When the Eye Suffers Retinal Detachment
What is Retinal Detachment
The retina is a thin membranous tissue inside the eyeball that takes in light and causes a biochemical process to stimulate an electrical response in the nerve endings that transmit the signals to the brain. Hence, we see and interpret the image according to our experience. Any damage to the retina adversely affects vision and one of the worst things that can happen is retinal detachment. About 10,000 people annually suffer from retinal detachment, a relatively low percentage of the population. This is a condition where the retina detaches from the underlying tissue inside the eye. A retinal detachment commonly starts with one eye and seldom happens to both at the same time. But once an eye gets the symptoms, the second eye should be examined and monitored so it doesn’t suffer the same fate.
What Causes Retinal Detachment
The condition results from retinal tear, hole or break. Breaks happen when the vitreous gel in the eye chamber loosens or separates from its retinal attachment. This is called posterior vitreous detachment (PVD) and will cause flashes and floaters in your visual field. The vitreous gel fills up two-thirds of the eye internals fronting the retina. When the gel gets loose it exerts traction on the retina which, if weak, will tear from its attachment. Most breaks do not result from injury but come as a result of getting older.
Retinal tear happens rarely from vitreous separations, but once the retina is torn, the vitreous gel goes through the tear to accumulate behind the retina. It is this build-up that causes the retina in part or in whole to detach from the back of the eyeball. As ore vitreous gel collects behind the retina, the detachment progresses to eventually detach the entire retina.
People with severe myopia or nearsightedness greater than 5-6 diopters have high risk to the condition. Those who have recently undergone cataract surgery or other eye surgeries further increase the chances especially if you already have myopia. Myopic eyes are larger and the peripheral retina gets more thinly stretched so that lattice degeneration can occur. This is the thinning of the retinal edges occurring in 6% to 8% of the population. Fortunately, only 1% of patients with lattice degeneration develop retinal detachment.
Diabetes can also lead to retinal detachment without PVD. A weak retina can be lifted off from its attachment as the blood vessels bleed into the vitreous gel, leaving scar tissue on the retinal surface to impair vision.
Certain eyedrops increase your risk as well. Those formulated with Pilocarpine which has been the mainstay in treating glaucoma have a strong association with retinal detachment. In addition, the eye drop is known to constrict the pupil which makes diagnosing for retinal disorders more difficult and could lead to diagnostic delays.
A PVD often precedes retinal detachment and its symptoms should immediately warn you that you are at a high risk for retinal detachment. When the vitreous gel shrinks, loosens and separates from the retina, it results in flashes and floaters. These floaters are spots, lines and specks floating through your field of vision. Flashes, on the other hand, are transient lightning streaks or sparkles that appear when the eyes are closed and appear at the periphery or edges of your vision field. Floaters and Flashes do not necessarily result in retinal detachment, but this a warning that you should have your retina checked by an ophthalmologist.
A progressive retinal detachment always results in loss of peripheral vision and will progress to full retinal detachment and loss of all vision if not treated. Retinal detachment can occur without warning and the initial symptom is shadowy vision across part of your vision field or a sudden loss in side or peripheral vision that only gets worst over time if left untreated.
Treating the Condition
Based on your description of what you see, doctors can suspect retinal detachment or early stages of the condition/ The doctor will use lighted magnifying instruments called ophthalmoscope to assess your retina to see if there are holes or tears or is already detached. When detected early enough, retinal tears can be treated with lasers to cauterize the retinal tear or a cryotherapy using a freezing probe to seal the tear and arrest the progression to full retinal detachment.
While immediate eye care is indicated, eye surgery is the only way to reattach and detached retina. Spontaneous retinal re-attachment may happen but this is rare. In many cases, the needed surgery can also restore good vision. There are several surgical procedures such as vitrectomy, pneumatic retinopexy and scleral buckling.