific features of the detachment.
This procedure may be performed in the office or in theatre. The surgeon injects a gas bubble into your eye. You then have to maintain a specific posture to float the bubble to the retinal tear to block the hole. Once the hole is blocked, your eye will naturally pump away the fluid underneath the retina. Once the retina around the tear has re-attached (usually around 2 days after the bubble is injected), the doctor will perform laser treatment around the tear to permanently seal off the hole from the rest of the retina. You will be expected to maintain the specific posture for at least 7 days after the laser to give the laser time to form a strong seal.
A scleral buckle is performed in the operating room under local anaesthesia with sedation or general anaesthesia. A piece of silicone is sewn onto the outer wall of the eye to supports the retinal tear(s). The fluid causing the retinal detachment is drained from underneath the retina. A “freezing” or laser treatment is then applied to the retinal tears to permanently seal off the holes from the rest of the retina.
Pars plana vitrectomy (“Vitrectomy surgery”)
A vitrectomy is performed in the operating room under local anaesthesia with sedation or general anaesthesia. Three small instruments are inserted through the white part of the eye. During the procedure, the gel on the inside of the eye is removed, the fluid causing the retinal detachment is drained and laser is applied around the retinal tears to permanently seal off the holes from the rest of the retina. At the end of surgery, your doctor will either put a gas bubble or a silicone bubble in the eye to give the laser treatment time to form a strong seal.
“Vision is the true creative rhythm”
- Robert Delaunay