Detached retina means lifting away of the retina from the back of the eye. The retina is a sensitive tissue made up of nerve cells called rods and cones. The retina is present in the backside of our eye and is the innermost layer of the eyewall. Nerve cells of the retina detect the light, shape, pattern and colour. Then it sends a signal to our brain what our eye sees. The retina is supported by a jelly-like transparent fluid known as vitreous. Retinal detachment occurs suddenly or spontaneously. When retinal detachment occurs, the retina does not function well and can blur vision or total vision loss. Retinal detachment is a matter of deep concern as it is a serious problem. If it is ignored, one can lose his/her eye permanently. When you get any sign of retinal detachment, you should consult an ophthalmologist as soon as possible.
Rhegmatogenous retinal detachment: It is the most common type of retinal detachment that can happen due to a break or small tear in your retina. The most common reason for this type of detachment is ageing.
Tractional retinal detachment: This type of detachment happens due to scar tissues. Holes or tears are not present in this type of retinal detachment.
Exudative retinal detachment: This type happens on the building up of fluid behind the retina.
Symptoms
Below are the symptoms of retinal detachment:
Experiencing flashes of sudden lights. Some persons feel this like seeing stars after being striking in the eye.
Experiencing a lot of floaters at a time. These can look like specks, flecks, cobwebs, threads, dark spots, lines in your vision field.
The appearance of a shadow or darkening inside vision.
A grey curtain over the part of the field of vision.
Sudden blurring of vision
Causes And Risk Factors
Below are the causes of retinal detachment:
Rhegmatogenous retinal detachment: Retinal detachment generally happens because of shrinkage of the vitreous gel with increased age. This shrinkage can lead to a tearing (hole) in the retina at a weak point. Vitreous gel fluid moves through the tear and collects under the retina. This lifts the retina from the back of the eye.
Tractional retinal detachment: Retinal detachment is not always due to the retinal tear. Scar tissue accumulation in the eye can pull on the retina. The process is known as traction. The most common cause for the traction is diabetes. Diabetes for a longer period damages your blood vessels and leads to the formation of scar tissues. These scars can become bigger and detach the retina from the back of your eye.
Exudative retinal detachment: Fluid can form under the retina due to different reasons other than a retinal tear. This fluid pushes the retina away from the back of your eye. The primary reasons for fluid formation are swelling behind the eye or leaking blood vessels. Many reasons cause leakage of blood vessels, including head injury, age-related macular degeneration, tumours in your eye, coats disease (a rare eye disorder), and nearsightedness.
Risk Factors
Below are the risk factors that increase the chances of retinal detachment:
Have had glaucoma, cataract, or other eye surgery.
Take medications for glaucoma that make the pupil size small.
Had a severe eye injury.
Had a retinal detachment or a tear in another eye.
Have a family history of retinal detachment.
Have weak areas in your retina confirmed by an eye doctor during an examination.
Ageing.
Nearsightedness or significant myopia.
Had trauma or eye surgery.
Retina thinning.
Prevention
As retinal detachment frequently occurs due to aging, this is unfortunate that in most cases, retinal detachment is not preventable. But by following the suggestions given below, you can keep a check on your eye health and lower the risk of retinal detachment:
Eye examinations protect your eye health. If you have nearsightedness, you should visit your ophthalmologist for a routine checkup. Myopia is among the disorders that make you more susceptible to retinal detachment. Your ophthalmologist should do dilated examinations to find minor retinal tears.
Wearing safety goggles, protective helmets or other protection to your eyes when playing games, riding or doing other activities that may be risky to your eyes.
If you notice any detached retina symptoms, visit your eye care provider without thinking for a while or go immediately to the emergency room.
Stay physically active, eat healthy foods, and take your medicine if you are experiencing diabetes.
Diagnosis
To diagnose retinal detachment, your ophthalmologist will examine your eyes and ask questions about the symptoms you have. Thereafter, the ophthalmologist uses eye drops to widen your eye, which allows him to examine it closely. These examinations do not hurt you. Other tests may also be recommended after the dilation examination.
If you have retinal detachment symptoms, your doctor will use an ophthalmoscope, a lighted magnifying tool, to examine your retina. With the procedure, your doctor can see tears, holes, or retinal detachment.
Optical coherence tomography (OCT): In this imaging technique, dilation of the eye is required. Your ophthalmologist will then ask you to sit in front of the OCT machine. To keep your head still, you need to put your head on a support. The machine scans your eye without touching it.
Eye ultrasound: You do not need dilation of the eye for this scan, but your ophthalmologist can use drops to make your eyes numb so you will not be able to feel any discomfort. You need to sit on a chair and keep your head on a support to keep it still. Your ophthalmologist places an instrument gently against the front of your eye for scanning it. After that, you have to sit with your eyes closed. Your ophthalmologist will put gel on the eyelids. Keeping your eyes closed, you have to move your eyeballs as your ophthalmologist will be scanning them with the same instrument.
Treatment
When someone suspects any of the symptoms of retinal detachment, it is necessary to visit an ophthalmologist right away. When retinal detachment remains untreated, one can lose his eye. The treatment option for the retinal detachment is reattachment of the retina. Surgical procedures are the only treatment option to reattach the retina. There are many methods to perform surgery, like using gas bubbles, lasers, or freezing probes to reattach the retina and seal tears in the retina. The following are some of the methods
Laser treatment or cryotherapy (freezing) techniques: The retina is sealed to the back of the eye wall. This type of surgery causes little or no discomfort and can be performed in the ophthalmologist's office. This treatment option is usually performed to prevent the progression of tears to retinal detachment.
Pneumatic retinopexy: This is a simple method for fixing a retinal detachment, yet it is not appropriate for all cases. The eye surgeon injects a gas bubble into the vitreous cavity to treat the tear(s) with either cryotherapy (freezing) or laser. The bubble presses the retina flat on the wall of the eye, and with the help of freezing or laser, the retina sticks down. To keep the retina in its position, it is necessary to follow the post-operative surgeon’s instructions. The gas bubble disappears gradually after some days or weeks after the surgery.
Scleral buckling: In this method, cryotherapy is used to treat the retinal tear. The fluid under the retina is drained. A specially-shaped silicone rubber piece is sutured to the eyeball. An indent is created by the silicone that pushes the eyeball back to the retina.
Vitrectomy surgery: The vitreous is removed surgically using fine instruments under an operating microscope. If any tear is present, it is treated with cryotherapy or laser after injecting a gas bubble or silicone oil. Again, to keep the retina in its position, it is necessary to follow the post-operative surgeon’s instructions. People after vitrectomy experiences poor vision due to gas in the eye, but if the vitrectomy surgery is successful, the vision gets improved when gas disappears and is replaced with your eye’s fluid. When silicone oil is used before the surgery, it does not go away by itself, and one more surgery is usually required after a few months.
Prognosis And Complications
Prognosis:
The rate of success of the surgery is very high. Out of 10, nine retinas are attached successfully.
Complications:
Below are the complications that can be resulted from retinal detachment:
Cataract formation (blur vision).
Glaucoma (increased eye pressure).
Infection.
Bleeding into the vitreous cavity.
Loss of vision.
Eye loss, though this is a very rare outcome with modern surgical techniques.
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