What You Need to Know: Retinal Detachment
The retina is located in the back of the eye, and if this tissue starts to pull away, it can cause permanent vision loss. When this happens, it’s considered a medical emergency, and you should seek immediate treatment to minimize the risk of permanent vision loss.
When the retina detaches, the layer of tissue separates the tiny blood vessels that deliver oxygen and nourishment. The longer your retina is not receiving nourishment, the higher the likelihood that you will have permanent vision loss.
The symptoms might not be noticeable if it is a small retinal detachment. But as it continues pulling away, it can change your vision. Common signs of retinal detachment include:
- Sudden increase in eye floaters
- Flashes of light
- A sensation of having a curtain or shadow over your field of vision
- Impact/injury to the eye, followed by an onset of symptoms
Keep in mind that these symptoms usually start suddenly. When you notice any of these symptoms that start quickly, you should seek emergency treatment as soon as possible. Prompt treatment can save your eyesight.
If there is any issue with your eye, then the best thing you can do is visit an ophthalmologist as soon as possible.
What Causes Retinal Detachment?
The two most common causes of retinal detachment are eye injuries and aging. But other risk factors can also influence the likelihood of retinal detachment:
- Aging: People over the age of 50 are at higher risk for retinal detachment.
- Injury: Impact on the eye can cause a jarring movement that causes the retina to tear.
- Myopia: Extreme nearsightedness
- History: Previous retinal detachment increases the likelihood of it happening again. Additionally, previous eye surgeries and injuries increase the risk.
- Eye Diseases: If you have other eye diseases, it could increase the likelihood of having a retinal detachment.
- Diabetes: Patients with diabetic retinopathy have a high risk of retinal detachment because it affects the blood vessels in the retina.
- Vitreous Detachment: When the gel-like fluid in the middle of the eye starts to pull away from the retina
Types of Retinal Detachment
There are three types of retinal detachment, and your eye doctor will determine the type to ensure you are getting proper treatment:
- Rhegmatogenous: This is the most common type of retinal detachment. A tear or hole in the retina allows fluid to pass through, causing a buildup under the retina. The increase of fluids pulls the retina away from its natural position.
- Tractional: If there is scar tissue on the surface of the retina, then it can cause the retina to pull away. This type of retinal detachment is most common in patients with uncontrolled medical conditions, such as diabetes.
- Exudative: Another type of retinal detachment that causes an accumulation of fluid behind the retina. In this situation, there are no tears or holes. Causes of exudative retinal detachment include tumors, eye injuries, age-related macular degeneration, or inflammatory disorders.
Diagnosis Process for Retinal Detachment
A comprehensive eye exam includes the specific tests that are needed to examine your retinal health. The eye doctor will use special drops to dilate the pupils, making them large enough to view the area in the back of the eye.
This checkup is a normal part of a comprehensive eye exam as part of preventive eye care. Additionally, tests can be used in an emergency situation to see if the retina is pulling away.
Usually, the diagnosis process is painless. The dilation is a little uncomfortable for a few hours, but your eyes will be back to normal when the pupils return to their regular size.
If additional information is necessary after dilation, then the ophthalmologist can use other tests to see the exact position of the retina: ultrasound or optical coherence tomography (OCT).
Treatment Options for Retinal Detachment
When there is a retinal tear, hole, or detachment, surgery is almost always the recommended treatment method. However, different techniques can be used depending on the type of retinal detachment you are experiencing.
Your eye doctor will discuss these treatment options to help you determine the right procedure for your unique needs. These are some of the most common treatment recommendations:
- Photocoagulation: This type of laser surgery burns the retinal tear to “weld” the affected area to the underlying tissue. Scarring holds the retina in place.
- Cryopexy: A similar result can be achieved by freezing the tear in place. A freezing probe is applied to the affected area to create scar tissue that holds the retina.
- Air Injection: The surgeon carefully injects gas or air into the eye. When this air is positioned correctly, it pushes the retina against the wall of the eye to stop the fluid flow. This technique is often combined with cryopexy to hold the tissue in place.
- Scleral Buckling: This process involves the placement of a piece of silicone material that is sewn onto the white area of your eye. It holds the eye shape to relieve the pulling force within the eye.
- Fluid Replacement: A vitrectomy is done by removing the vitreous fluid that is causing the retina to pull away. Then, gas, air, or silicone oil is injected into the space to flatten the retina into place.
What to Expect: Recovery After Treatment
Most patients need 1 – 2 weeks of recovery time after having retinal detachment surgery. If you have surgery that involves the placement of an air bubble in the eye, you must stay face-down for the first few days.
Even though you can return to regular activities within a week or two, it’s important to avoid certain activities like watching TV, heavy lifting, driving, and strenuous exercise. You can return to low impact work after 2 weeks.
Keep in mind that the risk of retinal detachment goes up when it has always happened before. So, it’s best to follow recovery recommendations to limit the chances of it happening again in the future.
Most patients notice that their vision begins to improve after several months. However, some people never recover their vision. The results vary depending on the severity of the detachment and the timing of treatment after the symptoms begin.