The retina is a thin layer of tissue located at the back of the eye that is responsible for capturing light and converting it into neural signals that are sent to the brain, allowing us to perceive visual images. The retina contains photoreceptor cells, such as rods and cones, which are sensitive to light and play a crucial role in vision. The retina is about as thick as your shirt. It lines the back of the eye and is held on mostly by suction.
A retinal tear occurs when there is a break or tear in the retina. This can happen for several reasons:
- Age-related changes: As people age, the vitreous gel inside the eye may undergo changes and pull away from the retina. This process is known as posterior vitreous detachment (PVD), and it can sometimes lead to a retinal tear.
- Trauma: Direct trauma to the eye, such as a blow or injury, can cause a tear in the retina.
- High myopia (nearsightedness): People with high myopia are more prone to changes in the vitreous and are at an increased risk of retinal tears.
A retinal tear can potentially lead to retinal detachment through the following mechanism:
- Vitreous fluid passage: The vitreous gel inside the eye is normally attached to the retina. When a tear occurs, it creates an opening through which the fluid from the vitreous can pass. This fluid can then accumulate behind the retina.
- Retinal detachment: As the fluid collects behind the retina, it separates the retina from the underlying layers of the eye, leading to retinal detachment. Once detached, the retina loses its normal blood supply and nutrient source, which can result in vision impairment or loss if not promptly treated.
It’s crucial to note that not all retinal tears lead to retinal detachment, and prompt medical attention is essential to prevent the progression to detachment. If someone experiences symptoms like flashes of light, sudden onset of floaters, or a curtain-like shadow in their vision, they should seek immediate medical attention to assess the possibility of a retinal tear or detachment. Early diagnosis and treatment can often prevent permanent vision loss.
Retinal detachment is a serious and vision-threatening condition that requires prompt medical attention. The symptoms of retinal detachment can vary, but common signs include:
- Floaters: Sudden appearance of numerous floaters (small, dark spots or specks) that seem to “float” in your field of vision.
- Flashes of Light: Seeing sudden flashes of light, often described as lightning streaks or light bursts, especially in peripheral vision.
- Shadow or Curtain Effect: A sensation that a shadow or curtain is descending over your field of vision. This usually starts from the peripheral vision and progresses towards the center.
- Blurred Vision: A sudden and significant decrease in vision, which may be accompanied by distorted or wavy vision.
- Loss of Peripheral Vision: Peripheral vision loss, often described as if a curtain or veil is blocking part of the visual field.
It’s important to note that these symptoms can also be associated with other eye conditions, such as a posterior vitreous detachment (PVD) or certain types of migraines. However, if you experience any of these symptoms, especially if they occur suddenly or worsen rapidly, it is crucial to seek immediate medical attention. Retinal detachment is a medical emergency, and early diagnosis and treatment are essential to prevent permanent vision loss.
If you suspect retinal detachment or are experiencing any of these symptoms, contact an eye care professional or go to the nearest emergency room for a comprehensive eye examination. Early intervention increases the chances of successful treatment and preservation of vision.
Small holes and tears are treated with laser surgery or a freeze treatment called cryopexy. These procedures are usually performed in the doctor’s office. During laser surgery tiny burns are made around the hole to “weld” the retina back into place. Cryopexy freezes the area around the hole and helps reattach the retina.
There are several was to repair a retinal detachment Some retinal detachments are treated with surgery which is performed either in a surgery center or hospital and some retinal detachments can be repaired with pneumatic retinopexy, an office procedure. In some cases a scleral buckle, a tiny silicone band, is attached to the outside of the eyeball to gently push the wall of the eye against the detached retina. If necessary, a vitrectomy may also be performed. During a vitrectomy, the doctor makes a tiny incision in the sclera (white of the eye). Next, a small instrument is placed into the eye to remove the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain a round shape. Gas is often injected to into the eye to replace the vitreous and reattach the retina; the gas pushes the retina back against the wall of the eye. During the healing process, the eye makes fluid that gradually replaces the gas and fills the eye. With all of these procedures, either laser or cryopexy is used to “weld” the retina back in place.
With modern therapy, over 90 percent of those with a retinal detachment can be successfully treated, although often second procedure is necessary. However, the visual outcome is not always predictable. The final visual result may not be known for up to several months following surgery. Even under the best of circumstances, and even after multiple attempts at repair, treatment sometimes fails and vision may eventually be lost. Visual results are best if the retinal detachment is repaired before the macula (the center region of the retina responsible for fine, detailed vision) detaches. That is why it is important to contact an eye care professional immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over the field of vision.
Surgery for Retinal Detachment