A retinal detachment is a potentially blinding condition which often requires surgical intervention. Retinal detachments caused by a retinal tear or hole in the retina are called “rhegmatogenous retinal detachment” (RRD).
The retina is the light sensitive tissue which lines the inside of the eye. It is also referred to as the “back of the eye.” Light enters the eye and is focused on the retina. The retina captures the light and sends this information to our brain via the optic nerve to produce our vision.
Damage to the retina can lead to permanent vision loss and blindness. A retinal detachment can be a surgical emergency.
Symptoms of Retinal Detachment
The most common symptoms of a retinal detachment are new flashes and floaters. Actually, new flashes and new floaters may arise from a posterior vitreous detachment or retinal tear.
A retinal detachment will usually produce a shadow or veil in your vision starting in your peripheral vision and moving centrally. Most retinal tears or holes start in the anterior or peripheral portion of your retina.
Retinal Tear or Holes
Just as wallpaper lines the inside of a room, the retina lines the inner eye. A tear in the retina can allow fluid move underneath the retina causing it to separate, or detach, from the underlying tissue.
Detached retina does not function very well and causes loss of vision in the areas detached. Vision loss can be gradual or sometimes gets worse in a matter of hours. Prompt diagnosis and surgery is paramount.
Retinal tears can be treated with laser or freezing if diagnosed before a retinal detachment begins.
Diagnosis of Retinal Detachment
Retinal detachments are best diagnosed by a complete dilated examination. Your eye doctor will dilate the pupils of your eyes and carefully examine you with a variety of lenses and instruments allowing him or her to directly visualize the retinal detachment.
Retinal pictures, or fundus photographs, are often taken to document the retinal problem.
If direct visualization is not possible, an ultrasound (B Scan Ultrasonography) of your eye may be necessary.
Treatment of Retinal Detachment
There are a variety of surgical techniques used to repair a retinal detachment. A retinal detachment will not “fix” itself or go away with surgery. Surgical options include;
- Scleral Buckle
- Pneumatic Retinopexy
- Combination of Above
Vitrectomy is the basic operation performed by a retina specialist. For purposes of this article, vitrectomy allows the retina specialist to repair the retinal detachment from inside the eye. Intraocular gas is often injected into the eye which will aid in keeping the retina attached during the healing phase.
Scleral buckle is a tried and true technique which allows the retina specialist to fix the retinal detachment from the outside of the eye. Just as a belt buckle squeezes your waist, the scleral buckle causes your eye to slightly indent or “buckle.” This indentation relieves some of the stress in the vitreous causing the detachment.
Pneumatic retinopexy involves the injection of intraocular gas into the eye. The gas bubble is used as a tool to keep the retina detached and functions as a “cork” to prevent fluid from moving underneath the retina. Pneumatic retinopexy is often used in combination with vitrectomy and scleral buckle techniques.
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Gregory Scimeca, M.D.
Ophthalmologist and Medical Director
Burlington County Eye Physicians
Eye Professionals, LLC (Millville, NJ)
Eye Physicians and Surgeons of Bucks County (Langhorne, PA)