What is Retinal Detachment?
The retina is the nerve layer located at the back of our eye that allows us to see. The tearing or detachment of the retina layer for any reason can cause sudden vision loss.
Myopic individuals are at high risk for retinal tears and detachment. Retinal tears are more common in glaucoma patients.
If retinal detachment occurs in one eye, there is a 10% chance it will occur in the other eye as well. It's essential to be cautious about the symptoms.
With aging or degenerative diseases, the vitreous tissue begins to deteriorate. The gel consistency changes, becomes more liquid, clots, and slowly detaches from the areas where the vitreous is attached to the retina. This detachment is called posterior vitreous detachment. In individuals with a healthy retina, vitreous detachment often resolves without issues. However, in some cases, the retina tears in one or more places. Fluid starts to enter from the tear, separating the retina from its position. This condition is called retinal detachment. When the retina is detached, it cannot function properly.
Retinal detachment, a severe eye problem that significantly threatens vision, occurs when the retinal nerve layer separates from the underlying pigment epithelium. It often develops when fluid seeps between these two layers following a tear or hole in the retina. This separation is similar to how wallpaper peels away from a damp wall.
Retinal tears and subsequent retinal detachment are serious conditions that do not heal on their own. If left untreated, they can lead to severe vision loss, potentially resulting in blindness. Light flashes and floaters do not necessarily mean retinal detachment, but it is essential to see an eye doctor as early as possible.
Some retinal detachments are detected during a routine eye exam. Detecting a retinal tear or early-stage retinal detachment requires a more detailed examination. Individuals with a family history of retinal detachment should have frequent eye exams and be aware of the symptoms.
The more advanced the detachment, the lower the success rate of surgery will be. Therefore, it is crucial not to delay seeking medical attention upon noticing symptoms.
What are the Symptoms of Retinal Detachment?
Retinal detachment is a condition that can result in vision loss and requires urgent attention. Therefore, its symptoms are significant. These symptoms include:
After some time, a defect in the visual field appears in the detached area, vision becomes blurred, and sometimes a moving gray curtain is perceived.
If one or more of the above symptoms are present, a retinal examination should be conducted without delay.
How is Retinal Detachment Diagnosed?
The eye examination is performed by dilating the pupil. The vitreous and retinal regions are examined extensively. In biomicrocopy, cells are often seen in the anterior chamber and anterior vitreous. During the fundus examination, retinal tears are detected. The tears may be oval, horseshoe-shaped, or crescent-shaped. If the torn retinal layer crosses a blood vessel, bleeding inside the eye is observed. The torn and detached retina appears elevated and white, and moves freely with eye movements. Ultrasonography is performed to detect detachment that cannot be seen in the fundus due to bleeding.
Peripheral retinal detachment causes a narrowing of the visual field. When the macula is also detached, the patient's central vision is impaired. In severe cases, the level of vision can drop to detecting hand movements.
In the eye with retinal detachment, intraocular pressure is lower than in the healthy eye. Cells are often seen in the anterior chamber and anterior vitreous in biomicrocopy. The detached and elevated retina appears white and moves freely with eye movements during the fundus examination.
How is Retinal Detachment Treated?
The goal is to prevent retinal detachment by treating emerging tears. In some cases, retinal tears can be monitored without treatment. In cases where thin and damaged areas could cause tears in the future, laser photocoagulation can be used to control the condition by applying laser shots. This procedure is painless and can be done in the office with minimal discomfort. The laser attaches the retinal nerve layer to the pigment layer below it, preventing fluid from leaking through. Laser treatment addresses the problematic area at that moment. If tears develop in another part of the same eye in the future, the risk of detachment remains. Therefore, patients with retinal issues should have frequent fundus examinations.
In cases where retinal detachment develops, surgery is the only treatment option. The surgical method depends on the number, size, location, shape, and duration of the retinal detachment.
Special surgical techniques such as vitrectomy are used to treat giant tears caused by diabetes, trauma, etc. The entire vitreous is cleaned from the eye to prevent the retina from being pulled or stretched. In cases where detachment is not fully corrected, subsequent surgeries may be necessary. Like any surgery, vitrectomy carries some risks. However, if retinal detachment is not treated, it can result in permanent vision loss or blindness.
Post-surgery, patients may experience some discomfort. Light flashes and floaters may persist for a while after surgery. If a gas bubble is applied inside the eye, the patient may need to keep their head in a face-down position for some time. Patients with a gas bubble should avoid air travel or high altitudes until the gas dissipates.
What to Expect During Retinal Detachment Surgery?
If the detachment is not treated early, adhesions can form in the retina, negatively affecting the surgery outcome.
The goal of the surgery is to reattach the detached retina and seal the tears.
Various methods can be applied to achieve this goal. However, immediate intervention is crucial.
Once the retina is detached, surgery is the only treatment option. The earlier the vitrectomy surgery is performed, the better the vision outcome. The vitrectomy operation takes 30 minutes to 1 hour. Since local anesthesia is applied, continuous communication with the patient is maintained.
How to Prevent Retinal Detachment?
The most significant risk factor for spontaneous retinal detachment is aging. Individuals with a family history of retinal detachment should be cautious as they may also have the problem. Eyes with high myopia form another risk group for retinal detachment. The retinal layer in high myopia is structurally very thin. Retinal detachment can occur especially from thinned areas.
Therefore, individuals with high myopia should be aware of increased floaters resembling a shower of soot and severe light flashes, as these may indicate a developing retinal tear.
In the presence of a retinal tear, the disease can be controlled with laser treatment without surgery. Bleeding from retinal vessels can occur during tear formation. This should raise suspicion of retinal detachment. Ultrasonography is a very important test in differentiating this condition.
There may not always be an underlying cause for retinal detachment, and it can proceed insidiously without causing sudden vision changes if it does not involve the macula. Retinal detachment usually begins after a tear.
How is Retinal Detachment Surgery Performed?
If there are multiple tears, large tears, or unusually located tears, or if tears cannot be detected, or if there are accompanying conditions such as intraocular bleeding or if significant time has passed, vitrectomy surgery may be required. In vitrectomy surgery, the retinal detachment is addressed from within the eye.
Complications if Treatment is Not Accepted
Retinal detachment is a serious eye problem that significantly threatens vision. It can occur at any age but is more common in middle-aged and older individuals. If not treated urgently, it can lead to partial or complete vision loss.
Retinal Detachment Surgery Cost
The cost of retinal detachment surgery varies depending on the underlying cause and the procedure to be performed. The treatment plan created by our specialist eye doctor after a detailed examination may vary from person to person.
For an appointment and price information, please click here.The above information is for informational purposes only. If you have any medical concerns or questions, please make an appointment with our doctors.