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Retinal Detachment

What Is Retinal Detachment?

Small tears or breaks in the retina can lead to a retinal detachment. If the retina detaches, then it is pulled from its normal position. If not promptly treated, retinal detachment can cause full and permanent vision loss.

Three Types of Retinal Detachment:

Rhegmatogenous. When a tear or break in the retina occurs, it can allow fluid to get under the retina and cause a separation from the retina pigment epithelium (RPE). This is the most common type of retinal detachment.

Tractional. Scar tissue causes the retina to separate from the RPE in this type of retinal detachment. This type is not very common.

Exudative. Sometimes, even though there are no tears or breaks in the retina, fluid leaks under the retina. This is commonly caused by retinal disease or injury to the eye.

Who Is at Risk of Retinal Detachment?

A retinal detachment can occur at any age, sex, or race. However, it is more common in people over the age of 40. Retinal detachment is known to affect Caucasians more than other races, and is more likely to occur in those patients with any of the following:

  • severe nearsightedness
  • previous retinal detachment
  • family history of retinal detachments
  • cataract surgery
  • eye injury
  • eye disease such as uveitis, degenerative myopia, lattice degeneration, or retinoschisis

What Are the Symptoms of Retinal Detachment?

The most common symptom is a slow or fast onset of flashes and floaters. Floaters can appear as specks or cobwebs floating around in your vision. Flashes appear as flashes of light or sets of matching floaters in your field of vision. Some patients even experience a curtain over their field of vision. If you have any of these symptoms, see your ophthalmologist immediately.

How Is Retinal Detachment Treated?

When a small tear or hole hasn't progressed to detachment, your doctor can usually perform an outpatient procedure to preserve most of your vision. This can be done with a treatment called cryopexy or photocoagulation. With cryopexy, your doctor freezes the retina surrounding the retinal tear. This leaves a delicate scar that can help mend the retina back in place. With photocoagulation, your doctor uses a laser beam to burn around the retinal tear, causing scarring that essentially 'welds' the retina back in place.

For a retinal detachment, the treatment can be more intense, often resulting in a hospital stay. Sometimes surgeons will use a scleral buckle that acts as a rubber band to gently push the eye wall against the retina. A more severe case might require a vitrectomy. This procedure removes the vitreous and replaces it with a clear gel-like alternative. This allows for your eye to keep its nice round shape. The vitrectomy procedure is performed under either local or general anesthesia in a surgical suite, and retinal repair may be needed. Often, a gas or air bubble is injected into the eye to hold the retina against the eye wall. After surgery, the patient may be required to remain in a facedown position for up to three weeks. This allows the air bubble to press against the retina as it heals. Although uncomfortable, this is a crucial step to the success of the surgery.

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