Retinal Detachment

introduction

What is Retinal Detachment?

Retinal detachment is separation of the neurosensory retina from the underlying retinal pigment epithelium.

Retinal Detachment Symptoms

Some of the many retinal detachment symptoms are mentioned below:

  • One of the biggest retinal detachment symptoms is experiencing brief flashes of light (photopsia) in the extreme peripheral (outside of centre) part of the vision.
  • In most cases, the primary retinal detachment symptom is sudden dramatic increase in the number of floaters.
  • A ring of floaters or hairs just to the temporal side of the central vision.
  • Seeing a veil like a curtain starting from the sides and progressing to the central vision.
  • Another striking retinal detachment symptom is getting an impression that a veil or curtain was drawn over the field of vision.
  • Distortion of vision occurs, which causes straight lines to appear bent or curved.
  • Central visual loss is another symptom of retinal detachment.

Causes of Retinal Detachment

Rhegmatogenous Detachment. Risk factors include the following:

  • Myopia
  • Previous cataract surgery
  • Ocular trauma
  • Lattice retinal degeneration
  • A family history of retinal detachment
  • Diabetic retinopathy

Tractional can be caused by vitreoretinal traction due to preretinal fibrous membranes, as may occur in proliferative diabetic or sickle cell retinopathy.

Serous Detachment results from the transudation of fluid into the Subretinal space. Causes include severe uveitis, especially in Vogt-Koyanagi-Harada disease, choroidal hemangiomas, and primary or metastatic choroidal cancers

Types of Retinal Detachment

What is Rhegmatogenous Retinal Detachment? Rhegmatogenous retinal detachment is separation of the neurosensory retina from the underlying retinal pigment epithelium characterized...

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What is Tractional Retinal Detachment? Tractional Retinal detachment is separation of the neurosensory retina from the underlying retinal pigment epithelium caused...

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What are the Risk Factors of Retinal Detachment?

Here are some of the many risk factors of retinal detachment:

  • History of having retinal detachment in one eye.
  • History of having eye surgeries like cataract removal
  • Ageing is another risk factor for retinal detachment.
  • Severe eye injury can also lead to the detachment of the retina
  • Family history of retinal detachment
  • Myopia or extreme near-sightedness
  • If a person is suffering from eye disorders and diseases like uveitis, lattice degeneration, or retinoschisis, they are more vulnerable to retinal detachment
prevention

Retinal Detachment Prevention

  • Avoid direct and indirect injury to the eyes
  • Regular eye check up
  • Controlling systemic risk factors and diseases such as diabetes

     

Retinal Detachment Prevention

  • Avoid direct and indirect injury to the eyes
  • Regular eye check-up
  • Controlling systemic risk factors and diseases such as diabetes

An Overview of Diagnosing Detached Retina

In the medical sector, there are 3 ways of diagnosing detached retina:

  • The first way of diagnosing detached retina is by ophthalmoscopy, with an indirect ophthalmoscope.
  • Another way is to perform fundus photography.
  • It is also possible to diagnose and confirm detached retina with an ultrasound B scan.

Retinal Detachment Treatment

Below we have given an insight into some of the many retinal detachment treatments:

Rhegmatogenous detachment is treated with one or more methods, depending on the cause and location of the lesion. These methods involve sealing the retinal breaks by laser or cryotherapy. In scleral buckling, a piece of silicone is placed on the sclera, which indents the sclera and pushes the retina inward, thereby relieving vitreous traction on the retina. During this procedure, fluid may be drained from the subretinal space. Pneumatic retinopexy (intravitreal injection of gas) and vitrectomy are other treatments. Laser photocoagulation using green Argon, red Krypton or Diode laser or cryopexy ( scarring the retinal tear by freezing) can help in treating retinal breaks. Surgical treatment is successful in most of the cases of rhegmatogenous retinal detachments.

Vitrectomy may be the treatment of choice for non-rhegmatogenous retinal detachments due to vitreoretinal traction. Systemic corticosteroids or systemic immunosuppressive drugs (e.g., methotrexate, azathioprine) are used to treat transudative detachments.

Alternatively, transudative detachments due to uveitis can be treated locally with a periocular corticosteroid injection, intravitreal corticosteroid injection, or an intravitreal dexamethasone implant. Primary and metastatic choroidal cancers also require treatment. Photodynamic therapy or rarely laser photocoagulation are used for treating choroidal hemangiomas.

FAQ

What is retinal detachment surgery cost?

The average cost for retinal detachment surgery in India is around Rs. 1,10,000. When it comes to health, it is always a good idea to invest in a good insurance plan that ensures that you do not have to go through a financial crunch in a time of need. On the other hand, there are several hospitals which will also allow you to pay the amount in installments according to your ease and convenience. Check the official website of Dr Agarwal’s Eye Hospital to know more about retinal detachment surgery.

A scleral buckle is a type of retinal detachment surgery where the surgeon fixes a flexible, tiny band around the white area of the patient’s eye called the sclera. The role of this band is to gently push the sides of the eye while slowly moving it towards the retina to help the retina get reattached. Once this retinal detachment surgery is successful, the band will remain in the eye permanently to ensure there are no problems in the future.

After this retinal detachment surgery, most people are allowed to go home on the same day. However, they are asked to keep some pointers in mind like:

  • Avoiding heavy exercises
  • Wearing an eye patch for over a day.
  • Having regular follow-ups with the doctor.

Also known as serous retinal detachment, exudative retinal detachment refers to a medical condition where fluid is collected behind the retina of the patient’s eye even though there are no tears or breaks in the retina.

In this case, if a huge amount of fluid gets filled up, it can automatically push the retina away and cause detachment. Coats disease, trauma/injury to the eye, inflammation inside the eye, and age-related muscular degeneration (AMD) are some of the many causes of serous retinal detachment.

Usually, in most cases, retinal detachment surgery is required to treat this eye condition. It is imperative to understand that retinal detachment is an eye emergency that must be treated as soon as possible. 

The retina of the eye is similar to the film integrated into a camera. Therefore, in order to get a clear and accurate picture, it has to be smooth and healthy. In the surgery, the surgeon makes use of several medical tools and devices to ensure that the retina is fixed back in its place without causing any problems in the future.

As mentioned above, there are several surgeries for retinal detachment like scleral buckle surgery, vitrectomy surgery, and pneumatic retinopexy. The last one is considered to be one of the simplest procedures to fix a retinal detachment. However, the only drawback is that it is not suitable in all cases.

In the first step of this retinal detachment surgery, the surgeon carefully injects a gas bubble in the vitreous cavity of the eye to treat the damage or the tear with cryotherapy/freezing or laser. The injected gas bubble gently presses the retina of the eye against the wall of the patient’s eye, and the freezing or the laser slowly sticks the retina down, bringing it back to its original position. Lastly, once the retinal detachment surgery is over, it is crucial to take all the preventive measures to give some time for the injected gas to gradually disappear on its own.

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