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Vision & Hearing

Prevent Retinal Detachment With Immediate Intervention

Retinal detachment is generally preventable, but if not caught on time, it could cause permanent vision loss. Medical attention should be sought as soon as possible, ideally within the first 24 hours of the first symptoms. To make sure you can spot it early, here is a guide to the basics of retinal detachment:

Overview
The retina is a vital layer of skin attached to the back of the eye. Its primary function is to sense light, recording it much like film in a camera. An underlying layer of blood vessels provides the retina with oxygen and nutrients. Retinal detachment occurs when a situation causes the retina to separate from the blood vessels, depriving it of necessary nutrients. Detachments usually begin with a tear or a hole in the retina. Eye fluids leak through the hole, building up under the retina until it separates the two layers. The U.S. National Library of Medicine astutely compares the process to an air bubble under wallpaper, and in this case, the wallpaper comes off. Occasionally, fluid can leak underneath the retina and cause detachment without an initial tear or hole.

Symptoms
Retinal detachment is preceded by its symptoms, so early detection can prevent the detachment from occurring. One telltale sign is the sudden appearance of floaters that look like spots, hairs or strings that seem to float in your field of vision. Sudden flashes of light in one or two eyes can also signal detachment. Additional warning signs include blurred vision or a shadow blocking a part of your visual field. If the retina becomes detached, the blood vessels may begin to bleed and cloud the fluid inside the eye, severely damaging vision.

Cause
The eye is filled with a jelly-like fluid called the vitreous humor, and shrinking or sagging vitreous can cause retinal detachment. Age is a risk factor for these changes in the vitreous humor, as its size and consistency may change over time. In a process known as posterior vitreous detachment, the vitreous humor could separate from the retina with enough force to create a tear. Other causes include trauma or injury to the eye and an inflammatory disorder. People with diabetes are susceptible, as diabetes can gravely affect the eye’s blood vessels and inner fluids.

Treatment
Retinal attachment is widely treated with surgery. For milder cases, doctors may be able to perform the surgery in their offices. Laser surgery can seal the damaged openings before the retina detaches. If the retinal detachment has occurred but is still small, the doctor can perform a pneumatic retinopexy. This procedure entails placing a gas bubble in the eye to coax the retina back into place, followed by lasers to seal the layers back together. Severe cases of retinal attachment need more involved operations, typically performed in hospitals. In a process called sclerical buckling, the surgeon will suture a small piece of silicon to the eye to push it up against the retina. For the largest tears or detachments, the surgeon will perform a vitrectomy. During a vitrectomy, the surgeon removes the vitreous humor from the eye, using air, gas or fluid to clear the inner jelly. Sclerical buckling will usually follow to bolster the reattached retina.