Center for Sight
Comprehensive Eye Care Center
Retinal Detachment is a serious medical problem that requires rapid emergency treatment to try to prevent severe vision loss and possibly blindness. In normal, healthy eyes, the risk of Retinal Detachment is about 5 per 100,000 per year with a greater frequency in the middle aged or elderly population of perhaps 20 per 100,000 per year. Retinal Detachment is more frequent if you are myopic or nearsighted and especially if your prescription is above 6.00 Diopters of correction. In fact, 67% of Retinal Detachment cases occur in myopic eyes. Further, Retinal Detachment is more prone to occur in association with certain eye conditions and diseases including after cataract surgery and in patients suffering from Diabetic Retinopathy. Fortunately, with modern cataract surgery and early treatment of Diabetic Retinopathy, the incidence of Retinal Detachment is low.
Rhegmatogenous Retinal Detachment which occurs as a result of a break-usually a tear or hole- in the retina that permits fluid to pass into the space underneath the Retina. Rhegmatogenous Retinal Detachment is the most common type of Retinal Detachment.
Exudative Retinal Detachment which can occur due to inflammation, injury or a Retinal Vascular Disease that causes fluid accumulation underneath the Retina without the presence of a Retinal Hole or Retinal Tear.
Tractional Retinal Detachment which can occur when fibrous or fibrovascular scar tissue has been formed on the Retina as a result of an injury, inflammatory disease or the presence of neovascularization, such as in Diabetic Retinopathy. The scar tissue actually pulls the Retina free from the underlying pigment layer it is normally attached to, causing a Retinal Detachment.
Treatment for Retinal Detachment will depend on the cause, type and severity but can include:
Cryopexy and Laser Photocoagulation Treatment to create a tiny scar around the edge of a Retinal Hole, or small Retinal Tear in order to prevent fluid from passing through the area and underneath the Retina causing or worsening a Retinal Detachment. Cryopexy uses a “cold” instrument, about the size of a pencil, to freeze the damaged area whereas Laser Photocoagulation Treatment uses a “laser beam” to achieve the creation of the tiny scar. Generally these two treatments are interchangeable but Cryopexy is often used if there is a considerable accumulation of fluid. Cryopexy is performed in an operating room, while laser treatment can often be done in the office.
Pneumatic Retinopexy is used to inject a “gas bubble’ into the back of the eye after first applying the laser or cold treatment. The patient’s head is positioned so that the “gas bubble” acts to place gentle pressure against the damaged area, allowing the fluid underneath to be absorbed and the Retina to reseal itself in place. This often requires that patients lie perfectly still in a particular position for several days or even a week in order for the results to take effect.
Scleral Buckle Surgery is performed by carefully sewing silicone bands in place in order to apply gentle pressure to the outermost walls of the eye so they move up against the Retinal Breaks, allowing the defect to close and the Retina to reattach. Scleral Buckle Surgery may be done in conjunction with Cryopexy or Laser Photocoagulation to assure the best possible results.
Vitrectomy is an increasingly common treatment for Retinal Detachment that involves surgically removing the Vitreous gel in the back part of the eye in conjunction with the injection of a “gas bubble.” In general, Vitrectomy is not the first surgery that is used to repair a Retinal Detachment because is often leads to the formation of a Cataract and should the initial surgery fail to allow reattachment of the Retina, the second procedure is often much more difficult and complex.
After surgery for Retinal Detachment, the results can often take many weeks for patients to achieve their visual recovery. In certain cases, the vision after Retinal Detachment Surgery may not allow the full recovery of precise vision, especially if the Macula was detached in addition to other areas of the Retina. Early diagnosis and rapid treatment are the keys to preventing vision loss from Retinal Detachment. Regular eye examinations are an excellent way to learn if you are at risk for Retinal Detachment.