Retinal detachment – medical information in daily life
Retinal detachment is an emergency condition in which a thin layer of the retina at the bottom of the eye pulls out and moves out of its normal position.
Retinal detachment separates retinal cells from the layer of blood vessels that provide oxygen and nourishment. The longer the retinal detachment lasts, the greater the risk of permanent vision loss in the affected eye.
Warning signs of retinal detachment can include any or all of the sudden onset of halos, flashes and double vision. Calling an eye doctor (ophthalmologist) right away can preserve your eyesight.
Symptoms of retinal detachment
Retinal detachments are usually painless, but warning signs always appear before they occur, such as:
- Sudden appearance of many halos, which are small spots that seem to drift into your field of vision
- Flashes of light in one or both eyes (photophobia)
- blurred vision
- Gradual decrease in side (peripheral) vision
- A curtain-like shadow over your field of vision
When do you see a doctor?
See your doctor right away if you have any signs or symptoms of retinal detachment. Retinal detachment is a medical emergency that can cause permanent vision loss.
Causes of retinal detachment
There are three different types of retinal detachment:
These types of retinal detachments are the most common. Detachment from other eye diseases is caused by a hole or tear in the retina that allows fluid to pass and collect under the retina, removing the retina from the underlying tissues and lying areas of the retina, being pulled away, diluting its blood supply and stopping in order to function, causing vision loss.
The most common cause of retinal detachment is aging. As you age, the jelly-like substance that fills in your eye, the vitreous humour, can change texture and shrink or become smoother. The vitreous usually separates from the surface of the retina without complications, and is a common condition. This is known as a posterior vitreous detachment. One of the complications of this separation is the occurrence of a crack.
When the vitreous detaches from or separates from the retina, it can pull on the retina with enough force to create a tear. If left untreated, the vitreous humor can enter the space behind the retina through the tear and cause a retinal detachment.
This type of detachment can occur when scar tissue grows on the surface of the retina and blocks the retina from the bottom of the eye. This usually occurs in people who have uncontrolled diabetes or other medical conditions.
With this type of detachment, fluid collects under the retina, but there are no holes or tears in the retina. Exudative detachment can be caused by age-related macular degeneration, eye injuries, tumors, or inflammatory diseases.
Risk factors for retinal detachment
The following factors increase the risk of developing a retinal detachment:
Diagnosis of retinal detachment
Your doctor may use the following tests, tools, and procedures to diagnose retinal detachment:
- Retinal examination. The doctor can use a bright light instrument and special lenses to examine the fundus of the eye, including the retina. This type of device provides a highly detailed view of the entire eye, allowing the doctor to see any retinal holes, tears, or compartments.
- Ultrasound imaging. Your doctor may perform this test if there is bleeding in your eye, making it difficult to see in your retina.
- Your doctor will likely examine both eyes, even if you only have symptoms in one eye. If this visit does not identify the problem, your doctor may ask you to return in a few weeks to make sure your eye does not have any problems with the detachment of the vitreous itself. Also, if you develop new symptoms, it is important to see your doctor immediately.
retinal detachment treatment
Surgery is almost always used to repair a retinal tear, hole, or detachment, and several techniques are available. Ask your eye doctor about the risks and benefits of your treatment options. Together, you can decide which action or combination of actions is right for you.
- Laser treatment. The surgeon directs the laser beam through the pupil into the eye, where the laser burns around the detached portion of the retina, creating scars that normally attach the retina to the tissues beneath.
- Freeze. After receiving a local anesthetic to numb your eye, the surgeon places a frozen probe on the outside of the eye, just above the detached portion of the retina, and the freezing creates a scar that anchors the retina to the eye wall.
- After the procedure, you will likely be advised to avoid activities that may irritate your eyes, such as running, for a few weeks or so.
- If the retina has peeled off, you will need to have surgery to repair it, preferably within days of diagnosis. The type of surgery your surgeon recommends depends on several factors, including the severity of the separation.
- Injecting air or gas into your eyes. In this procedure, known as pneumatic retina, the surgeon injects a bubble of air or gas into the central part of the eye (the vitreous cavity). When placed correctly, the bladder presses on the area of the retina that has a hole or holes in the eye wall, stopping the flow of fluid into the space behind the retina. Your doctor will also use cryofixation to repair a retinal hernia during the procedure.
- The fluid that collects under the retina is absorbed by itself. The retina can then adhere to the eye wall. You may need to hold your head in a specific position for up to several days to keep your bladder in the correct position. The bubble will eventually disappear on its own.
- Alteration of the lower ocular surface. During this procedure, the surgeon stitches a piece of white silicone into your eye over the affected area. This procedure puts pressure on the wall of the eye and relieves some of the force of the vitreous attraction on the retina.
- If you have a lot of perforations or a wide detachment, the surgeon can make a solid buckle that completely surrounds your eye as a strap; The buckle is positioned so that it does not obstruct your vision and usually stays in place permanently.
- Strain and replace the fluid in the eye. In this procedure, known as a vitrectomy, the surgeon removes the vitreous along with any tissue that has been pulled into the retina, then injects air, gas, or silicone oil into the vitreous cavity to flatten the retina.
- Eventually, air, gas, or liquid is absorbed and the vitreous cavity is filled with body fluid, and if silicone oil is used, it can be surgically removed months later.
After surgery, it may take several months for your eyesight to improve and you may need a second surgery for successful treatment. Some people never fully regain their lost sight.
Treatment and support for retinal detachment
Retinal detachment can lead to vision loss, and depending on the degree of vision loss, your lifestyle can change dramatically. You may find the following ideas helpful as you learn to live with low vision:
- Bring some glasses. Improve your eyesight with glasses designed specifically for your eyes, and order safety glasses to protect your best seeing eyes.
- Lighting your home. Make sure you have the right lighting in your home for reading and other activities.
- Ask for help from others. Tell friends and family about your vision problems so they can help you.
- Get help from technology. Digital conversation books and computer screen readers can aid in reading, and other new technologies are constantly being developed.
Check in transportation. Explore trucking and volunteer networks, or check out locations near you for the visually impaired.
- Talk to others who are visually impaired. Take advantage of the Internet, support groups, and resources for people with visual impairments.
Get ready for your doctor’s appointment
Here’s some information to help you get ready for your appointment.
what you can do
- Learn about any limitations in time. When you make the appointment, ask if there’s anything you need to do in advance.
- Make a list of any symptoms you’re experiencing, including those that seem unrelated to the reason for which you scheduled the appointment.
- A list of key personal information, including major stresses and recent life changes.
- Make a list of all medications, vitamins and supplements you’re taking, including the doses.
- Invite a family member or friend to accompany you. You may want to ask someone who can drive you home if your eyes are dilated at the exam. Or, this person can write down information from your doctor or other hospital staff during the appointment.
List of questions to ask your doctor
Some basic questions about retinal detachment are:
- What is the possible cause of my symptoms?
- What are other possible causes for my symptoms?
- What tests do I need? Do you need any special preparations?
- Is my condition temporary or continuous?
- What treatment options are available to me and which do you recommend?
- What are the alternatives to the first approach you’re suggesting?
- I have another disease. How can I best manage it?
- Should I restrict my activities in any way?
- Should I see another specialist?
- Do you have brochures or other printed material that I can take with me? What sites do you recommend for me?
- What determines whether I should plan a follow-up visit?
- If I need surgery, how long will it take to recover?
- Can I travel after the operation? Will it be safe to travel by plane?
What do you expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did the first symptoms appear?
- Do you have symptoms all the time, or do they come on occasionally?
- How severe are the symptoms?
- Have you had any symptoms in your other eye?
- Have you ever had an eye injury?
- Have you ever had an eye infection?
- Have you ever had an eye operation?
- Do you suffer from other conditions such as diabetes?
- Has anyone in your family had retinal detachment?