Retinal Detachment and Retinal Detachment Surgery
Retinal detachment is a serious disease which may follow eye injuries, but more often strikes without warning. It is more common in eyes which have had cataracts. Although it is not very common, it may sometimes run in a family. The disease occurs when the retina, which is the part of the eye which does the same job in the eye that the film does in a camera. It normally lines the back of the eye, where it is held in place by the pressure of the gel and fluids that fill the eye. If a hole or tear forms in the retina, it will no longer be held in place and will detach, or fall to the center of the eye. Since the retina gets most of its blood supply from blood vessels in the wall of the eye, when it is detached, it does not get enough oxygen and other essential nutrients form the blood and vision stops in the part of the retina that is detached. If it is all detached, nearly all vision will stop in the affected eye. This is why repair of retinal detachment is usually needed very quickly, as the longer the retina is deprive of blood supply, the more damage that it may suffer. The patient may notice flashes of light and or an increase in floating spots when the hole or tear in the retina forms, then hours to months later may notice a darkening of vision in some part of the field of view. This darkening is often described as being light a curtain slowly closing over the vision. It is much better if repair can be done before the curtain crosses the center of the vision.
Repair of retinal detachment always requires some form of surgery. There is no drop, pill, nor other form of non-surgical treatment which can repair a retinal detachment. There are several types of surgical procedures which may be used. Some may be done in the clinic, others may require the operating room, and may take from one to four hours of surgery depending on the severity of the detachment and whether there is any scar tissue formed which holds the retina in a detached position. Often a gas bubble is placed in the eye during surgery to help hold the retina in place after the operation. If so, you may need to limit your movements and positioning for up to several weeks after surgery. Your doctor will discuss this with you.
Most, but not all retinal detachments are repairable today. Forty years ago we could only repair about 10% of retinal detachments. Today we are able to repair about 90% of detachments. This means that about 10% of detachments can not be repaired. Even when retinal detachments are repaired, the sharpness of vision will depend on how long the retina was detached before repair. We can reattach the retina so it can get back its blood supply, it then must begin to heal, and the less the time that the retina has been without full oxygen supply, the better it will heal.
Your doctor will also carefully examine your other eye. If any risk factors for retinal detachment are present there, your doctor will recommend a follow up program or treatment to prevent detachment in that eye. Prevention is always better than repair.
