Things to know about Retinal Detachments



What is retinal detachment?


The retina is a light-sensitive membrane located at the back of the eye. When light passes through your eye, the lens focuses an image on your retina. The retina converts the image to signals that it sends to your brain through the optic nerve. The retina works with the cornea, lens, and other parts of your eye and brain to produce normal vision.

Retinal detachment occurs when the retina separates from the back of your eye. This causes loss of vision that can be partial or total, depending on how much of the retina is detached. When your retina becomes detached, its cells may be seriously deprived of oxygen. Retinal detachment is a medical emergency. Call your doctor right away if you suffer any sudden vision changes.

Symptoms of retinal detachment

There’s no pain associated with retinal detachment, but there are usually symptoms before your retina becomes detached. Primary symptoms include:
  1. blurred vision
  2. partial vision loss, which makes it seem as if a curtain has been pulled across your field of vision, with a dark shadowing effect
  3. sudden flashes of light that appear when looking to the side
  4. suddenly seeing many floaters, which are small bits of debris that appear as black flecks or strings floating before your eye
Also read: The crainal nerve that supply the eye

Types and causes of retinal detachment

There are three types of retinal detachment:
  1. rhegmatogenous
  2. tractional
  3. exudative

Rhegmatogenous retinal detachment

If you have a rhegmatogenous retinal detachment, you have a tear or hole in your retina. This allows fluid from within your eye to slip through the opening and get behind your retina. The fluid separates the retina from the retinal pigment epithelium, which is the membrane that provides your retina with nourishment and oxygen, causing the retina to detach. This is the most common type of retinal detachment.

Tractional retinal detachment

Tractional retinal detachment occurs when scar tissue on the retina’s surface contracts and causes your retina to pull away from the back of your eye. This is a less common type of detachment that typically affects people with diabetes mellitus. Poorly controlled diabetes mellitus can lead to issues with the retinal vascular system, and this vascular damage can later lead to scar tissue accumulation in your eye that could cause retinal detachment.

Exudative detachment

In exudative detachment, there are no tears or breaks in your retina. Retinal diseases such as the following cause this type of detachment:
  1. an inflammatory disorder causing fluid accumulation behind your retina
  2. cancer behind your retina
  3. Coats’ disease, which causes abnormal development in the blood vessels such that they leak proteins that build up behind your retina.
Also read: How to appreciate Traumatic exophthalmos  

    Diagnosis of retinal detachment

    To diagnose retinal detachment, your doctor will perform a thorough eye exam. They’ll check:
    1. your vision
    2. your eye pressure
    3. the physical appearance of your eye
    4. your ability to see colors
    Your doctor might also test the ability of your retina to send impulses to your brain. They may check the blood flow throughout your eye and specifically in your retina.

    Treating retinal detachment

    • Vitrectomy

    Vitrectomy is used for larger tears. This procedure involves anesthesia and is often performed as an outpatient procedure, but may require an overnight stay in the hospital. Your doctor will use small tools to remove abnormal vascular or scar tissue and vitreous, a gel-like fluid from your retina. Then they’ll put your retina back into its proper place, commonly with a gas bubble. Cryopexy or retinopexy is performed during the vitrectomy procedure.

    • Retinopexy

    An option is pneumatic retinopexy to repair minor detachments. For this procedure, your doctor will put a gas bubble in your eye to help your retina move back into place up against the wall of your eye. Once your retina is back in place, your doctor will use a laser or freezing probe to seal the holes.

    • Photocoagulation

    If you have a hole or tear in your retina but your retina is still attached, your doctor may perform a procedure called photocoagulation with a laser. The laser burns around the tear site, and the resulting scarring affixes your retina to the back of your eye.

    • Cryopexy

    Another option is cryopexy, which is freezing with intense cold. For this treatment, your doctor will apply a freezing probe outside of your eye in the area over the retinal tear site, and the resulting scarring will help hold your retina in place.


    Preventing retinal detachment

    In general, there’s no way to prevent retinal detachment. However, you can take steps to avoid retinal detachment that results from an injury by wearing protective eyewear when playing sports or using tools. If you have diabetes, control your blood sugar and see your doctor regularly. Get yearly eye exams, especially if you have risks for retinal detachment.
    It’s important to know the symptoms of retinal detachment. Recognizing when you may have a retinal problem and seeking medical care immediately can save your vision.

    Before you go, please kindly answer the following question about the retinal detachment.

     Ques: Which of the following statements is TRUE regarding acute traumatic retinal detachments?
    • (A) Most detachments can be visualized on standard fundoscopy
    • (B) Eighty percent of detachments occur within 24 h of the traumatic event
    • (C) Most detachments originate in the inferotemporal quadrant
    • (D) Visual outcome depends on the extent of involvement of the optic disc
    • (E) Sudden onset of pain is a prominent feature
     Answer: Click here

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