Retinal detachment

Detached Retina (Retinal Detachment)

Retinal detachment

Your Questions about Retinal Detachment Answered: To view all 9 of the videos in this series, click on the icon in the upper left of the video screen.

What Is a Detached Retina (Retinal Detachment)?

A detached retina occurs when the retina is pulled away from its normal position in the back of the eye. The retina sends visual images to the brain through the optic nerve. When detachment occurs, vision is blurred. A detached retina is a serious problem that can cause blindness unless it is treated.

The retina normally lies smoothly and firmly against the inside back wall of the eyeball and functions much the film in the back of a camera.

Millions of light-sensitive retinal cells receive optical images, instantly “develop” them, and send them on to the brain to be seen.

If any part of the retina is lifted or pulled from its normal position, it is considered detached and will cause some vision loss.

Symptoms

  • Floaters
  • Flashing lights
  • Gray curtain or veil moving across your field of vision

The symptoms described above may not necessarily mean that you have a detached retina. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam.

Causes

The vitreous is the clear collagen gel that fills the eye between the retina and the lens. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye.

Usually the vitreous separates from the retina without causing a problem. But sometimes the vitreous pulls hard enough to tear the retina in one or more places, causing the retinal detachment.

Fluid may pass through the retinal tear and lift the retina off the back of the eye wallpaper can peel off a wall.

Risk Factors

A detached retina can occur at any age, but it is more common in midlife and later. Conditions that can increase the chance of a retinal detachment include nearsightedness; previous cataract surgery; glaucoma; severe trauma; previous retinal detachment in your other eye; family history of retinal detachment; or weak areas in your retina that can be seen by your ophthalmologist.

Treatment and Drugs

  • Retinal Tears Retinal holes or tears will usually need to be treated with laser treatment or cryotherapy (freezing), to seal the retina to the back wall of the eye again. These treatments cause little or no discomfort and may be performed in your ophthalmologist's office. This treatment will usually prevent progression to a retinal detachment. Occasionally retinal tears are watched without treatment.
  • Detached Retina Retinal detachments may require surgery to return the retina to its proper position in the back of the eye. There are several ways to fix a detached retina. The decision of which type of surgery and anesthesia (local or general) to use depends upon the characteristics of the retinal detachment. In each of the following methods, your ophthalmologist will locate any retinal tears and use laser surgery or cryotherapy (freezing) around them to seal the tear.

Surgery for a Detached Retina

  • Pneumatic retinopexy Pneumatic retinopexy describes the injection of a gas bubble into the vitreous space inside the eye enabling the gas bubble to push the retinal tear back against the wall of the eye and close the tear. Laser or cryosurgery is used to secure the retina to the eye wall around the retinal tear. Your ophthalmologist will ask you to maintain a certain head position for several days. The gas bubble will gradually disappear. Sometimes this procedure can be done in the ophthalmologist's office.
  • Scleral buckle A scleral buckle or flexible band is placed around the equator of the eye to counterbalance any force pulling the retina place. Often the ophthalmologist will drain the fluid from under the detached retina, allowing the retina to return back to its normal position against the back wall of the eye. This procedure is performed in the operating room, usually on an outpatient basis.
  • Vitrectomy A vitrectomy is a surgical procedure to remove the vitreous gel that pulls on the retina. This may also be necessary if the vitreous is to be replaced with a gas bubble. Your body's own fluids will gradually replace this gas bubble, but the vitreous gel does not return. Sometimes a vitrectomy may be combined with a scleral buckle.

After Surgery

You can expect some discomfort after surgery for a detached retina. Your ophthalmologist will prescribe any necessary medications for you and advise you when to resume normal activity. You will need to wear an eye patch for a short time.

If a gas bubble was placed in the eye, your ophthalmologist may recommend that you keep your head in special positions for a time.  If a gas bubble is used, you will be restricted from air travel, scuba diving, and certain types of anesthesia until after the bubble is gone.

A change of glasses may be necessary after the retina has been reattached.

What Are the Risks of Surgery?

Any surgery has risks; however, an untreated retinal detachment will usually result in permanent severe vision loss or blindness.

Some of these surgical risks include infection, bleeding, high pressure inside the eye, or cataract. Most retinal detachment surgery is successful, although a second operation is sometimes needed.

If the retina cannot be reattached, the eye will continue to lose sight and ultimately become blind.

Will Your Vision Improve?

Vision may take many months to improve and in some cases may never fully return. Unfortunately, some patients, particularly those with chronic retinal detachment, do not recover any vision.

The more severe the detachment, and the longer it has been present, the less vision may be expected to return.

For this reason, it is very important to see your ophthalmologist at the first sign of trouble. 

Find a Doctor or Location

  • Find a doctor 
  • Find a location
  • Call 734-764-4190 

Reviewed by Grant M. Comer, M.D., M.D.

Source: https://www.umkelloggeye.org/conditions-treatments/detached-retina-retinal-detachment

Retinal Detachment

Retinal detachment

Retinal detachment is an eye problem that happens when your retina (a light-sensitive layer of tissue in the back of your eye) is pulled away from its normal position at the back of your eye.

If only a small part of your retina has detached, you may not have any symptoms.

But if more of your retina is detached, you may not be able to see as clearly as normal, and you may notice other sudden symptoms, including:

  • A lot of new gray or black specks floating in your field of vision (floaters) 
  • Flashes of light in one eye or both eyes
  • A dark shadow or “curtain” on the sides or in the middle of your field of vision

Retinal detachment can be a medical emergency. If you have symptoms of a detached retina, it’s important to go to your eye doctor or the emergency room right away.

The symptoms of retinal detachment often come on quickly. If the retinal detachment isn’t treated right away, more of the retina can detach — which increases the risk of permanent vision loss or blindness.

Anyone can have a retinal detachment, but some people are at higher risk. You are at higher risk if:

  • You or a family member has had a retinal detachment before
  • You’ve had a serious eye injury
  • You’ve had eye surgery, surgery to treat cataracts

Some other problems with your eyes may also put you at higher risk, including:

  • Diabetic retinopathy (a condition in people with diabetes that affects blood vessels in the retina)
  • Extreme nearsightedness (myopia), especially degenerative myopia
  • Posterior vitreous detachment (when the gel- fluid in the center of the eye pulls away from the retina)
  • Certain other eye diseases, including retinoschisis or lattice degeneration

If you’re concerned about your risk for retinal detachment, talk with your eye doctor.

There are many causes of retinal detachment, but the most common causes are aging or an eye injury.

There are 3 types of retinal detachment: rhematogenous, tractional, and exudative. Each type happens because of a different problem that causes your retina to move away from the back of your eye.

There’s no way to prevent retinal detachment — but you can lower your risk by wearing safety goggles or other protective eye gear when doing risky activities playing sports.

If you experience any symptoms of retinal detachment, go to your eye doctor or the emergency room right away. Early treatment can help prevent permanent vision loss.

It’s also important to get comprehensive dilated eye exams regularly. A dilated eye exam can help your eye doctor find a small retinal tear or detachment early, before it starts to affect your vision.

Retinal detachment can happen to anyone

If you have an eye injury or trauma ( something hitting your eye), it’s important to see an eye doctor to check for early signs of retinal detachment

Seeing a few small specks in your vision (floaters) is normal — but if you suddenly see a lot more floaters than usual, it’s important to get your eyes checked right away

If you see any warning signs of a retinal detachment, your eye doctor can check your eyes with a dilated eye exam. The exam is simple and painless — your doctor will give you some eye drops to dilate (widen) your pupil and then look at your retina at the back of your eye.

If your eye doctor still needs more information after a dilated eye exam, you may get an ultrasound or an optical coherence tomography (OCT) scan of your eye. Both of these tests are painless and can help your eye doctor see the exact position of your retina.

Depending on how much of your retina is detached and what type of retinal detachment you have, your eye doctor may recommend laser surgery, freezing treatment, or other types of surgery to fix any tears or breaks in your retina and reattach your retina to the back of your eye. Sometimes, your eye doctor will use more than one of these treatments at the same time.

Treatment for retinal detachment works well, especially if the detachment is caught early. In some cases, you may need a second treatment or surgery if your retina detaches again — but treatment is ultimately successful for about 9 10 people.

Last updated: June 26, 2019

Source: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment

Your Eyes and Retinal Detachment

Retinal detachment

  • What Is a Detached Retina?
  • Types of Retinal Detachment
  • Do I Need Surgery?

This serious eye condition happens when your retina — a layer of tissue at the back of your eye that processes light — pulls away from the tissue around it. Since the retina can't work properly when this happens, you could have permanent vision loss if you don’t get it treated right away.

You're more ly to get one if you:

A detached retina doesn't hurt. It can happen with no warning at all. But you might notice:

  • Flashes of light
  • Seeing lots of new “floaters” (small flecks or threads)
  • Darkening of your peripheral (side) vision

If you have any of those symptoms, contact your eye doctor immediately.

Sometimes it comes before full detachment. It usually has the same symptoms. If your retina gets torn, the fluid inside your eye can leak underneath and separate the retina from its underlying tissue. That's retinal detachment.

Go to the eye doctor. She can fix it in the office with a simple laser procedure. If you don’t and it detaches fully, you'll need more serious surgery to repair it.

As part of an eye exam. The doctor will give you eye drops that widen your pupil (she'll call this dilating your eyes). She'll use a special tool to look into it and see if your retina is detached.

Early diagnosis is key to preventing vision loss from a detached retina.

Your doctor has several options:

Laser (thermal) or freezing (cryopexy). Both methods can repair a tear if it is diagnosed early enough. The procedures are often done in the doctor's office.

Pneumatic retinopexy. This works well for a tear that’s small and easy to close. The doctor injects a tiny gas bubble into the vitreous, a clear, gel- substance between your lens and retina. It rises and presses against the upper part of the retina, closing the tear. She can use a laser or cryopexy to seal the tear.

Scleral buckle. In this surgical procedure, the doctor sews a silicone band (buckle) around the white of your eye (she'll call it the sclera). This pushes it toward the tear until it heals. This band is invisible and is permanently attached. Laser or cryo treatment can seal the tear.

Vitrectomy. This surgery is used to repair large tears. The doctor removes the vitreous and replaces it with a saline solution. Depending on the size of the tear, she might use various combinations of vitrectomy, buckle, laser, and gas bubble to repair your retina.

Sometimes. Get to your eye doctor immediately if you develop new floaters, see flashing lights, or notice any other changes in your vision. Early is always better than late when it comes to treating retinal tears, detachments, and other serious issues.

An eye exam can also flag early changes in your eyes that you may not have noticed. Treating those could prevent problems down the road.

Get your eyes checked once a year, or more often if you have conditions diabetes that make you more ly to have eye disease. Regular eye exams are also important if you’re very nearsighted. That makes detachment more ly.

If you have diabetes or high blood pressure, keep those conditions under control. That will help keep the blood vessels in your retina healthy.

Not sure how often you should get your eyes checked? Ask your eye doctor.

Wear eye protection if you need it. Try sports goggles with polycarbonate lenses if you play racquetball or other sports that could harm your eyes. You may also need special glasses if you work with machines, chemicals, or tools for your job or at home.

SOURCES:

National Eye Institute: “Finding the Right Eye Protection” and “What Kind of Eyewear Can I Use to Protect My Eyes.”

American Academy of Ophthalmology, geteyesmart.org: “Retinal Detachment: What Is a Torn or Detached Retina?”

American Society of Retina Specialists: “Retinal Disease/Health Series,” “Retinal Tears.”

Harvard Health Publications: “What you can do about floaters and flashes in the eye.”

American Academy of Ophthalmology: “What are Dilating Eyedrops?” “What to Expect When Your Eyes Are Dilated.”

© 2018 WebMD, LLC. All rights reserved. Types of Retinal Detachment

Source: https://www.webmd.com/eye-health/eye-health-retinal-detachment

What Is the Recovery Time After Detached Retina Surgery?

Retinal detachment

  • Recovery Timeline
  • Pneumatic Retinopexy
  • Scleral Buckling
  • Vitrectomy

There are three types of surgery used to repair a detached retina. The recovery timeline is different for each, but the overall range is two to six weeks. (Learn More)

A retinal detachment can result in permanent vision loss if it is not treated quickly. The detachment happens when the retina pulls away from its normal position.

The type of surgery a doctor performs depends on the severity of the retinal detachment. (Learn More)

Pneumatic retinopexy helps the retina to attach itself to the eye’s wall. (Learn More)

Scleral buckling uses a silicone material to make the repair. This technique may be ideal for extensive detachment. (Learn More)

Vitrectomy may be done with or without silicone. It involves removing the vitreous and any other tissue that is pulling on the retina. (Learn More)

Recovery Timeline

There are three primary types of detached retina surgery. The one the surgeon chooses will depend on the severity of the detachment.

The recovery timeline depends on multiple factors, such as the person’s overall health, the exact surgery performed, and how they approach the post-surgical period.

The following are the average recovery times for the three primary types of detached retina surgeries:

Pneumatic Retinopexy

This procedure may be done in an office setting un other detached retina procedures. It works to reposition the retina and hold it in place until it attaches on its own.

Preparation

The doctor will provide full instructions regarding how to prepare for this procedure. It is imperative that everything is followed exactly.

Patients must undergo all eye examinations necessary before surgery.

Procedure

The doctor will inject either a gas or air bubble into the vitreous cavity of the eye. The bubble works to push the detached portion of the retina so fluid stops flowing into the space behind this structure. Any fluid that did collect before the surgery is naturally absorbed, allowing the retina to attach itself to the eye wall.

In some cases, cryopexy is used as part of this surgery. This is a technique that releases extreme cold to promote scar tissue formation. A metal probe is used to introduce the cold into the proper area of the eye.

Recovery

Following this surgery, people have to maintain a specific head position for several days. This is necessary to ensure that the bubble stays in place long enough to repair the detached retina. Eventually, the bubble absorbs on its own.

After the surgery, people should expect about three weeks for recovery. They cannot travel by air during the recovery period because doing so could expand the bubble.

If any of the following symptoms occur, people must alert their doctor immediately:

  • Reduced vision
  • Signs of infection around the eye, such as redness, swelling, or pain that is getting worse
  • Any new visual field changes, such as flashes, lights, or floaters
  • Any discharge coming from the eye

There are possible risks of pneumatic retinopexy.

  • A retinal detachment that is not repaired and recurs
  • Scar- process on the retina that causes another detachment
  • Gas getting trapped in the eye
  • Eye inflammation
  • Bleeding in the eye
  • New retinal tear
  • Folds in the retina
  • Increased eye pressure
  • Detached choroid, which is below the retina

Scleral Buckling

This procedure uses a piece of silicone to repair the retinal detachment. People who have extensive detachment may undergo this procedure.

Vitrectomy

This procedure may be done alone or with scleral buckling. It drains eye fluid and then replaces it.

References

Pneumatic Retinopexy for Retinal Detachment. University of Wisconsin School of Medicine and Public Health.

Scleral Buckling. Healthline.

Vitrectomy: Procedure, Complications, and Recovery. Medical News Today.

Detached or Torn Retina. American Academy of Ophthalmology.

Retinal Cryopexy. Encyclopedia of Surgery.

Pneumatic Retinopexy. Johns Hopkins Medicine.

Scleral Buckling. Johns Hopkins Medicine.

Vitrectomy. Johns Hopkins Medicine.

Source: https://www.nvisioncenters.com/conditions/retinal-detachment/recovery-time/

Diagnostic testing

Your retina specialist will perform a detailed eye exam, including a careful examination of the peripheral retina. This may include pushing on the outside of the eye (scleral depression) to view the far most peripheral retina to identify any retinal breaks that will need to be treated.

Photographing the retina is sometimes performed to document the extent of the detached retina, and an optical coherence tomography (OCT) scan of the retina can be useful to determine whether fluid has detached the center of the retina (the macula). When a clear view of the retina cannot be obtained by direct visualization, an ultrasound of the eye can be helpful.

Treatment and prognosis

The goal of treatment is to re-attach the retina to the back wall of the eye and seal the tears or holes that caused the retinal detachment. Several approaches can be employed to repair a retinal detachment:

  1. Scleral buckle—In this surgery, a silicone band is placed outside the eye wall to push the wall of the eye closer to the retinal tear in order to close the tear. The tear is treated with a freezing treatment to induce controlled scarring around the tear and permanently seal it. The fluid under the retina is sometimes removed at the time of surgery.
  2. Vitrectomy—In this surgery, three small incisions are made in the white part of the eye and fine instruments are manipulated using an operating microscope to remove the vitreous gel that fills the eye and drain the fluid from under the retina. The surgeon may then use a laser or cryopexy to seal the retinal tears or holes. The eye is then filled with a gas bubble to hold the retina in place while it heals.
  3. Pneumatic retinopexy—In this office-based procedure, a gas bubble is injected into the eye and the patient maintains a specific head posture to position the gas bubble over the retinal tear. The tear itself is sealed either with a freezing treatment at the time of the procedure, or with laser after the retina is re-attached.
  4. Laser surgery—In certain cases, a retinal detachment can be walled off with laser to prevent the retinal detachment from spreading. This is generally appropriate for small detachments.

the characteristics of the detachment, a retina specialist can determine which approach is most suitable. In general, retinal detachment repairs succeed in about 9 10 cases, though sometimes more than one procedure is required to successfully put the retina back into place.

The visual results depend on each patient’s pre-operative vision and other factors that differ between individual patients.

In general, when the center of the retina has not detached before surgery, the post-operative vision tends to be similar to the pre-operative vision.

If the central retina is detached prior to surgery, successful re-attachment often leads to vision improvement, though some degree of permanent vision loss may occur.

Source: https://www.asrs.org/patients/retinal-diseases/6/retinal-detachment

Causes of Retinal Detachment

Retinal detachment

There are three main causes of retinal detachment, each with its own set of risk factors. The most common type is called a “rhegmatogenous” detachment, and is caused by a tear or hole in the retina.

The retina is the thin, light-sensitive tissue that lines the back inside wall of the eye. If the retina tears, thick liquid called vitreous (which fills the back two-thirds of the hollow eyeball) can seep through the hole.

The fluid accumulates underneath the retina, causing the retina to peel away from the back of the eye.

Risk factors for rhegmatogenous retinal detachments include aging, cataract surgery, thinning of the outer retina known as lattice degeneration, a high degree of nearsightedness (also called high myopia), and head trauma. Let's look at each one of these causes in more detail:

As we age, our vitreous gradually changes from a thick, gelatin- consistency to a consistency more egg white. The vitreous is attached to the retina.

As it becomes thinner and moves around more inside the eye, it tugs on the retina and eventually tugs free of the retina. This usually occurs between 55 and 65 years of age.

If the vitreous is attached tightly enough to the retina, the separating vitreous can pull a tear in the retina, much pulling a piece of tape off a piece of paper can rip a hole in the paper.

Cataract surgery involves replacing the large, cloudy human lens inside the eye with a thinner plastic lens implant. This creates extra room inside the eye, removing some clothes from a tightly packed suitcase. As vitreous flows into the newly created space, it can tug on the retina and occasionally create a retinal tear.

Lattice degeneration is the name of a lace- thinning at the edges of the retina that can make the retina more vulnerable to tears. Nearsightedness of more than 5 diopter powers is associated with a greater risk of retinal tears, possibly because nearsighted eyes are longer than normal and the retina is stretched thinner than normal.

It may also be that high nearsightedness is associated with vitreous that is attached to the retina more tightly. A sudden blow to the head or eye, such as hitting a windshield or having an air bag deploy, can also create a tear in the retina. Head trauma is also among the most common causes of retinal detachment in children.

Other risk factors for rhegmatogenous detachments include a family history of retinal detachment and certain congenital or hereditary eye diseases.

A less common type of retinal detachment is called a “tractional” detachment. This occurs when vitreous tugs on the retina over time, gradually causing the retina to tent up off the back of the eye. Tractional detachments do not occur suddenly and are not associated with retinal tears.

One of the most common causes of tractional detachments is advanced diabetic eye disease in which vitreous grabs onto and tugs on abnormal blood vessels that are growing on the surface of the retina.

In children, the most common cause of tractional detachments is a condition called retinopathy of prematurity which can affect premature newborns who receive oxygen in the high-risk neonatal nursery.

The third, even less common type of retinal detachment is called an “exudative” detachment in which fluid leaks blood vessels within or underneath the retina. This can occur in inflammatory conditions such as uveitis and scleritis, certain collagen vascular or autoimmune diseases, tumors of the eye, and congenital diseases such as Coat's disease.

What causes dry eyes? See Answer

Source: https://www.medicinenet.com/causes_of_retinal_detachment/views.htm

Retinal Detachment: Are You at Risk?

Retinal detachment

We explored the critical role the retina plays in maintaining healthy vision in our previous blog post and offered lifestyle adjustments that promote retinal health for you and your family.

Here’s a brief recap: eat lots of orange veggies (carrots, sweet potatoes, apricots, peaches) in addition to those leafy greens (kale, broccoli, spinach), protect your eyes from UV rays every day, and exercise regularly.

While these changes can support overall retinal health, there are still serious potential problems that can impact the retina and therefore your vision. Retinal detachment is one of them.

What is a Retinal Detachment?

The retina is a delicate layer of tissue in the back of the eye that communicates with the optic nerve to provide visual signals to the brain.

When the retina becomes detached from the wall of the eye, it is separated from its normal position and can suffer from a loss of blood flow leading to tissue death.

This condition can severely and permanently impact vision if it isn’t detected and repaired—fast!

To better understand the condition, picture retinal detachment as similar to wallpaper coming unglued and peeling from a wall. It can start out with just a small piece detaching, which might cause some small pieces of wallpaper to flutter to the floor. In the eye, when the retina becomes detached, a person might notice the sudden onset of more “floaters” in their field of vision.

If the retinal detachment worsens or is more severe to begin with, a person may see flashing lights, dark shadows or experience a “curtain effect” of the eye where the central vision is darkened. This is because the retina is detached from its normal position and isn’t able to process and receive light correctly to send visual signals to the brain.

Symptoms of a Retinal Detachment

–      Noticeable increase in the number of “floaters”

–      Flashing lights

–      Shadow or curtain effect on vision

The severity of the symptoms often parallels the severity of the retinal detachment.

These symptoms are critical warning signs and should be heeded: If you experience a sudden change to your vision, a noticeable increase in floaters, flashing lights or a sharp darkening of your vision, call your optometrist immediately to have the condition diagnosed. Time is critical when it comes to preserving vision during a retinal detachment, because the condition can lead to retinal tissue death and irreversible blindness.

Risk factors for Retinal Detachment

  • Lattice degeneration: a thinning of peripheral retina tissue
  • Extreme near-sightedness, in which the eye is often elongated and more prone to retinal detachment
  • Aging: retinal detachments are more common after age 40
  • Family history of retinal tears or retinal detachment
  • Previous retinal detachment
  • Eye surgeries, including cataract surgery
  • Trauma 

Treatment for Retinal Detachment

Retinal detachment is a medical emergency that warrants immediate action for diagnosis and treatment.

Treatment involves re-attaching the retina to the back wall of the eye so that it can regain its normal position and blood supply. If there is a hole or tear involved, that must be repaired. Because there are several causes of retinal detachments, there are multiple ways to treat them, both surgically and with lasers, depending on the severity and cause of the condition.

A retinal specialist will determine which approach is ideal for each case. The good news is that retinal detachment repair is successful in approximately 9 10 patients.

Whether the patient will recover the same clarity of vision that he or she enjoyed prior to the retinal detachment depends on each individual’s health and other risk factors. Generally speaking, most patients regain vision similar to what they enjoyed pre-surgically, though there is always a possibility for some degree of permanent loss of vision.

If left untreated, retinal detachment will almost always result in permanent blindness.

If you experience significant changes to your vision or see flashing or increased floaters and suspect a retinal detachment, call our office immediately so we can guide you about where to receive the best possible care as fast as it can possibly be given.

Source: https://dunneyecare.com/retinal-detachment-are-you-at-risk/

healthnewschronicle.com