When the retina (a thin layer of tissue at the back of the eye) pulls away from the usual position, this emergency situation is called as the retinal detachment. The retina is a light sensitive membrane and has an important function of converting the image to signal and transmitting it to the brain via optic nerve. The retina, along with lens, cornea and other parts of the eye and brain are responsible for producing normal vision.
In case of retinal detachment, the layer of blood vessels providing nourishment and oxygen gets separated from the retinal cells, which severely affects the vision. It is extremely important to get it treated on time else the risk of permanent vision loss increases if left untreated or if the treatment is delayed. Some of the warning signs of retinal detachment are- tiny specks that drift through field of vision or appearance of several floaters. It is a case of medical emergency, so your eye doctor immediately in case of any sudden vision changes.
Detached Retina Symptoms
There are several warning signs of retinal detachment which pop up before it occurs or has advanced, but it does not cause any pain. Some of the symptoms are-
- Shadowing effect which appears like curtain pulled over the visual field
- Gradual reduction in peripheral (side) vision
- Blurred vision
- Photopsia, which is flashes of light occurring in one or both the eyes especially when looking to the side.
- Sudden appearance of floaters or tiny specks which seem to be floating before the eyes.
Detached Retina Causes
The three main causes of detached retina are-
- Rhegmatogenous- it is one of the most common type of retinal detachment which occurs due to a tear or hole in the retina. The hole formed enables fluid to pass through and get collected near the retina. This pulls away the retina from the underlying tissues and the areas from where the retina detaches stops functioning due to the loss of blood supply. This severely affects the vision.Rhegmatogenous detachment usually occurs due to ageing. The gel-like material present inside the eyes (called as vitreous) changes consistency and even shrinks becoming more of a liquid, due to ageing. Usually, the vitreous moves away from the surface of the retina. This condition is known as PVD (posterior vitreous detachment). As the vitreous peels off the retina, it might tug on the retina forcefully causing retinal tear. If left untreated, the vitreous passes on to the space behind retina, resulting in the detachment of retina.
- Exudative- the condition where fluid accumulates behind the retina without causing holes or tears are called exudative. It can be caused due to injury to the eye, age-related macular degeneration, inflammatory disorders or tumors.
- Tractional- when the scar tissues grow on the retina’s surface, this type of detachment occurs. As a result, the retina gets pulled away from the back of the eye. This type of detachment is commonly observed in those who have poorly controlled diabetes or other medical condition. Diabetic retinopathy treatment is performed to prevent vision loss due to diabetes.
Who are at risk?
- Previous eye disorder or disease which includes uveitis or lattice degeneration (thinning of peripheral retina), retinoschisis.
- Severe eye injury in the past
- Eye surgery or cataract removal in the past
- Extreme myopia (nearsightedness)
- Family history
- Detachment of retina in one eye in the past
- People above the age of 50 years
Detached Retina Treatment
Surgery is often required to repair a detached retina. For minor tears and detachment, minor surgery may be required at the doctor’s clinic.
- Cryopexy- this process involves freezing with intense cold. The eye specialist applies a freezing probe outside the eye area over the retinal tear site. The scarring caused helps in holding the retina in its place.
- Photocoagulation- Eye specialist performs a procedure called photocoagulation with laser in case there is a tear or hole in the retina but the retina is still attached. The laser is used to cause burns around the tear site so that the scarring affixes retina to the back of the eye.
- Retinopexy- eye specialists repair minor detachments with the help of retinopexy. The procedure involves putting gas bubbles in the eye, so that the retina moves back to its normal place, which is against the wall of the eye. After the retina moves back into its position, doctor uses freezing probe or laser to seal the holes.
- Vitrectomy- in case the tear is large, vitrectomy procedure is applied. In this, anesthesia is given to the patient and is performed as an outpatient procedure. Patients may be required to stay in the hospital overnight. The eye specialist removes scar tissue or abnormal vascular and vitreous using a small tool. The retina is then put back to its proper place using a gas bubble. Retinopexy or Cryopexy is performed during this procedure.
- Scleral buckling- the severe detachments require eye surgery in the hospital. The sclera buckling process involves placing of band around the outside of the eye so that the wall of the eye is pushed back into the retina. This helps in getting it back in its place for complete healing. Scleral buckling is often done along with vitrectromy. Retinopexy or Cryopexy procedure is performed during sclera buckling.
Thorough eye check up is performed to diagnose retinal detachment like-
- Ability to see colors
- Physical appearance of the eye
- Eye pressure
- Vision check
Also, the ability of retina to send impulse to the brain and blood flow throughout the eye and retina is checked.