WHAT IS THE RETINAL DETACHMENT?


Retinal detachment is the separation of the two layers that compose the retina: internal layer (neuroepithelium) and external layer (pigment epithelium) by a liquid called subretinal fluid. Retinal area detached does not function and causes a significant loss of vision, which can be partial or total.

The retinal detachment can be rhegmatogenous i.e. produced as a result of a retinal tear. The causes of retinal tears are multiple, and include: after an injury (possibly overlooked by the patient), after a strenuous exercise, after a coughing fit, sneezing, vomiting, constipation.

There is also tractional retinal detachment that is produced due to abnormal vitreoretinal tractions (the vitreous gel is located inside the eye behind the lens and in front of the retina). A small initial retinal detachment can extend progressively, reaching a total detachment. If the detachment is total, the eye will not be able to see at all. A detached retina causes vitreous gel transformations which, if there is an existingtraction, accentuate the detachment. On the other hand, a detached retina loses its elasticity after a variable interval, becoming rigid and brittle. The retinal detachment is an emergency requiring surgical treatment as quickly as possible.

WHAT ARE THE SYMPTOMS?


The onset is usually sudden and painless, with the emergence of a black curtain covering a part or all of the visual field. This shade is often preceded by mobile opacities or bright flashes in the visual field. If a patient shows mobile opacities, he/she should consult a WEST EYE HOSPITAL ophthalmologist in order to ascertain if there are serious retinal problems (such as retinal detachment or retinal tears).

DIAGNOSIS OF RETINAL DETACHMENT


The patient should consult an ophthalmologist immediately after the aforementioned signs appeared. The patient will have his pupil dilated and then the fundus of the eye will be examined. Ultrasonography (eye ultrasound) is mandatory in setting an accurate diagnosis.

Early  diagnosis of retinal tear is very important before it evolves to retinal detachment. If flashes appear, the patient must consult an ophthalmologist as urgently as possible. Through examination, the doctor determines the place of retinal tear and blocks it using the laser.

WHAT IS THE TREATMENT FOR RETINAL DETACHMENT?


The treatment is surgical. There are different surgery techniques depending on the extension of the detachment, number of retinal tears, the onset of retinal detachment.

Silicone sponge scleral indentation is a method through which special sponge are applied to the sclera surface next to the breaks.

Another method is vitrectomy. If the retinal detachment has several tears or tears were not detected before surgery, vitrectomy has to be done because in this way, the doctor has access inside the eye.

WHAT ARE THE RISK FACTORS?



  • Myopia;

  • Ocular trauma;

  • Diabetes;

  • Posterior vitreous detachment;

  • Peripheral retinal degenerative lesions (Lattice degeneration);

  • Surgery on the anterior or posterior segment of the eye;



Retinal detachment can occur spontaneously. It occurs most often in people with myopia.

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