Detachmen of the retina
What is a detached retina?
The retina is the most internal layer of the nervous tissue which covers the inside of the eye. Detachment of the retina is an eye condition which is caused by the physical separation of the neurosensory retina from the pigmentary epitelio of the retina.This latter remains adhered to the coroides and this in turn remains adhered to the esclera.
It’s occurrence is variable , depending on age, the anatomical state of the eye etc, and is estimated to affect 5 to 10 people out of 100,000. In most cases it happens to the shortsighted, people over 50 and those with a family history of it.
What causes it?
The most common type of detachment of the retina comes about by a breakage caused by traction of the vitreous humour which is adhered to it inside the eye. It occurs mostly in weak areas of the retina, almost always preceded by a spontaneous separation of the vitreous from the retina.This is known as posterior vitreous detachment. Other causes of retina detachment would be ocular traumas, high inflammation, diabetes and eye surgery complications.
What symptoms might be noticed?
It’s a condition which is painless at first , symptoms are usually imperceptable, at most hardly affecting sight. Nevertheless it is normal that the patient may mention one of the following:
- Spots before the eyes, defined as points or webs which move in the direction of the gaze and which intensify when looking at a white surface.
- Flashes, bright lights.
- Seeing a black curtain over the field of vision.
How is it diagnosed?
The Ophthalmologist will carry out a series of check ups with a view to making a diagnosis such as a sight test, an examination by slit lamp, pupil dilation to explore the back of the eye with an ophthalmoscope, directly or indirectly . In some cases it will be necessary to resort to more specific examinations like ocular ecography when other methods lack clarity.
Is it possible to prevent it?
Yes,it is in some cases, so all those people at risk such as the shortsighted, diabetics, and those with a family history of detached retina should undergo an annual check up. However you must go to an ophthalmologist immediately if you suddenly notice spots before the eyes, flashes of light or loss of visual field.
How is it treated?
It is a medical emergency and treatment will depend on the cause, the time lapsed since the detachment occured and the state of the retina. There is no standard treatment for all patients but the most usual techniques are:
- Laser photocoagulation where controlled burns around the area of detachment are made to try to seal it.
- Criotherapy where a criosonda, directed through the external wall of the eye and around the detached area, tries to seal it, as in the above procedure, and make a scar in order to prevent further detachment.
- Neumatic retinopexy where a bubble of gas is inserted which will press against the ocular wall and try to tampon the break ( press the retina back into place) then seal it after with a laser.
- Vitrectomy where first the vitreous humour is extracted from inside the eye using special instruments after which introduction of gas will put (press) the retina back into place and seal it at the same time.
- Classical surgery where a band of silicon is placed around the eyeball to make the detached retina go back into its place, normally by applying cold.
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