Retinal detachment, does that word sound familiar to you? If not, hear out what exactly it is and how it impairs our vision.

When the retina detaches, it separates the thin tissue layer at the back of the eye away from its usual position. Just like any other kind of attachment, detachments also bring about events of pain. 

Retinal detachment separates retinal cells from the layer in which blood vessels that supply oxygen and nutrition to the eye are found. The longer the condition stays untreated, the more chances there are of suffering a complete loss of vision in one eye. 

Reduced vision is one of the basic symptoms of retinal detachment, which is the sudden emergence of dark floating shapes and flashes of light within your vision. The loss of side vision can be the ultimate result. Call an ophthalmologist at Vision Concern now to save your sight.

What is retinal detachment?

Retinal detachment is the loss of vision without any sensation of pain. Understanding this in better terms, this condition occurs when the retina, which is the layer of tissue at the back of your eye, separates from the tissues that help support it.

If you remain oblivious or careless, a detached retina will also affect your vision and can lead to blindness. This unfortunate interference is dangerous because your retina can sense light and send signals to your brain so you can see it. 

When it pulls away from the tissues that support it, it effectively loses its blood supply. Those tissues have blood vessels that supply your retina with nutrients and oxygen.

Symptoms of retinal detachment: When to see a doctor

Retinal detachment usually has no pain. Many times, there will be hallucinations at any time before or while the detachment evolves. You may experience the following symptoms:

• Hazy vision
• Peripheral vision becomes worse
• A curtain shades across the field of vision
• The sudden emergence of specks or wavy lines gliding around within the field of vision; floaters
• Sounds of light flashing possibly in either or both of the eyes; photopsia

Don't wait to see if you're going to have pain. Your provider needs your treatment to start as soon as possible.

Types of retinal damage and their causes

There are three broad classification components of retinal detachment, with each based on cause and corresponding manifestations: 

1. Rhegmatogenous Retinal Detachment

The tear or break in the retina is the most common form of retinal detachment, whereby rupture of the process allows the fluid from the vitreous gel to sneak behind the retina and detach thereby. Most patients presenting with retinal detachment in a clinic will have this.

Causes
Changes in the aging vitreous lead to posterior vitreous detachment.

• Trauma into the eye.
• High myopia (nearsightedness).
• Eye surgery done in the past, for instance, cataract surgery.

Symptoms
Sudden flashes of light, floaters, and shadows or curtain effects in vision.

2. Tractional Retinal Detachment

It develops when scar tissue forms on the surface of the retina and contracts and pulls away from the underlying tissue. This usually slowly happens over time.

Reasons

• Usually occurs in diabetic retinopathy when diabetes damages the blood vessels supplying blood to the retina and causes the formation of scars.
• Other conditions cause the formation of scars, like sickle cell disease or retinal vein occlusion.

Symptoms
Same as in rhegmatogenous detachment, these include seeing changes in vision and possibly the shadow effect.

3. Exudative (serous) retinal detachment

Here, it is that the fluid volume is collected beneath the retina with neither breaks nor tears. The fluid accumulation forces the retina from its normal position.

Causes

• Inflammatory conditions like uveitis or systemic diseases such as lupus and sarcoidosis
• Tumors in or near the eye cause leakage of fluid
• Age-related macular degeneration (AMD)

Symptoms
Blurred vision and distortion media, but usually no sudden flashes or scallops.

Is retinal detachment common?

Retinal detachment is a very rare event but one that can pose an impending danger to one's eyes by threatening to take sight from that person if he/she does not promptly seek treatment. Rates of incidence vary according to geography, age, or other factors.

Estimates regarding the incidence of retinal detachment vary. One other study estimates the annual risk of rhegmatogenous retinal detachment, which is the most common type, at 6.3–17.9 per 100,000.

How do you treat retinal detachment?

Your eye doctor will have certain discussions about how to provide the right treatment for your retinal detachment. Sometimes, you may require a certain combination of treatments for effective results.

Treatments include:

1. Laser therapy or cryopexy

At times, the retinal tear is diagnosed by your healthcare provider while there is still some retention of the retina on the eyeball. Such incidences require the application of a medical laser tool or freezing one to seal the tear. Scar tissue forms and holds the retina into the eye.

2. Pneumatic retinopexy 

Your clinician may recommend this option for selected cases. During pneumatic retinopexy: 

• Your clinician injects a small gas bubble into the eye. 
• The bubble presses against the retina, closing the tear. 
• For this treatment, you may need a laser or cryopexy (freezing) to seal the tear. 
• Your body reabsorbs the fluid that is collected under your retina, which can now stick to the eye wall like it should. Eventually, your body also absorbs the gas bubble. 

Preventive procedures hold you still for a few days after the surgery to hasten recovery. You may also lie down or sleep with your provider. 

It might seem gross or troublesome, but they are important. They are just a temporary discomfort for long-term benefits.

3. Scleral buckle

During a scleral buckle surgery:

• Your provider surgically places a silicone band or sponge (buckle) around the eye.
• This band will hold the retina in place and be held there permanently—you won't see this band.
• Sealing the tear with a laser or cryopexy is done by the provider.
• It may inject a gas bubble or drain the fluid under the retina to have it attached again.

4. Vitrectomy

In the course of a vitrectomy:

• An operation for the surgical removal of vitreous. 
• By some form of laser or freezing, it seals all the retinal tears or holes.
• An air, gas, or oil bubble is placed into the eye to push the retina back into place. 
• Months later, if your provider uses an oil bubble, the bubble will be removed. 
• Gas and air bubbles are reabsorbed by your body.

In the case of a gas bubble, some activities should be avoided at heights. This means that a change in altitude may cause an increase in the size of the gas bubble and consequently the pressure in your eye. Avoid flying and climbing to high altitudes. Your provider will tell you when you can start doing that again.

Complications/side effects of retinal detachment treatment 

Although surgery to reattach your retina is quite successful, like all surgery, it has risks and complications. These include:

• Bleeding
• Infection
• Increased pressure in your eye (intraocular pressure)
• The likelihood that you may end up having to undergo further surgery
• Membranes that develop postoperatively can then shrink and pull the tissues outwards; the name for this is proliferative retinopathy or epiretinal membrane. 
• Prompt formation of cataract requiring additional cataract surgery

Retinal detachment surgery aftermath

You might experience some discomfort as a result of treatment for your detached retina but that is just for a few weeks. Your provider will discuss medication and other pain relief measures with you.

Likely, you are also going to need to rest for a couple of weeks. Inquire from your provider when you can start exercising, resume driving, or go back to doing your normal routine activities.

Some other things you will see after the surgery are:

1. Eye patch: Use your provider to apply this eye patch.

2. Head position: If your provider puts a bubble in your eye, follow instructions for your head position. 

It will tell you what position should be the position of your head and how much time should be spent while doing so to heal your eye. 

3. Eye drops: Instruction on how the drops should be used will come from your provider to aid in the healing of your eye.

4. Improved vision: You may notice an improvement in your vision in about four to six weeks after surgery. The full effects may take several months for you to realize.

How do you prevent retinal detachment?

It will not stop rhegmatogenous retinal detachment, but it will help reduce the risks:

1. Regular eye care
Eye checks keep your eyes healthy. Eye tests must be done, especially by nearsighted persons, because they are at the greatest risk of retinal detachment. Dilated exams should include finding small retinal tears by the eye care provider.

2. Be safe
Use safety goggles or other such equipment for your eyes while playing or doing anything dangerous.

3. Prompt treatment
See your eye care provider as soon as you have any sign of retinal detachment or head to the closest emergency room.

4. Stay healthy
Take care of chronic diseases and balance your diet and exercise.

Control glycemic and blood pressure levels to minimize the incidence of sight-threatening tractional retinal detachment in those with diabetes.

Conclusion 

Retinal detachment can be a serious condition, and in most cases, it is painless. Other symptoms may indicate the retina has become detached: a sudden increase in eye floaters, bursts of light, or darkening in your field of vision. Seek medical attention if you notice any of these symptoms. 

Call your eye care practitioner or visit Vision Concern for further help. Most likely, some kind of surgery will be required. Just waiting a few days for treatment may lead to permanent blindness. 

It is now necessary to continue eyesight care according to the instructions given by your surgeon post-surgery.

FAQs

1. Which queries do I need to ask my eye care provider?

For those who are suffering from retinal detachment (or are highly prone to it):
What is the best treatment for retinal detachment for me?
Will I need surgery?
How do I protect my eye health after surgery?
Is there anything else that can be done to reduce the risk of retinal detachment?
How regularly should I be having an eye exam?

2. When should I go to the emergency room?

Your surgeon's instructions should include situations classified as emergencies; however, if you: 

• Suddenly have excruciating pain.
• Experience symptoms of an infection, such as swelling and increased body temperature. 
• Unexpectedly develop discharge from one of your eyes. 
• Notice an abrupt drop in your capability to see. 

Seek consultation with your provider or pursue emergency assistance.