What is a Retina?
The retina is the nerve layer that lines the back of the eye. If you think of the eye as a camera, the retina is the film in the camera. A clear gel called the vitreous, located just in front of the retina, fills up the inside cavity of the eye. As one ages, the vitreous gel contracts and liquefies. As this occurs, the vitreous gel may sometimes pull a tear in the retina. Fluid from inside the eye can leak through the tear, and the retina can separate from the back wall of the eye, creating a retinal detachment.
What Causes a Detached Retina in the eye?
Retinal detachments occur with a frequency of 1 per 10,000 people per year. It is a serious condition that may lead to blindness if not treated appropriately. Risk factors for retinal detachment include nearsightedness (myopia), history of cataract surgery, family history of retinal detachment, retinal detachment in the other eye, and weak areas in the retina such as lattice degeneration.
Retinal Detachment Symptoms
Symptoms of a retinal detachment include the onset of floaters, flashing lights, and a “curtain” or area of darkness that may encroach on vision from the side. There is no pain with retinal detachment. You should contact your eye doctor as soon as possible if any of these symptoms develop.
How Can a Detached Retina be Repaired?
Retinal detachment repair brings the retina back into position and then sealing the hole or tear in the retina. Retinal detachment is almost always treated with some form of surgery. If the detachment is not extensive, laser treatment or cryotherapy (freezing) in the office are options. A procedure called pneumatic retinopexy treats some detachments. This involves the injection of air or gas into the eye in conjunction with laser or cryo. Doctors provide patients with specific head position instructions which allow the bubble to float up against the retina and keep it in position as it heals. Pneumatic retinopexy is only suitable for a select group of retinal detachments.
One of the most common surgical techniques in retinal detachment repair is a scleral buckle procedure. This is an operating room procedure in which a silicone band is placed around the eye. The band changes the shape of the eye and brings the retina back into contact with the wall of the eye. Then, cryo or lasers treat around the retinal breaks and other weak areas.
Vitrectomy surgery also has a role in retinal detachment repair. This technique removes the vitreous gel and any scar tissue from the eye. After the retina reattachment, a gas bubble fills the vitreous cavity to help hold the retina in position. The bubble generally lasts in the eye for several weeks and is gradually absorbed by the body. A silicone oil bubble is an alternative to an oil bubble in more complex cases. Once the retinal tissues are stable, a second surgery removes the silicone oil because it does not dissolve on its own.
Retinal Detachment Surgery
Surgery for most retinal detachments takes about one hour and local anesthesia is an option. Although hospital admission is not necessary, your surgeon may give you specific instructions regarding head positioning in order to maximize the chances of a successful outcome. Surgeries involving gas bubbles usually include limitations on flying in an airplane or traveling to high altitudes. Also, if you need surgery for any other reason while a gas bubble is in the eye, it is important to notify the anesthesiologist to prevent the gas bubble from expanding in the eye.
Retinal Detachment Surgery Results
The visual results of retinal reattachment depend on three main factors: how long the retina has been detached, how much of the retina has been detached and most importantly, whether the center of vision has been involved. If the surgery does not involve the center of vision, nearly full visual recovery is more likely. If the surgery does involve the center of vision, there is usually some permanent loss of vision. Your prescription for glasses may also need adjustments as a result of the surgery.
Schedule a Consultation
If you are interested in learning more about Retinal Detachment, please call (800) VRS-2500 to schedule a consultation. We have locations in Minneapolis, St. Paul, Blaine, Edina, Oakdale, Plymouth, St. Cloud and Duluth.