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When is Retinal Detachment Surgery Necessary?

What is a Retinal Detachment?

Retinal detachment is a serious eye condition whereby the retina (a type of tissue at the back of the eye) is pulled away from its original position. The incidence rate of retinal detachment is about 1 in 10,000 to 15,000 people in Singapore. Therefore, one should not take this eye condition lightly. The type of retinal detachment surgery, retinal laser treatment or retinal tear treatment recommended is dependent on the severity of the condition and the type of retinal detachment.

Causes of Retinal Tears and Detachments Singapore

Types of Retinal Detachment

1. Rhegmatogenous 

Rhegmatogenous retinal detachment is the most common type of retinal detachment. It usually starts with minor retinal tears. As the fluid from the vitreous chamber enters the inner layer of the retina via the tears, fluid will accumulate there, thus pushing the retina away from its original position. Once the retina is fully pushed away from the eyeball, retinal detachment occurs.

2. Tractional

Tractional retinal detachment, like its name, means the pulling away of the retina from its original position. This is caused by excessive growth of scar tissues in the eye due to diseases such as retinal vein occlusion or uncontrolled diabetes.

3. Exudative

Exudative retinal detachment is due to the leaking of blood vessels or other fluids in the eye. This leads to the pooling of fluids within the layers of the retina. As time goes by, the pooling of fluids will push the retina away from its original position, leading to retinal detachment. This can be caused by age-related macular degeneration or trauma in the eye. 

Signs You May Have a Retinal Detachment or Retinal Tear/Break

1. Sudden onset of floaters: Shapes such as dots, lines or circles that are floating in your vision. Some people see it but it may be due to other eye diseases. However, a sudden increase in the size or amount of floaters may point to a retinal detachment.

2. Flashes: Sudden flash-light vision like light flickering in the room appearing in your normal vision.

3. Curtain vision: A sudden dark shadow blocking your vision similar to when you are closing the curtain.

4. Sudden loss of vision

A retinal detachment requires emergency retinal detachment surgery as it is a serious eye condition. The retinal detachment surgery should be performed by a retinal surgeon as soon as possible after diagnosis. If left untreated, it can cause loss of vision. Possible types of retinal detachment surgery, retinal laser treatment and retinal tear treatment include:

1. Pneumatic retinopexy

The retinal surgeon will inject a gas bubble into the eye, pushing the retina back into its position. After which, a fixed position will need to be maintained for a few days to a few weeks.

Retinal disease treatment

2. Vitrectomy

Vitrectomy involves the removal of the vitreous, a gel-like substance that holds the shape of the eyeball. The retinal surgeon will treat the retina via freeze or retinal laser treatment. Lastly, a gas or oil bubble will be injected to replace the vitreous and hold the eyeball in shape. If an oil bubble is used, the surgeon will remove it after a few months.

vitrectomy

3. Scleral buckle

During a scleral buckle, the surgeon places a silicon or plastic rubber band in the white part of the eyeball. The band applies slight pressure on the eyeball to help the retina get reattached to its original position. This procedure can be performed in conjunction with vitrectomy.

Scleral Buckle

4. Laser photocoagulation

Depending on the severity of the retinal detachment, some surgeons may perform a laser photocoagulation though the procedure is mainly a retinal tear treatment or retinal break treatment. In this instance, a laser is used to burn and create a retinal scar. This helps to seal the retina and prevent the vitreous fluid from leaking into the inner layers of the retina.

5. Retinal cryopexy

Similar to laser photocoagulation, retinal cryopexy is also usually a retinal tear treatment or retinal break treatment. However, if the retinal detachment is not that severe, the surgeon may opt for this procedure to create a retinal scar through a freezing technique. After the retinal scar is created, it is sealed off and fluid from the vitreous will not be able to enter the retinal tear. This serves to prevent further retinal detachment.

If you suspect you have retinal issues and would like to seek advice on the types of possible retinal detachment surgery, retinal laser treatment or retinal tear treatment available in Singapore, please contact us at +65 6694 1000 or manager@eyemax.sg. For more information, visit Eye Max Centre.

References:

https://www.aao.org/eye-health/diseases/detached-torn-retina
https://www.singhealth.com.sg/patient-care/conditions-treatments/retinal-detachment
https://www.ttsh.com.sg/Patients-and-Visitors/Documents/Retinal%20Detachment%20Surgery.pdf
http://retinacare.org.uk/useful-guide/guide-to-laser-retinopexy-or-retinal-cryopexy-treatment-for-retinal-breaks/
https://my.clevelandclinic.org/health/diseases/10705-retinal-detachment
https://entokey.com/posterior-vitreous-detachment-evolution-and-complications-of-its-early-stages/ 

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