Retina and Uveitis Center | Retinal Artery Occlusion, Choroidal Nevus and Vitrectomy for Floaters

Retinal Detachment Repair

The retina's role often gets compared to the function film plays in a conventional camera. With millions of photoreceptors known as rods and cones, the retina translates focused light into the full-color visual information that gets sent to the brain.

In a healthy retina, this intricate process operates seamlessly. However, when a retinal disorder affects this area in the eye, it can cause vision impairment, low vision, and even blindness.

What is a detached retina?

A detached retina occurs when the light-sensitive tissue layer at the back of the eye gets pulled away from the underlying supporting tissue—thereby separating the retina from its blood and oxygen supply. In some cases, a retinal detachment happens after a retinal tear when vitreous fluid seeping through the opening detaches the retina from the tissue underneath.

Diagnosing a detached retina

A dilated eye exam gives the eye doctor a view of the back of the eye and an opportunity to check for evidence of retinal detachment, holes, or tears. Also, when indicated, ultrasound and optical coherence tomography (OCT) can offer more detailed information, especially when the retina is obscured.

The need for prompt care

Because the photoreceptors begin to deteriorate quickly when a retinal detachment occurs, it's essential to get a prompt evaluation and care. A retinal detachment can worsen rapidly and lead to permanent vision loss or even blindness. Plus, the longer the retina has been detached, there's less likelihood vision can get restored.

It's essential to be aware of any sudden onset vision changes, including:

  • New floaters
  • Blurred vision
  • The sudden appearance of flashing lights
  • Reduced peripheral vision
  • Abrupt, unexplained vision loss
  • A dark curtain or veil appears in the visual field

Repairing a retinal detachment

The goal of repairing a retinal detachment is to place the light-sensitive tissue back into its normal position, restore vision as possible, and prevent permanent vision loss. While some repairs may require more than one surgery, statistics demonstrate that more than 9 out of 10 detachments can get repaired. However, it's too late to restore normal vision when a detachment occurs in the macula, which is responsible for central vision. In this case, surgery aims to prevent further vision loss and total blindness.

Procedures to repair a detached retina

Since a retinal tear puts you at increased risk of developing a detached retina, the tear should get repaired with laser photocoagulation or a cryopexy procedure.

Repairing a detached retina involves one or a combination of the following procedures:

  • Pneumatic retinopexy - This procedure involves injecting gas into the vitreous cavity. This bubble pushes the retinal detachment against the wall of the eye and back into place. In order to form an adhesion, a cryotherapy or laser procedure follows either the same day or later. Post-operative instructions include proper body positioning to support optimal success.
  • Scleral Buckle – A scleral buckle involves placing a tiny, flexible band around the white part of the eye. This band indents the wall of the eye, moving it closer to the affected area of the retina. The band does not interfere with vision and remains in place permanently. An additional laser or cryotherapy procedure is sometimes performed to repair any tears.
  • Vitrectomy – A vitrectomy is recommended to release the vitreal traction responsible for the retinal tear and subsequent detachment. During the procedure the surgeon removes the vitreous. The eyeball then gets filled with air, gas, or silicone oil to replace the vitreous and help flatten the retina and hold things in place. In some cases, a laser procedure to seal around any retinal breaks and other weak areas may also be performed.

It's essential to keep in mind that the type of surgery required depends on the extent of the detachment and where it is located. It's not uncommon to undergo a combination of procedures to achieve optimal success. Following retinal detachment repair, it can take several months to see improvements.

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