What is a retinal detachment?
The retina is a lining of the inside of the back of the eye. It receives all of the messages of light and processes these and sends them to the optic nerve, which transmits these to the part of the brain responsible for vision, so we can interpret what we see.
A retinal detachment is when this lining is not attached to the back of the eye. Â
You can notice a curtain or shadow that moves in and out of your visual field. If it affects your macula, you loose central vision.
A retinal detachment is an eye emergency which can result in permanent vision loss.
Surgeons at Coastal Eye Surgeons are equipped to provide emergency treatment in order to restore your vision.
Symptoms
Retinal detachment itself is usually painless. Other symptoms will usually start to appear as soon as it happens, and may get worse the longer it’s left untreated.
You may notice:
- Flashes of light in your vision
- Floaters – little specks or a "rain cloud of tadpoles" in your vision
- Blurred vision
- A shadow which appears from the side of your vision and gradually spreads across it
- A feeling like a transparent curtain is being gradually pulled over your vision
Healthy vision versus detached retina affected vision.
If you notice these symptoms appearing suddenly, it’s important to see an eye care professional as soon as possible. For the best outcome, retinal detachment needs to be managed as soon as possible.
Coastal Eye Surgeons can treat retinal detachment on an emergency basis – call us on 07 5616 0008 and explain your symptoms so we can give you an emergency appointment as soon as possible. You can also get a referral to us from a GP or optometrist.
How is a retinal detachment diagnosed?
Your optometrist or the Doctors at Coastal Eye Surgeons, will perform a retinal examination – a special lamp is used to look at the back of your eye, letting the doctor see any retinal holes, tears or detachments. This is usually done at a routine appointment, or if you present with the symptoms described above.
If your doctor or optometrist diagnoses retinal detachment, you will be referred to an ophthalmologist and ophthalmic surgeon for immediate confirmation and treatment. Treating retinal detachment quickly is essential to preventing vision loss.
Your eye surgeon will perform other tests before they operate, usually within their office. These include:
Pupil dilation
Drops are put in your eye which cause the iris to relax, opening the pupil for a better view of the eye’s structures.
Intraocular pressure measurement
This helps rule out other conditions (such as glaucoma) and gives the surgeon a baseline figure to compare against after your procedure.
Macular Scans
A technique similar to ultrasound is used to make a 3D image of your eye, which allows a baseline of your macular involvement.
After the examination and scans Coastal Surgeons will tailor the treatment that is best suited to provide the best visual outcome for the individual.
Treatments for retinal detachment
Treatment for retinal detachment is always surgical, as the breaks in the retina need to be physically sealed to prevent further damage.Â
Surgical treatment for retinal detachment aims to reattach the separated retina to the back of the eye and repair any tears in the retina itself. This may be achieved with a variety of approaches.
Depending on the tear’s location and level of complexity, your surgeon may use a combination of approaches some of the techniques outlined below.
Photocoagulation and cryotherapy
Photocoagulation and cryotherapy is used to "patch weld" around the area of the retinal tears, in order to ensure the break is contained and cannot result in further retinal detachment.Â
Photocoagulation uses laser to do this, whereas cryotherapy does it using extreme cold.
Scleral buckling
Scleral buckling involves sewing a thin band of silicone or rubber around the sclera (the outside white part of the eye), which gently molds the sclera to a shape which guides the retina back into position.
Vitrectomy
A Vitrectomy involves draining the vitreous fluid from your eye and directly visualising the retinal tear and detachment. The fluid that is causing the retina to "detach" is drained and the tear is generally lasered.Â
The eye is then filled with air, gas or oil, which "tamponades" the retina against the sclera.Â
Depending on the makeup of the bubble, you may need to position your head in a certain position after the surgery or have another procedure later to remove it.
Pneumatic retinopexy
Pneumatic retinopexy combines laser or cryotherapy to "weld" the retinal tear and an injection of generally gas, to press the retina back into position.Â