Jun01
Posted by Dr. Jatin Ashar on Wednesday, 1st June 2022
Retina Detachment Treatment In GhatkoparEye is made up of Iris, Pupil, Cornea and Retina. The retina is an extremely thin tissue that lines the inside of the back of the eye. It is the light-sensitive portion of the eye. Light from the objects we are looking at, enters the eye. Cornea and the eye lens focus the light image onto the retina. Human eye works like a camera, light striking the retina causes a complex biochemical change within certain layers of the retina and this, in turn, stimulates an electrical response within other layers of the retina.
These electric signals are transmitted by the nerve endings to the brain through optic nerve, which connects the eye to the brain. Within specific areas of the brain, this electrical energy is received and processed to allow us both to see and to understand what we are seeing. The retina has been compared to the film of a camera. However, once used, film has a permanent image on it. The neurosensory retina, in contrast, continually renews itself chemically and electrically, allowing us to see millions of different images every day without them being superimposed.
The retina is about the size of a postage stamp. It consists of a central area called the macula and a much larger peripheral area of the retina. The light receptor cells within the retina are of two types called the cones and the rods. Cones are concentrated within the macular (central) area and provide us with the sharpness of central vision and color vision. Rods predominate in the peripheral area of the retina and allow us to see in conditions of reduced illumination. The peripheral retina allows us to see objects on either side (peripheral vision) and, therefore, provides the vision needed for a person to move about safely.
Retinal Detachment
Retinal detachment occurs when the retina becomes separated from the nerve tissues and blood supply underneath it. While painless, visually this has a clouding effect that has been likened to a gray curtain moving across the field of vision.
There are 3 types of detachment: rhegmatogenous (which involves a retinal break), traction, and serous (exudative) detachment. Traction and serous retinal detachments do not involve a break and are called nonrhegmatogenous.
Rhegmatogenous detachment is the most common type and caused by a tear or hole in the retina. Risk factors include the following:
Myopia
Previous cataract surgery
Ocular trauma
Lattice retinal degeneration
A family history of retinal detachment
Traction retinal detachment can be caused by vitreoretinal traction due to preretinal fibrous membranes as may occur in proliferative diabetic or sickle cell retinopathy.
Serous detachment results from transudation of fluid into the subretinal space. Causes include severe uveitis, especially in Vogt-Koyanagi-Harada disease, choroidal hemangiomas, and primary or metastatic choroidal cancers (see Cancers Affecting the Retina).
Symptoms
A person with a detached retina may experience a number of symptoms.
These include:
Photopsia, or sudden, brief flashes of light outside the central part of their vision, or peripheral vision. The flashes are more likely to occur when the eye moves.
A significant increase in the number of floaters, the bits of debris in the eye that make us see things floating in front of us, usually like little strings of transparent bubbles or rods that follow our field of vision as our eyes turn. They may see what looks like a ring of hairs or floaters on the peripheral side of the vision.
A heavy feeling in the eye
A shadow that starts to appear in the peripheral vision and gradually spreads towards the center of the field of vision
A sensation that a transparent curtain is coming down over the field of vision
Straight lines start to appear curved
Diagnosis
Your doctor may use the following tests, instruments and procedures to diagnose retinal detachment:
Retinal examination. The doctor may use an instrument with bright light and special lenses to examine the back of your eye, including the retina. This type of device provides a highly detailed view of your whole eye, allowing the doctor to see any retinal holes, tears or detachments.
Ultrasound imaging. Your doctor may use this test if bleeding has occurred in the eye, making it difficult to see your retina.
Treatment
The goal of treatment is to re-attach the retina to the back wall of the eye and seal the tears or holes that caused the retinal detachment. Several approaches can be employed to repair a retinal detachment:
Scleral buckle - In this surgery, a silicone band is placed outside the eye wall to push the wall of the eye closer to the retinal tear in order to close the tear. The tear is treated with a freezing treatment to induce controlled scarring around the tear and permanently seal it. The fluid under the retina is sometimes removed at the time of surgery.
Vitrectomy - In this surgery, three small incisions are made in the white part of the eye and fine instruments are manipulated using an operating microscope to remove the vitreous gel that fills the eye and drain the fluid from under the retina. The surgeon may then use a laser or cryopexy to seal the retinal tears or holes. The eye is then filled with a gas bubble to hold the retina in place while it heals.
Pneumatic retinopexy - In this office-based procedure, a gas bubble is injected into the eye and the patient maintains a specific head posture to position the gas bubble over the retinal tear. The tear itself is sealed either with a freezing treatment at the time of the procedure, or with laser after the retina is re-attached.
Laser surgery - In certain cases, a retinal detachment can be walled off with laser to prevent the retinal detachment from spreading. This is generally appropriate for small detachments.
Complications after the surgery
Like any other surgery, retinal detachment procedures can also be followed by complications like:
Allergies to medications
Bleeding in the eye
Double vision
Cataracts
Glucoma
Eye infection
Chance that the retina does not reattach properly
Chance that the retina detaches again
Things to expect after surgery:
You might have some discomfort for a few a days to weeks after surgery. You will be given pain medicine to help you feel better.
You need to rest and be less active after surgery for a few weeks. Your ophthalmologist will tell you when you can exercise, drive or do other things again.
You will need to wear an eye patch after surgery. Be sure to wear it as long as your doctor tells you to.
If a bubble was put in your eye, you will need to keep your head in one position for a certain length of time, such as 1–2 weeks. Your doctor will tell you what that specific head position is. It is very important to follow the directions so your eye heals.
You might see floaters and flashing lights for a few weeks after surgery. You may also notice the bubble in your eye.
Your sight should begin to improve about four to six weeks after surgery. It could take months after surgery for your vision to stop changing. Also, your retina may still be healing for a year or more after surgery. How much your vision improves depends on the damage the detachment caused to the cells of the retina.