Retinal Detachment
We continue this series of top threats to your eyes by Mary Browne F.A.O.I. who is based at our Rathmines branch. Retinal detachments are something that we tend to associate with the outdoor life and the traumas we put ourselves through when enjoying sports, adventure and sheer mishaps. However age also has a role to play. Firstly a bit about your retina, what it does and what can happen to it.
What is your Retina ?
The retina is a thin layer of tissue back of the eye.
• It is composed of two types of cells
o Rods
– Better for night vision
– Don’t give fine detail
o Cones
– Good for colour vision
– Give precise detail for things like reading and threading needles
• There are two parts of the retina
o Macula
– High density of cones
– Responsible for central vision and fine detail in vision
o Peripheral Retina
– Made up mainly of cones
– Vision isn’t as sharp as central vision
– Better at night time
What is a Retinal Detachment?
• If the retina develops a hole or tear, the vitreous gel in the eye can seep through the hole and pull the retina away from where it should be.
• This can cause the perception of flashes of light.
• A tear may not always lead to a detachment, it depends on how well attached the retina is.
• If a blood vessel also becomes detached, this can also cause bleeding inside the eye.
• As a person ages, sometimes the gel in the eye can shrink, and pull away from the retina, sometimes causing a tear in the retina, which could sometimes lead to a detachment.
Symptoms
• Flashes :Bright sparks of light in front of the eye, that may be coloured
• Floaters : Looks like dark particles floating in front of your vision
• Shadow or Curtain over vision : May be noticed if the retina is peeling off in a layer:
Risk Factors
• Head Trauma
• Myopia (short-sightedness) : As the eye gets more short sighted, it stretches, meaning that the inner layers of the eye are not as strongly attached as before.
• Post Surgery: Retinal detachment is a possible post operative complication following cataract surgery, and can even occur a decade or more after surgery.
• Family history of the condition
• Diabetes
• Very high blood pressure
• More common in males then females
Treatment
• Must be treated with surgery
• The urgency for treatment depends on the extent and location of the detachment.
• Vision can be lost permanently over a few hours or days, depending on the severity of the detachment.
• Timely treatment is often successful, and vision can be restored to normal
• To repair a hole or tear
o The surgeon may use laser burns to seal the hole and prevent fluid leaking through it.
• If the area surrounding the hold is starting to detach
o The surgeon may put a gas bubble into the eye, and position the patient so that the gas bubble floats to the detached area, helping it to reattach
o Then laser may be used to seal the hole
• More serious detachments
o Usually treated with a scleral buckle, where the white part of the eye is indented so it meets the hole.
o Vitrectomy may be used, where the surgeon reduces the tension on the retina to allow it to reattach.
