What is Retinal Detachment?
The retina is a delicate tissue that lines the back wall of the eye. Retinal detachment is a serious condition that occurs when the retina—the thin layer of light-sensitive tissue at the back of the eye—lifts away from its normal position. The retina is essential for vision, acting like the film in a camera to capture images and send them to the brain. When it detaches, it is separated from the blood vessels that supply it with oxygen and nutrients, leading to a loss of vision. Retinal detachment is a medical emergency that requires prompt treatment to prevent permanent vision loss.
Types of Retinal Detachment
There are three main types of retinal detachment:
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Rhegmatogenous: This is the most common type. It is caused by a tear or break in the retina that allows fluid to pass into the space behind it. This tear is often caused by posterior vitreous detachment (PVD), a natural age-related process where the vitreous gel pulls away from the retina.
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Tractional: This type of detachment occurs when scar tissue on the surface of the retina contracts and pulls the retina away from the back wall of the eye. This is often seen in advanced diabetic eye disease.
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Exudative: This type is caused by fluid leaking from blood vessels and accumulating under the retina, without a tear or break. It is often a result of inflammatory eye disorders, tumors, or other systemic diseases.
Symptoms of Retinal Detachment
The symptoms of a retinal detachment are typically sudden and painless. It is not always accompanied by an abrupt change in vision, but some patients may experience:
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A sudden increase in floaters, which are small specks or threads that drift across your vision.
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Flashes of light (photopsia) in your peripheral vision.
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A shadow or curtain beginning in your peripheral vision and gradually moving toward the center.
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Blurred vision.
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A gradual loss of vision in the affected eye.
If you experience these symptoms, it's a medical emergency, and you should seek immediate evaluation by an ophthalmologist.
Diagnosis of Retinal Detachment
An ophthalmologist can diagnose a retinal detachment during a comprehensive eye examination. The diagnosis typically involves:
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A dilated eye exam: The doctor will use special instruments to view the retina and determine the location and extent of the detachment.
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Optical Coherence Tomography (OCT): An OCT scan provides a detailed cross-sectional image of the retina, allowing the doctor to see the detachment and any associated fluid.
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Ultrasonography: In cases where a cataract or vitreous hemorrhage obstructs the view of the retina, an ultrasound may be used to assess the back of the eye.
Treatment of Retinal Detachment
The only effective treatment for retinal detachment is surgery. The goal of surgery is to reattach the retina to the back wall of the eye and seal the retinal tear.
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Vitrectomy
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Vitrectomy is the most common surgical procedure for retinal detachment. The surgeon uses tiny instruments to enter the eye and carefully remove the vitreous gel that is pulling on the retina. The retina is then reattached with the use of gas or silicone oil, and a laser or cryotherapy (freezing) is used to seal the retinal tear.
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Scleral Buckle
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A scleral buckle is a surgical procedure that involves placing a small, flexible band around the outside of the eyeball. This band gently pushes the wall of the eye inward, helping to flatten the retina and close the retinal tear.
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Pneumatic Retinopexy
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This is a less invasive procedure for small retinal detachments. The surgeon injects a small gas bubble into the vitreous cavity. The patient's head is then positioned so that the bubble floats to the correct position, pushing the retina against the back wall of the eye, allowing the retinal tear to seal.
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