Retina Detachment is a disorder of the eye in which the retina detaches from the retinal pigment epithelium. Retinal detachments can be produced by fluid leaking behind the retina through the tears, fluids secreting from the retina. Traction on the retina. The severity of retinal detachment diagnosis is dependent on how long the detachment has occurred if its macula was detached, and the underlying health of both the retina and circulatory system of the eye.
The retina is a thin layer of tissue that is sensitive to the light, existing on the back wall of the eye. The ocular system of the eye concentrates light on the retina much like light is centered on the film or sensor in a camera. The retina transpose that concentrated image into neural impulses and sends them to the brain through the optic nerve on some occasions posterior vitreous detachments, trauma or injury to the eye or head may cause a tiny tear in the retina. Vitreous fluid seeps through the tear in the retina, and the retina peels away like a bubble wallpaper.
Signs and Symptoms of Retina and detachment.
Photopsia –flashes of light – brief and far peripheral (outside of the center) part of vision
A sudden and dramatic increase of floaters in the eye.
A ring of floaters or hairs slightly left or right to the temporal (skull) side of the central vision
In most cases posterior vitreous detachments do not deteriorate into retinal detachments, however, if it does, the following symptoms occur.
- A thick shadow that begins in the peripheral vision and slowly encroaches towards the central vision.
- Straight lines, edge of a wall, road, window sills, etc., suddenly begin to appear curved.
- The feeling that curtain or a veil has been placed over your field of vision.
Central visual loss
- If you are experiencing sudden flashes of light or floaters, you should see an eye doctor immediately. A shower of floaters or any vision loss is a medical treatment, and you should get treatment right away.
- Retinal detachment is painless however warning signs will always appear before it occurs or worsens.
You should get checked routinely if you are over the age of 50 or if you are extremely nearsighted.
Aging-related retinal tears can lead to retinal detachment.
As a person ages, the vitreous may change in consistency and shrink or become a liquid. Eventually, the vitreous may spate form the surface of the retina, a common condition called posterior vitreous detachment (PVD)
When vitreous separates or peels off the retina, it may pull on the retina with enough force to create a retinal tear. If retinal is left untreated, fluid form the vitreous cavity will leak through the tear in the space behind the retina, causing a detachment.
Risk Factors of Retinal Detachment
Risk factors for retinal detachment can include severe myopia, trauma, retinal tears, family history or even complications from cataract surgery.
Retinal detachment can be avoided in some cases when it is caught early, The most effective method of prevention and to reduce risk is through understanding what the early signs of retinal detachment are. It is encouraged that people seek ophthalmic medical attention if they have symptoms that suggest posterior vitreous detachment. The Early examination will discover of retinal tears. These tears can be treated with cryotherapy or lasers. These treatment options reduce the risk of retinal detachment in people who have tears at 1L3 to 1L20. Consistent monitoring is recommended by sports players because of this risk, and regular eye examinations are required.
In high-impact sports or high-speed sports, trauma related cases of retinal detachment are more common. Although some healthcare professionals may recommend avoiding that increase the pressure on the eye, including diving and skydiving, there is little evidence that supports the recommendation, specifically for the general populous. However ophthalmologist, generally recommend that individuals with high degrees of myopia try to avoid exposure to high speed, pressure activities. These activities can potentially cause trauma or pressure on the eye itself, through rapid acceleration and deceleration, such as roller-coaster and bungee jumping.
Also, intraocular pressure can also cause exceedingly high points of pressure during any activity that includes the Valsalva maneuver, including weightlifting The Valsalva maneuver is performed by moderate force attempted exhalation against a closed airway. A study suggests that heavy manual lifting may be associated with increased risk of rhegmatogenous retinal detachment. However, this is not a definite correlation. In the study, obesity had also increased the risk of retinal detachment.
There are genetic factors that can cause local inflammation and photoreceptor degeneration and risk increased with these diseases and disorders listed below:
Family History fo retinal detachment
Smoking and passive smoking
Von Hippel-Lindau disease
Metastatic cancer, spreading to the eye
Retinal Detachment Diagnosis
Retinal detachment can be examined through an ophthalmoscope or a fundus photography. Fundus photography needs a much larger instrument than the ophthalmoscope but has the advantage of availing the image to be reviewed by a specialist at another time, as well as providing documentation for future references. Modern fundus photographs will recreate larger areas of the funds than what can be seen at any time with hand-held ophthalmoscopes.
The doctor may use a medical apparatus with a bright light and a special lens (ophthalmoscope) to examine the back portion of your eye as well as the retina.
Ultrasound has a diagnostic accuracy similar to that of examination by an ophthalmologist. The recent meta-analysis shows the diagnostics accuracy. The doctor will test if bleeding as occurred in the eye or if there are any fluids making it difficult for you to see.
Your doctor well examines both your eyes even if there is just one eye with symptoms. If the tear is not found at this visit, you doctor may ask you to return within the next few weeks to confirm if the eye has not developed a tear later as a result of the same vitreous separation. Also, you may experience new symptoms that should be taken care of right away.
Surgery is usually the treatment option to repair for retinal tears, holes or detachments. There are multiple implementation techniques. You can ask your ophthalmologist about the risk and benefits of each. With your doctor, you can determine what procedure or combination of procedures would work for you.
Retinal Tears and Holes Repair Surgery
In Cases where retinal tears or holes that haven’t progressed to detachment, your surgeon may recommend one of the following procedures to prevent detachment and preserve your vision.
Laser surgery (Photocoagulation). The surgeon targets a laser beam into the eye into the pupil. The laser makes burns around the retinal tear, creating scarring that bonds the retina to the tissue beneath it.
Freezing (Cryopexy) After you are given a local anesthetic to numb the eye, the doctor will apply a freezing probe to the out surface directly over the tear. The freezing much the same way as the laser, and causes scarring that helps bonds the retina to the eye wall.
Both of these operations can be completed as outpatient procedures. After the surgery, you be given instructions or what activities to avoid, that my jolt the eyes, such as running for a few weeks.
Retinal Detachment Surgery
You will need surgery to repair a detached retina. It is recommended that you have the procedure within days of diagnosis. The type of surgery will depend on multiple factors, including severity.
Injecting air or gas into the eye, via pneumatic retinopexy. The doctor injects a bubble of air or gas into the eye (vitreous cavity) If the bubble is position properly, it will push the areas of the retina containing the hole or holes in the eye wall, which prevents the flow of fluid into space behind the retina. The doctor could also use cryopexy during the operation to repair the retinal break.
The fluid that has been collecting under the retina is absorbed by itself so that the retina can attach to the wall of the eye. You may need to hold your head in a certain position for the next several days to keep the bubble in the correct position. The bubble will reabsorb on its own.
The second procedure (scleral buckling) is indenting the surface of the eye. In this procedure, the surgeon sews (suture) a piece of silicon material to the white of the eye(sclera) over the affected area. This procedure indents the wall or the eye and relieves some force caused by the vitreous pulling on the retina.
If there are several tears or holes or is an extensive retinal detachment, the surgeon may create a scleral buckle that encircles the entire eye like a belt. The buckle is placed in a way that does not block the vision but remains in place permanently.
Draining and replacing the fluid in the eye, or Vitrectomy. In a Vitrectomy, the surgeon removes the vitreous along with any tissue that is pulling on the retina. Air gas or silicone oil is injected into the vitreous space to flatten the retina.
Over time the air, gas, or liquid is reabsorbed, and the vitreous space will refill with body fluid, if silicone oil is used, it can be surgically removed within months
A vitrectomy may be done with a scleral buckling procedure.
After surgery, it may take several months for your vision to improved. Some people may need a second surgery for successful treatment and others may never fully recover all of their lost vision.