What is a Retinal Detachment?
Before we answer this question it is important to understand what exactly the retina is. The retina is the layer of nerve tissue which line the inside of the eye. It is responsible for detecting light, converting this signal into a nerve impulse and sending this information through the optic nerve to the brain. A retinal detachment occurs when the retina becomes separated from the wall of the eye. It typically occurs after a retinal tear has developed. A retinal detachment is a serious condition and can lead to significant permanent vision loss. The degree of permanent damage depends on how much and what part of the retina becomes detached. The macula is the portion of the retina which is responsible for your central most precious and detailed vision. If the macula becomes detached, you have a poorer visual prognosis and you may not regain good enough vision to read or drive with that eye even after anatomically successful surgery.
Why do I have a Retinal Detachment? What are the symptoms?
A retinal tear or retinal hole usually precedes a retinal detachment. The compromised area of the retina allows fluid to leak under the retina, thus detaching it from the wall of the eye. Retinal detachments are more common in patients who are very near-sighted, have a family history of retinal detachment, and in eyes that have had prior trauma or eye surgery. Patients may complain of flashes, sudden onset of new floaters and/or a shadow forming in their vision.
Assessment for Retinal Detachment
A retinal detachment is detected during a dilated eye exam. Your retinal surgeon will carefully and thoroughly examine your eye to identify all the retinal tears or holes and determine the extent of the retinal detachment. During the examination your doctor may need to press on your eye to fully examine your retina. At this point your doctor will determine the best treatment to repair the retinal detachment.
There are three basic options to repair a retinal detachment:
Pneumatic Retinopexy: This procedure is performed in the office. After numbing the eye a freezing (cryopexy) or laser treatment is performed to seal the retinal tear or hole and a gas bubble is injected into the eye to block any more fluid from leaking under the retina.
Scleral Buckling Surgery: This procedure is performed in the operating room. The scleral buckle is a silicone band that is placed around the eye to bring the wall of the eye closer to the retina. Sometimes scleral buckles are placed along with vitrectomy surgery.
Vitrectomy Surgery: This procedure is performed in the operating room. Small microsurgical instrument are introduced into the eye to remove the vitreous gel. Fluid that has leaked underneath the retina is removed and laser or cryopexy applied to the retina to seal the retinal tear or hole. Towards the end of rite surgery a gas bubble is placed to fill the inside of the eye and block fluid from entering the retinal tear or hole. It is important to understand that after surgery, head positioning is typically required for the first 1-2 weeks following surgery.