-
What is retinal detachment?
-
What
are the symptoms of retinal detachment?
-
What are the different types of
retinal detachment?
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Who is at risk for retinal
detachment?
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Detection and Diagnosis
-
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Other Names:
Detached
retina, and retinal tear.
What is retinal detachment?
The retina is
the light-sensitive layer of tissue that lines the inside of the eye and sends
visual messages through the optic nerve to the brain. When the retina detaches,
it is lifted or pulled from its normal position. If not promptly treated,
retinal detachment can cause permanent vision loss.
In some cases there may be small
areas of the retina that are torn. These areas, called retinal tears or retinal
breaks, commonly occur when there is traction on the
retina
by the
vitreous
gel inside the eye. In a child’s eye, the vitreous has an egg-white consistency
and is firmly attached to certain areas of the retina. Over time, the vitreous
gradually becomes thinner, more liquid and separates from the retina. This is
known as a posterior vitreous detachment (PVD).
PVDs are
typically harmless and cause floaters in the eye; but in some cases, the
traction on the retina may create a tear. Retinal tears frequently lead to
detachments as fluid seeps underneath the retina, causing it to separate and
detach.
What
are the symptoms of retinal detachment?
Symptoms
include a sudden or gradual increase in either the number of floaters, which are
little "cobwebs" or specks that float about in your field of vision, and/or
light flashes in the eye. Another symptom is the appearance of a curtain over
the field of vision. A retinal detachment is a medical emergency. Anyone
experiencing the symptoms of a retinal detachment should see an eye care
professional immediately.
What are the different types of
retinal detachment?
There are
three different types of retinal detachment:
Rhegmatogenous
[reg-ma-TAH-jenous] -- A tear or break in the retina allows fluid to get under
the retina and separate it from the retinal pigment epithelium (RPE), the
pigmented cell layer that nourishes the retina. These types of retinal
detachments are the most common.
Tractional --
In this type of detachment, scar tissue on the retina's surface contracts and
causes the retina to separate from the RPE. This type of detachment is less
common.
Exudative --
Frequently caused by retinal diseases, including inflammatory disorders and
injury/trauma to the eye. In this type, fluid leaks into the area underneath the
retina, but there are no tears or breaks in the retina.
Who is at risk for retinal
detachment?
A retinal
detachment can occur at any age, but it is more common in people over age 40. A
retinal detachment is also more likely to occur in people who:
-
Are
extremely nearsighted
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Have
had a retinal detachment in the other eye
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Have
a family history of retinal detachment
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Have
had cataract surgery
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Have
other eye diseases or disorders, such as retinoschisis, uveitis, degenerative
myopia, or lattice degeneration
-
Have
had an eye injury
Detection and Diagnosis
Retinal
detachments are usually found because the patient calls the doctor’s office with
a symptom mentioned above. It is critical that these problems are reported
early, because early treatment can greatly improve the chance of restoring
vision.
The doctor makes the diagnosis of
a retinal detachment after thoroughly examining the retina with
ophthalmoscopy. The retinal surgeon’s first concern is to determine whether
the
macula
(the center of the retina) is attached. This is critical because the macula is
responsible for the central vision. Whether or not the macula is attached
determines the type of corrective surgery required and the patient’s chances of
having functional vision after the operation.
Ultrasound
imaging of the eye is also very useful for the doctor to see additional detail
of the condition of the retina from several angles.
How is
retinal detachment treated?
Small holes
and tears are treated with laser surgery or a freeze treatment called cryopexy.
These procedures are usually performed in the doctor's office. During laser
surgery tiny burns are made around the hole to "weld" the retina back into
place. Cryopexy freezes the area around the hole and helps reattach the retina.
Retinal
detachments are treated with surgery that may require the patient to stay in the
hospital. Pneumatic retinopexy is one type of procedure to reattach the retina.
After numbing the eye with a local anesthesia, the surgeon injects a small gas
bubble into the vitreous cavity. The bubble presses against the retina,
flattening it against the back wall of the eye. Since the gas rises, this
treatment is most effective for detachments located in the upper portion of the
eye. In order to manipulate the bubble into the ideal location, the surgeon may
ask the patient to keep his or her head in a specific position. The gas bubble
slowly absorbs over the next 2-6 weeks.
In some cases
a scleral buckle, a tiny synthetic band, is attached to the outside of the
eyeball to gently push the wall of the eye against the detached retina. The
scleral buckle is not visible and remains permanently attached to the eye. This
technique of reattaching the retina may elongate the eye, causing
nearsightedness.
If necessary,
a vitrectomy may also be performed. During a vitrectomy, the doctor makes a tiny
incision in the sclera (white of the eye). Next, a small instrument is placed
into the eye to remove the vitreous, a gel-like substance that fills the center
of the eye and helps the eye maintain a round shape. Gas is often injected to
into the eye to replace the vitreous and reattach the retina; the gas pushes the
retina back against the wall of the eye. During the healing process, the eye
makes fluid that gradually replaces the gas and fills the eye. With all of these
procedures, either laser or cryopexy is used to "weld" the retina back in place.
With modern
therapy, over 90 percent of those with a retinal detachment can be successfully
treated, although sometimes a second treatment is needed. However, the visual
outcome is not always predictable. The final visual result may not be known for
up to several months following surgery. Even under the best of circumstances,
and even after multiple attempts at repair, treatment sometimes fails and vision
may eventually be lost. Visual results are best if the retinal detachment is
repaired before the macula (the center region of the retina responsible for
fine, detailed vision) detaches. That is why it is important to contact an eye
care professional immediately if you see a sudden or gradual increase in the
number of floaters and/or light flashes, or a dark curtain over the field of
vision.
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ONLINE ACCESS
WEBSITES.
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Surgery Resource
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Online
http://www.Uveitis.com.ph - Uveitis Online
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EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
Mobile E-Yellow Pages. Via
SMS, text LUK4 EYEREPUBLIC
(send to 2851 for Globe and Sun Cellular, and 2951 for Smart). |
EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
Direct:
(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
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EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
Direct and Fax:
(632) 407-3883
Mobile: (63917) 855-2020
Map and directions
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CLINIC HOURS
First-Come, First-Served
Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
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RETINAL DETACHMENT information compiled by
Dr.
Edmin Michael G. Santos and initially uploaded on May 1, 2005.
Last updated on
September 14, 2007. |
