Retina Detachment

Retinal detachment is the separation of the retina from the back of the eye and is a medical emergency. Without urgent surgery, sight will be lost permanently. The retina is a transparent layer of nerve tissue at the back of the eye. It is probably the most important structure in your eye because it converts what you see into electrical impulses to your brain. 

Retinal detachment occurs in less than 1 in 10,000 people but is more common in the following

• people with high myopia
• previous eye trauma
• complicated cataract surgery
• older age group

How does a Retina Detach?

The vitreous is a transparent jelly like structure inside the eye that is attached to the retina. As you get older, this vitreous jelly degenerates and pulls away from the retina. Sometimes, this can cause a hole or tear in the retina. The hole or tear allows fluid to enter underneath the retina thereby causing it to detach (like a wallpaper peeling off the wall).

Image from Encyclopaedia Britannica

What are the symptoms of Retina Detachment?

• Flashing lights at the periphery
• Floaters (in the form of black spots, wavy lines, cobweb-like or fly-like)
• Loss of peripheral vision (like a curtain or shadow)
• Total loss of vision if left untreated

Diagnosis of Retinal Detachment

The diagnosis can be made by an eye doctor who needs to examine the back of your eye with an ophthalmoscope or retina scan.

Click to watch Thomas Eye Group AAO video on Retina Detachment

Treatment of Retina Detachment

Retinal detachment is a medical emergency and needs to be treated by a trained retinal surgeon.  There are a few surgical options depending of the extent, type and site of the retina detachment.

Image from Encyclopaedia Britannica

1. Retina Cryo-Buckle Surgery: A way to treat retinal detachment is by suturing a piece of silicone called a scleral buckle to the outside of the eye and treating the retinal hole with freezing treatment called cryotherapy.  The scleral buckle can also be combined with vitrectomy in more complicated retinal detachments.

2. Vitrectomy: Modern vitrectomy surgery can now be done without sutures. Suture-less small gauge vitrectomy surgery allows faster recovery after surgery with less post op pain. We also now use special wide-angled viewing systems with the operating microscope to have better visualisation of the retina during surgery.

Visual Prognosis

Surgery for retinal detachment is quite successful and the success rate of reattaching the retina is over 90% with one operation. Sometimes, further surgery is required if the retina re-detaches again.

How to Take Care after Retina Surgery

• Patients often have to posture face down after surgery to allow the gas bubble to come into direct contact with the retina to help reattach the retina. Your retinal specialist will tell you how to posture, for how often and for how long
• The gas bubble in the eye usually dissolves by itself after 1 month and patients should not travel in an aeroplane when you have gas in the eye. This is because the gas bubble will expand at high altitude and cause very high pressure in the eye
• Patients with silicone oil injected into the eye, will need to have it removed after 6 months with a second operation

What Precautions are Required after Retina Detachment Surgery?

• DO sleep or position your head as advised if there is a gas bubble in your eye
• DON’T travel by airplane if there is a gas bubble in the eye
• DON’T perform strenuous exercises or lift heavy objects

In summary, if you have any symptoms of retinal detachment, you should seek expert advice from a retinal surgeon as soon as possible.  The visual prognosis is better when the retina detachment is treated early but after 4-7 days, the chances of success will be poor.

Check your vision regularly (at least once a week) using Amsler Grid and Vision Chart to monitor your condition

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Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.