What is a Retinal Detachment?
The Retina covers the inside of the eye the multi-layered light sensitive tissue is responsible for sending visual information to the brain. Retinal detachment occurs when the inner layers of the Retina separate from the underlying Retinal Pigment Epithelium (RPE). This tear causes fluid from inside the eye to leak underneath the Retina and the light sensitive cells are no longer able to transmit their message to the brain. A Retinal Detachment is a medical emergency which can cause vision loss and ultimately blindness, you should seek treatment from the Eye Specialist Institute immediately.
Retinal Detachment can occur in four different ways:
Rhegmatogenous – Is the most common form of Retinal Detachment and it occurs when a Retinal tear allows fluid to successfully separate the Retina away from the underlying RPE layer.
Tractional Retinal Detachment – refers to the scarring between the Vitreous gel and the Retina which causes the surface of the Retina to contract. This force separates the Retina from its RPE layer.
Exudative Retinal Detachment – refers to fluid leakage underneath the Retina due to not Retinal tears but Retinal Diseases.
Posterior Vitreous Detachment- A posterior vitreous detachment (PVD) occurs with symptoms of floaters and flashes. Such symptoms should lead to early retinal examination within a week. Although 95% of people will not develop any problems, the few patients who do develop a retinal tear as a result of the PVD will need retinopexy (retinal adhesion with laser or cryo) to prevent the tear progressing to blinding retinal detachment.
Retinal Detachment Symptoms
Retinal Detachment symptoms are similar to that of a Retinal Tear, and you may experience blurred or decreased vision, peripheral bright flashing lights or sparks as well as new onset floaters. Other symptoms include:
- A shadow may forming in the vision area that the Retina would normally process.
- Complete and sudden loss of vision.
- The impact on a person’s eyesight depends on the location and severity of the detachment.
Who is at risk of developing a Retinal Detachment?
Retinal Detachments most commonly occur in patients with Posterior Vitreous Detachments (PVD), however, they can also happen after trauma, ocular conditions and surgery which has caused a traction on the Retina surface. Typically, the risk of Retinal Detachment in the general population is low with 15 per 100,000 cases occurring. It can happen at any age, but it is more prevalent over the age of 40 and in males.
A Retinal Detachment is more likely to occur in people who:
- Are extremely nearsighted
- Have had a retinal detachment in the other eye
- Have a family history of Retinal Detachment
- Have had an eye injury
- Have had prior eye surgery (e.g. Cataract Surgery)
- Have other eye diseases or disorders
How are Retinal Detachments Diagnosed?
A Retinal Detachment can be diagnosed with a straight forward eye examination. During your appointment with the Eye Specialist Institute, your ophthalmologist will use drops to dilate the pupil and a specialised microscope will be used to examine the Retina to identify any retinal holes, tears or detachments present. (The Dr Bourke site mentioned something about Ultra-wide-filed imaging do you use this as well?)
What treatment is available for Retinal Detachment?
Day surgery is the only available treatment for Retinal Detachment. The aim of Retinal Detachment surgery is to inhibit the progression of vision loss. Depending on the cause, location and type of detachment will govern which surgical procedure will work best. Existing eye conditions can also influence the type of surgery selected. The Eye Specialist Institute currently use two types of surgery to fix Retinal Detachments, they are:
Vitrectomy Surgery- involves intraocular microsurgery to remove the vitreous gel of the eye. If needed, scar tissue may also be removed to support the retina once reattached. A liquid is injected into the eye to smooth the retina into place and then a gas or silicone oil is used to secure it in place as the eye heals.
Cyro-buckle Surgery – which is performed under anaesthetic and involves pushing the Retinal Pigment Epithelium (RPE) back towards the detached retina. Cyro (freezing) is then used to create a scar and attach the Retina to the RPE.
During your consultation, your ophthalmologist will explain the procedure in greater detail as well as why they have chosen that particular surgical option over the other.
The quality of vision following surgery will vary from patient to patient depending on whether the central vision has been affected by the retinal detachment. If the macula has been detached, a person’s ability to read and see fine detail will already be greatly impaired and may not fully recover after surgery. Only 60-70% of patients with macular detachments recover good central vision, compared to 90-95% of patients who do not have macular detachments. For more information about Retinal Detachment or to make an appointment with one of our specialists please contact the Eye Specialist Institute today.