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Retinal detachment: What you need to know

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retinal detachment

Figure 1. Eye showing presence of a retinal detachment and a retinal tear. (Source: Mayoclinic)

What is a retinal detachment?

A retinal detachment is an eye condition that occurs when the retina (the layer of tissue with light-sensitive cells lining the back of your eye) separates from the other layers and structures at the back of your eye, which may cause blindness. Some common symptoms of a retinal detachment include; flashes of light, blurred vision, and the presence of floaters.

How do you get a detached retina?

The vitreous or vitreous humour contains a jelly-like substance that permeates the middle of your eye. As you age, the volume of the vitreous in your eyes will progressively decrease. Posterior vitreous detachment (PVD) can develop when the gel in the vitreous humour separates from the retina. In a normal eye, movement can cause the vitreous to move around the retina without much concern. However, sometimes the vitreous may stick to the retina and pull at it firmly enough to tear it. Once the retina is torn, fluid can seep through the tear and detach the retina [1].

 

What are the causes of retinal detachment?

There are 3 different types of retinal detachment with different underlying causes [2].

The first and most common type of retinal detachment is the type known as a rhegmatogenous retinal detachment. Rhegmatogenous retinal detachment is the most common type of retinal detachment and is attributable to ageing. As you age, thinning of the vitreous humour in your eye would move around the retina when your eye moves and latch onto the retina and pull it. The resultant tear in your retina permits fluid to pass through and accumulate underneath the retina. Consequently, such fluid pulls the retina away from underlying tissues and the retinal cells are separated from the layer of blood vessels that provides oxygen and nourishment. The affected areas where the retina detaches lose their blood supply and stop working.

The second type of retinal detachment is a tractional retinal detachment as a result of other underlying health conditions such as diabetes. This type of retinal detachment happens when scar tissue develops on the surface of the retina, prompting the retina to pull away from the back of the eye.

Exudative (or serous) retinal detachment is the third type of retinal detachment whereby fluid gathers underneath the retina without any consequent holes in the latter. This type of retinal detachment is usually caused by eye injuries or tumors.

 

What are the risk factors for retinal detachment?

Generally, the older you get, the higher the risk of you getting a retinal detachment, especially if you are over the age of 50 years. Also, if you have previously suffered a retinal detachment in one eye, you would be more vulnerable to developing a retinal detachment in the other eye. Moreover, retinal detachment can be hereditary, so if you have a family history of retinal detachment, you may be at a greater risk. You may also be more susceptible to getting a retinal detachment if you suffer from high myopia (nearsightedness) or had prior eye surgery such as cataract removal. 

Early signs of a retinal detachment

As a detached retina would pose a major threat to your vision, it is important to consult with your eye doctor immediately once you display symptoms of this eye condition. The longer you delay the treatment of retinal detachment, the greater your risk of permanent vision loss in the affected eye. You may also not feel any pain during the early stages of the eye condition, which is why going for regular comprehensive eye checks is of utmost importance.

The following are the common symptoms of a retinal detachment:

  • Experiencing flashing lights (or ‘seeing stars’) abruptly
  • Experiencing blurry vision
  • Perceiving many new floaters (that look like small dots, circles, cobwebs, lines and specks) in your field of vision
  • Noticing a shadow surfacing in your peripheral (side) vision
  • Noticing a gray curtain enveloping part of your field of vision

If you experience any of these symptoms of a retinal detachment, it is essential that you consult the advice of an eye health professional or eye doctor immediately by scheduling an eye check up.

 

How is a retinal detachment diagnosed?

During a comprehensive eye check, an eye health professional or eye doctor may conduct a retinal examination by using an instrument with a bright light and special lenses to evaluate the back of your eye, including the retina, for any tears, detachments, and holes.

If your eye is bleeding and your retina cannot be examined easily, your eye doctor may use an ultrasound imaging test to diagnose the eye condition.

 

How can retinal detachment be treated?

Retinal detachment is sometimes treated using laser photocoagulation to seal retinal tears. This method is carried out by an eye doctor using a laser light to burn the edges of the retinal tear. The consequent scarring will adhere the retina to the underlying layer of tissue enduringly.

The other treatment method of a retinal detachment would be that of freezing or cryopexy. This method involves freezing the eye wall around your retinal tear to fasten the retina to the underlying tissue, particularly if your retinal holes are hard-to-reach.

Many retinal detachments can also be re-attached by modern surgical techniques. The first type of surgery is called scleral buckle. This surgery involves securing the retinal tears with a silicone material that is put around the sclera (the tough white protective tissue of the eyeball).

The second type of surgery is a vitrectomy to address more complicated conditions of retinal detachments. A vitrectomy involves removing the vitreous (the jelly-like substance in the eye cavity) and filling the eye with a gas bubble to hold the retina in place.

Sometimes, the stage of your retinal detachment may necessitate more than one operation. Again, it is advised to consult your eye doctor about the optimal course of treatment for you [3]. Book your eye appointment today with planoEyecheck to get your eyes evaluated for a retinal detachment or other vision problems.

 

Can a retinal detachment be prevented?

Once you have been diagnosed as being at risk for a retinal detachment, you may wish to avoid activities involving a certain amount of risk of pressure to the eyes such as hang-gliding or bungee jumping.

The reality is that there is no way to completely prevent retinal detachment. Hence, regular eye check ups are important to detect potential eye health problems early on. Consult an eye health professional immediately once you detect any signs of a retinal detachment, especially in the early stages. Prompt treatment can mitigate the risk of permanent vision loss as a result of an untreated retinal detachment.

 

References

[1] American Academy of Ophthalmology. 2021. Detached Retina. [online] Available at: <https://www.aao.org/eye-health/diseases/detached-torn-retina> [Accessed 2 September 2021].

[2] Mayo Clinic. 2021. Retinal detachment – Symptoms and causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/retinal-detachment/symptoms-causes/syc-20351344> [Accessed 2 September 2021].

[3] 2021. [online] Available at: <https://www.singhealth.com.sg/patient-care/patient-education/retinal-detachment> [Accessed 2 September 2021].

 

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