Retinal detachment occurs when it gets lifted or pulled up from its normal position.
If not promptly treated, it can cause permanent vision loss.
There are 4 types of retinal detachment :
- Rhegmatogenous retinal detachment
- Tractional retinal detachment
- Exudative retinal detachment
- Combined retinal detachment
Tractional & combined retinal detachments occurs commonly in vascular retinopthy, hence explained there.
It is a type of detachment in which a tear or break in the retina allows fluid to get accumulated under the retina and separate it from the overlying cell layer that nourishes it.
Tractional retinal detachment happens when scar tissue or other tissue grows on your retina and pulls it away from the layer underneath. It can lead to serious vision loss.
This type is often found in people with diabetes or other vascular diseases causing damage to blood vessels in the retina.
Exudative (serous) retinal detachment is rare. It happens when fluid collects under your retina, but there is no tear/break. It can affect both eyes.
This type of detachment is often seen as a complication of a wide range of diseases. These include various inflammatory diseases, eye tumors, and severe high blood pressure
Patients often complain of flashes (lightening) &/or new floaters (black spots) initially. Later, they complaints of shadow forming in their vision when a retinal detachment occurs.
- High myopia
- Family history of retinal detachment
- Any type of trauma to eye
- Any type of eye surgery
Minor detachments (Sub-clinical) : LASERS or Cryo-therapy ( freezing the retina)
LASERS: It is a OPD procedure. During LASER photocoagulation, laser is focused over retinal tear or small detachment. Laser emits a beam of light that travels through eye and burns the area around retinal tear or detachment to create a scar. This scar tissue helps seal tear or reattach a detached portion of retina to underlying tissue. With retinal tears, procedure prevents fluid from traveling underneath the retina, where it can cause detachment.
After this relatively painless procedure, your doctor may suggest that you refrain from strenuous activities to allow the scars to form and your eye to heal.
Cryotherapy: It uses cold, or freezing therapy, to create a scar. After injecting an anesthetic around the eye, the surgeon places a freezing probe over the tear or small area of retinal detachment.
Retinal detachment: Scleral Buckle or Vitrectomy surgery
It is a method of closing breaks and flattening the retina.
Usually done for limited & early RD.
A scleral buckle is a piece of silicone sponge, rubber, or semi-hard plastic that your retina specialist places on the outside of the eye (the sclera, or the white of the eye). The material is sewn to the eye to keep it in place. The element pushes in, or “buckles,” the sclera toward the middle of the eye. This buckling effect on the sclera relieves the pull (traction) on the retina, allowing the retinal tear to settle against the wall of the eye. The buckling element is usually left in place permanently.
The vitreous gel, which is pulling on the retina, is removed from the eye and replaced with a gas bubble or oil to keep the retina in place. Your body’s own fluids will gradually replace a gas bubble. An oil bubble will need to be removed from the eye at a later date with another surgical procedure. Sometimes vitrectomy is combined with a scleral buckle. After surgery, your ophthalmologist will recommend that you keep your head in special positions for a time.
Indications for vitrectomy are :
Old , severe RD
RD with proliferative vitreo-retinopathy
The success of vitrectomy surgery is highest when the gas/oil bubble is positioned correctly over the retinal hole or tear where it can maintain constant gentle pressure. Your doctor will tell you what the optimal positioning will be in your particular case.
Initially your vision will be blurry for 3-4 weeks. If gas is put into your eye, initially there will be no vision. As the bubble absorbs over the weeks, your vision will improve. In case of oil, there will be greater shift of your power & therefore you will have to wear temporary thicker glasses (till oil is removed).
It is not uncommon to have some discomfort and a scratchy feeling. Your doctor will advise you of the appropriate pain reducing techniques for you. Deep ache or throbbing pain should be reported to your doctor. Redness is common and will gradually lessen over time. You will be restricted from routine work & will be advised precautions to be taken for a period of time.
It depends on the severity of the condition and how quickly you get expert medical care.
If treatment is taken quickly & macula is not involved some people will recover near complete vision. However, some people may not regain full vision, especially if the macula is damaged and treatment isn’t sought quickly enough.
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