What is the retina?
The retina is the sensory tissue that lines the back of the eye. Similar to a film of a camera, it receives the images. These images are then transformed into electrical impulses that are transmitted to and interpreted by the brain.
How does a retinal detachment develop?
The vitreous is a transparent, viscous substance that fills the posterior cavity of the eye. With aging, it liquefies and separates from the retina, leading to a posterior vitreous detachment. Occasionally, when the vitreous comes off, it can take a piece of retina with it, creating a tear or a hole in it. Liquid inside the eye can then go underneath the retina through this tear, lifting the retina to cause a retinal detachment.
Which populations are at higher risk?
A retinal detachment can develop in anyone at any time of life, but the frequency of this condition is higher in the following groups:
- High myopia – please have regular retina exams if you have high myopia
- Persons aged 50 and over
- Family history of retinal detachment
- After trauma to the eyes
- After intraocular surgery (for example, cataract surgery)
- Diabetes with diabetic retinopathy
What are the symptoms?
After 40 years of age (sometimes younger), many people may see floaters (black dots, lines or other opacities that move) in their field of vision. These opacities are often more easily perceived by looking at a white wall or a white screen. These are symptoms of a posterior vitreous detachment, a natural phenomenon that happens to everyone. These opacities will never completely disappear from your eye, but your brain will gradually learn to ignore them.
Common symptoms of retinal tears or detachment are:
- Sudden appearance of floaters
- Sudden light flashes
- Loss of visual field in case of retinal detachment, which can be perceived as a growing black shadow
- Decreased visual acuity
NB: Retinal detachment is painless
Please consult with an ophthalmologist quickly when the above symptoms appear.
What are the different available treatments?
Retinal detachment is a condition that can lead to permanent vision loss if left untreated. Appropriate treatment should be applied urgently. Treatment effectiveness depends, among other factors, on the time between retinal detachment and its re-attachment. Different treatments are available depending on the type, location and extent of retinal tear and detachment.
● If the retina is torn but not detached, prompt treatment can prevent detachment. The tears can be repaired by applying laser around the tear. The generated heat forms sealing scar tissue around the tear and prevents fluid from passing under the retina.
In some cases, the cryoprobe is needed. This probe freezes the various layers of the retina to induce similar sealing scar around the tear.
● If the retina is detached, the treatment is surgical. Urgent surgery aims to repair tears and reattach the retina. Retinal detachment can usually be effectively repaired with timely treatment.
With the vitrectomy, the vitreous is cut and aspirated. Air (or gas) is then injected to push the retina back into place to promote re-attachment and healing.
With scleral buckle, a silicone band is placed around the eye to re-approximate the eye wall towards the detached retina.
What to expect before the surgery?
Your ophthalmologist will assess the type of retinal detachment and determine the best type of surgery for you.
What to expect during and after the surgery?
The surgery is done as outpatient day surgery (you are not hospitalized) and it lasts almost an hour. It is done under regional anaesthesia (The eye is completely anaesthetized) with a slight sedation if necessary. An eyelid speculum is used to keep the eyelids open and prevent the eye from blinking during the procedure. Initially, the vision will be blurred after the procedure but it improves during the first few weeks. The complete healing of the eye may take up to six months. The eye may be red and irritated for a few weeks after surgery. Your ophthalmologist will see you the day after surgery and then after 1 week. You will have to take healing drops for about 3 months after surgery. You may need to update your glasses prescription after surgery at your optometrist’s office – consult your ophthalmologist to find out when it is best to update the prescription. After surgery, you may have to undergo other procedures.