Retinal Tears & Detachments
What is the Retina?
In order to see, light passes into the eye and is focused onto a layer at the back called the retina. The retina is a thin nerve layer at the back of your eye that detects the light and sends the message to your brain.
What is Retinal Detachment?
It is called a retinal detachment if the thin retina is pulled off the back of the eye. When detached, the retina cannot properly detect light, thus making your vision blurry. This is a very serious problem and unless treated, can cause blindness.
What Causes Retinal Detachment?
Your eye is filled with a clear gel-like substance called vitreous. As we age, this vitreous shrinks a little, which pulls on your retina. In some cases, the vitreous separates from the retina without causing any problems. In other more serious cases, it can tug on the retina to the point where it is torn or pulled right off the back of the eye.
Some conditions that increase the chances of this happening are:
- Cataract surgery
- Severe injury
- Previous retinal detachments
- Family history of retinal detachment
- Weak areas in your retina
A retinal detachment may be present if you experience any of these symptoms:
- Flashing lights
- A shadow in the periphery of your vision
- A gray curtain moving across your vision
Having any of these symptoms does not necessarily mean you have a retinal detachment – the symptoms could indicate something less serious. However, to find out the cause, it is important to have your eyes examined by your ophthalmologist as soon as possible.
To prevent the progression to retinal detachment, which is sight threatening, a retinal tear needs to be treated with laser surgery or cryotherapy (freezing). These procedures seal the retina onto the back of the eye, and are performed right within your ophthalmologist’s office with little to no discomfort.
Patients with a retinal detachment require surgery in order to get the retina into its proper position at the back of the eye. Depending on the type of retinal detachment, there are several different surgical procedures that can be performed:
- Scleral Buckle – after draining the fluid behind the detached retina, an ophthalmologist will place a tight scleral buckle (a flexible band) around the eye. This counteracts the force pulling the retina off the back of the eye, allowing the retina to settle back into place. This procedure is performed in an operating room.
- Pneumatic Retinopexy – in this procedure, a gas bubble in injected into your eye, putting pressure against the detached retina and forcing in back into its proper position. Until it is healed, you must maintain a certain head position to make sure the gas bubble pushes up against the detached spot. This procedure can be performed right within your ophthalmologist’s office. Over time the gas bubble disappears.
- Vitrectomy – in this procedure, the vitreous gel that is pulling on the retina is removed and replaced with a gas or oil bubble. The bubble acts to force the retina into its proper position until it heals. The gas bubble will gradually disappear on it’s own, but an oil bubble will need to be removed once it has helped the retina heal. This procedure is done in an operating room.
After any of these procedures, it’s normal to expect some discomfort and for the flashes or floaters to continue for a while. You may have prescribed medications to help relieve this and will need to wear an eye-patch for a short period of time.
If you have a gas or oil bubble injected to help heal your retina, it is important to keep your head in the proper position for the prescribed amount of time. Until the gas bubble has dissolved, DO NOT FLY IN AN AIRPLANE OR TRAVEL AT HIGH ALTITUDES! Changing altitudes can cause a dangerous rise in eye pressure. However, it is okay to do so when an oil bubble has been used.
Like any surgery, there are some risks involved with treating a retinal detachment:
- Increased pressure within the eye
Although there is some risk, NOT treating a retinal detachment can result in permanent, severe vision loss or blindness. Surgeries are usually successful, but sometimes a second procedure might be required.
Will Vision Be Improved?
It may take several months for your vision to improve after a successful surgery. Depending on the individual and severity of the detachment, it is possible that your vision may not return fully or even improve at all. Thus, it is important to see your ophthalmologist as soon as possible if you notice any symptoms of a retinal detachment before it gets worse. Some detachments cannot be surgically fixed. If this is the case, you will continue to lose vision and eventually become blind.