A medical emergency, to say the least. It is the condition when the retina of the eye breaks away from its support, causing blindness, if not treated on time. In medical terms it is a condition in which the sensory glands of the retina separate from its choroid, the wall of the eye which provides oxygen, blood and nutrients to the retina. The retina, which is light sensitive and thin tissue, converts the light entering the eye through the lens, to electric waves and sends them to the brain via the optic nerve. As soon as the symptoms are noticed it should be immediately treated, for the retina upon not receiving oxygen for a long time, may cause a greater risk of eye damage
There are several causes that lead to the detachment of the retina. One of the main reasons is when the vitreous, which is a collagen gel located in between the lens and the retina, converts to liquid and starts to push the retina causing tears or holes. As this liquid seeps behind the retina, through the holes formed, it detaches the retina from its wall. This happens due to aging but other factors could also be responsible for the detachment of the retina. Nearsightedness or myopia is also a major cause for the retinal detachment. Trauma or accidents, inflammatory disorder, diabetes, retinal detachment in the other eye, cataract surgery, glaucoma, history of the detachment in the family, week retina, etc are few of the other causes for the retina to detach.
The process of the detachment is painless. Though the symptoms are noticed much before the actual detachment, so that proper treatment can be taken to prevent any damage to the retina and retain the eye sight. Mostly flashes of light, dark areas in the vision, heaviness on the eye or debris like spots that are seen before the eyes indicates an onset of the detachment.
As more floaters or spots are noticed in the line of vision a medical checkup becomes very necessary. The doctor first checks the retina with the help of an instrument called ophthalmoscope. If a tear or detachment is noticed then immediate surgery is advised. There are two types of surgery for retinal tears. Retinal tear or holes means that the retina has still not detached, so minor surgery like photocoagulation or cryopexy could be performed in the clinic itself. Photocoagulation is a process where a laser beam is sent through the lens which burns the tears and fixes the retina to its walls. Under Cryopexy the retina tear or hole is freezed leaving a delicate scar that attaches itself to the wall and prevents detachment. These surgeries help in retaining most of the vision.
However, if the detachment has started spreading then Scleral buckle surgery, Pneumatic retinopexy, or Vitrectomy may be performed depending on position and the amount of damaged cased.
Scleral buckle surgery- under this process the eye is indented on the surface. This means that a silicon rubber or a band is placed around the eye to secure the retina to its wall. This rubber is placed on the white of the eye (sclera). After giving anesthesia to the patient, the fluid is removed from behind the retina, and then Cryopexy procedure is performed to seal all the holes or tears. This ensures that no more liquid will seep behind the retina to cause further detachment. Then a silicon band is placed around the entire eye, this further strengthens the affected area from being tugged by the vitreous.
Pneumatic retinopexy- after injecting local anesthesia a bubble or gas is injected into the eye at the vitreous humor space. After this either Cryopexy or photocoagulation surgery is performed and the hole or tear is sealed. The bubble further seals the hole and helps in evaporating the liquid behind the retina. Even the bubble disappears with time. After the procedure the patient is required to tilt the head in such a position such that the air bubble is always on the hole. This may take weeks to be healed. But only those patients can avail of this treatment whose retinal detachment is towards the upper part f the eye, as the air bubble being light always rises above.
This is the most common type of surgery performed for correcting a detached retina. The vitreous el is removed and replaced by the gas bubble, which gradually seals the hole, and disappears with time. The body fluid may sometimes fill up this place. In most cases Scleral buckle surgery is also performed simultaneously. Cataract is the problem that may occur after this surgery.
A note of caution is that not all surgeries are successful and they do not necessarily improve the eye vision. It may take a long time for the results to be noticed and feel a considerable difference in the vision.