What is retinal detachment? And are you at risk?
Retinal detachment occurs when the retina, a thin nerve membrane at the back of the eye, gets detached from its normal position. Retinal tears develop when the vitreous pulls on the retina and it can lead to retinal detachment as the vitreous humour can leak behind the tear, causing the retina to be separated from the wall of the eyeball. This causes the retina to lose its oxygen and nourishment supply. The retina senses light and transmits signals to the brain so that we can see. Retinal detachment can cause permanent loss of vision if it is left untreated.
There are 3 main types of retinal detachment:
Rhegmatogenous – The most common being type which occurs because of a retinal tear.
Tractional – When scar tissues pull on the retina, usually due to diabetes damaging the blood vessels in the back of the eye
Exudative – Caused by fluid building up behind the retina but there is no retinal tear. The fluid will push your retina away from the tissue behind it. Age-related macular degeneration, inflammation, vascular abnormalities, tumour, and trauma are the common causes.
Risk factors for retinal detachment include:
- Ageing, especially those over the age of 50. One reason is due to the shrinking of the vitreous humour and this can pull on the retina resulting in a tear.
- Eye injury or trauma retinal detachment can be classified into 2 types – blunt contusion and those due to perforation of the posterior segment of the eye. Retinal detachment due to eye injury can occur at any age.
- A family history of retinal detachment increases the risk as studies have shown that retinal detachment can cluster in families, and the cumulative lifetime retinal detachment risk doubles when you have a relative with retinal detachment. Those with Marfan and Stickler syndrome also have an increased risk of retinal detachment.
- Having a previous retinal detachment history and/ or a previous eye surgery, or a previous eye disorder that can include uveitis, thinning of the peripheral retina and high myopia also increases the risk of retinal detachment.
A retinal detachment usually needs to be repaired quickly. You may not have much time to think about it.
There are a few procedures that eye doctors perform to fix a detached retina:
- Pneumatic retinopexy
- Scleral buckle
- Laser surgery (photocoagulation)
The type of surgery you need will depend on several factors including how much of your retina is detached and where in your eye it detached.
In pneumatic retinopexy, a small bubble will be injected into the eye to push the retina back into position. To keep the bubble in the correct position, you may have to hold your head in a certain position for a few days. The bubble will eventually be reabsorbed on its own.
During scleral buckle surgery, a tiny, flexible band usually made of silicone will be attached on the outside of the eyeball, so to gently push the eyeball towards the detached retina, to help it reattach. This band will stay on the eye permanently.
In a vitrectomy, the eye surgeon will remove the clear vitreous gel that fills the cavity of the eye, and any holes in the retina will be lasered. Air, gas or silicone oil is injected into the vitreous space to keep the retina in place.
If air or gas is used, the eye will begin producing vitreous that will replace it. In the meantime, flying, travelling to high altitudes or scuba diving are not recommended as altitude change will cause the gas to expand thus increasing the eye pressure.
If silicone oil is used, the eye surgeon will remove it after a few months.
For laser surgery, the eye surgeon uses a laser beam to burn around the retinal tear to create a scar that will weld the retina to its underlying tissue preventing further tear.
Retinal detachment surgery can be performed under local or general anaesthesia and is usually a day procedure. However, a complex retinal detachment may require a longer surgical time and hospitalisation.
Signs and symptoms of retinal detachment include a sudden increase in the number of floaters, flashes of light, curtain-like shadow vision over your field of vision or darkening of peripheral vision.
Contact us at +65 6694 1000 or email@example.com to see an eye doctor if you experience any of the above signs and symptoms. Retinal detachment is a serious medical emergency which can cause permanent loss of vision if not treated timely.