A retinal detachment is a serious and sight-threatening event. Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. It is usually affects middle-aged or older people. Retinal detachment occurs when the retina separates from the choroid. The retina is a thin layer of light-sensitive tissue on the back wall of the eye. The optical system of the eye focuses light on the retina much like light is focused on the film in a camera. The retina translates that focused image into neural impulses and sends them to the brain via the optic nerve. Occasionally, posterior vitreous detachment, injury or trauma to the eye or head may cause a small tear in the retina. The tear allows vitreous fluid to seep through it under the retina, and peel it away like a bubble in wallpaper.
Retinal detachment can occur more frequently after surgery for cataracts. The estimate of risk of retinal detachment after cataract surgery is 5 to 16 per 1000 cataract operations. There are three different types of retinal detachment. First is rhegmatogenous a tear or break in the retina allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. These types of retinal detachments are the most common. Second is tractional. In Tractional type of detachment, scar tissue on the retina's surface contracts and causes the retina to separate from the RPE. This type of detachment is less common.Third is exudative-frequently caused by retinal diseases, including inflammatory disorders and injury/trauma to the eye.
In this type, fluid leaks into the area below the retina, but there are no tears or breaks in the retina. There are several methods of treating a detached retina which all depend on finding and closing the holes (tears) which have formed in the retina. Small holes and tears are treated with laser surgery or a freeze treatment called cryopexy. These procedures are usually performed in the doctor's office. During laser surgery tiny burns are made around the hole to "weld" the retina back into place. Cryopexy freezes the area around the hole and helps reattach the retina. Scleral buckle surgery is an established treatment in which the eye surgeon sews one or more silicone bands (bands, tyres) to the outside of the eyeball.Vitrectomy is an increasingly widely used treatment for retinal detachment.
Retinal Detachment Treatment and Prevention Tips
1. Laser photocoagulation can repair smaller retinal tears.
2. Vitrectomy is an increasingly widely used treatment for retinal detachment
3. Cryopexy uses extreme cold to cause scar formation and seal the edges of a retinal tear.
4. Liquid silicone may be injected to replace the vitreous fluid to maintain the normal shape of the eye.
5. Early examination allows detection of retinal tears which can be treated with laser or cryotherapy.
6. Effective way of preventing retinal detachment is by educating people to seek ophthalmic medical attention
After Retinal Detachment Surgery
What are the symptoms?
The only symptoms are abnormalities of vision in the affected eye. Since the other eye is almost always normal, it may compensate for the affected eye, so that early symptoms may not be noticed. The first signs of a detached retina may be flashes of light, which often occur shortly before a hole is formed in the retina. Floating, black, often cobweb-like shapes may be seen when the hole is actually formed. Once detachment starts you may notice the loss of part of your peripheral vision in the affected eye. This often appears as a narrow black "curtain" coming from the top, the bottom, or one side of the eye. If detachment continues unchecked, the loss of vision spreads. What vision remains becomes progressively blurred.
What are the risks?
Retinal detachment is rare. It occurs mainly from middle age onwards, and men and women are equally susceptible. You are particularly at risk if you are nearsighted, because your retina is likely to be stretched due to the shape of your eyeball. If your eye is injured, or if you have the lens of your eye removed because of a cataract, you are also at risk. If the disorder is neglected, there is a risk of permanent blindness in the affected eye.
What should be done?
If you experience any of the symptoms described, see your physician without delay. An ophthalmologist will be able to detect retinal detachment by looking into your eye through an instrument called an ophthalmoscope.
What is the treatment?
If a hole in the retina is discovered before detachment has started, you may need to have an operation to seal the hole permanently. This is done by freezing or by a laser beam after a local anesthetic has been given. If retinal detachment has begun, a different operation done under a local or general anesthetic may be necessary. In this procedure, the vitreous humor between the retina and the choroid is drained away, which allows the retina to sink back against the choroid and regain its blood supply. Then, the hole in the retina is sealed.
If the operation is carried out before detachment has started or when it has occurred only around the front edge of the retina, your vision will probably return to normal. If the detachment is more extensive and your central vision has been impaired, although the full field of vision will probably be restored. central vision will be permanently blurred to some extent. In five per cent of cases of complete detachment, the retina fails to sink back against the choroid after the operation. and the eye remains blind. After surgery. retinal detachment recurs in only a small minority of cases.
Following retinal detachment in one eye. there is a considerable risk that the condition will develop in the other eye. After the operation, you should see your ophthalmologist regularly to have the other eye examined. Any weak areas in the retina that are likely to develop into a hole can be detected and may be treated surgically.
Both Juliet Cohen & Nikhil Jain are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
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