Retinal detachment is a potentially blinding condition where the retina comes away (detaches) from the inside of the back of the eye. The most common cause for this is age related change in the vitreous in the back part of the eye. The next most common cause is an injury- for example a blow to the eye.
The vitreous in the eye is normally attached to the retina at certain points. As time progresses the vitreous collapses and pulls away from the retina (posterior vitreous detachment). This in itself is not a problem, however, occasionally when it pulls away it causes a tear in the retina. Fluid then goes through this tear and causes the retinal lining to detach from the inside of the eye; this is further encouraged by continued traction from the vitreous.
Symptoms that may occur prior to retinal detachment include crescentic or lightning-type flashes of light in the peripheral vision. This may be accompanied by a increase in "floaters".
If the retina detaches a "shadow" may develop which obscures part of the vision. Untreated, this shadow usually enlarges rapidly until the whole of the vision is lost. This requires urgent and specialist surgical treatment by a surgeon trained specifically in vitreoretinal surgery. Without early treatment the large majority of people will be blind in the affected eye.
If retinal detachment is treated early, ideally before the central vision is affected, the results are very good with a high proportion of people maintaining normal or near normal vision. Once the central vision is affected the results are less predictable, although a significant proportion achieve good vision if treated promptly.
There are a number of methods which can be employed to treat a retinal detachment. The choice of method, or methods, depends on the configuration of the detachment. The basic principles of surgery are to minimize/remove traction on the retina, encourage any fluid behind the retina to resolve, close and permanently seal any tears in the retina.
In very early cases, when there is a tear in the retina and no/very little fluid, laser or freezing treatment (cryotherapy) can be used to seal the tears. In more advanced cases surgery to reattach the retina may involve placement of plastic components on the outside of the eye, laser treatment, freezing treatment, removal of the vitreous and the use of special gases, liquids and oils to facilitate retinal reattachment.
Ultrasound scan of the eye showing tear in the retina (red arrow). Vitreous (yellow), sclera (blue)
Retinal Detachment. The whitish, out of focus area is the area of detachment
www.retinalspecialist.com The Virtual Home of Niladri (Ted) Saha 2009