Retinal Tears and Detachments

The retina is the seeing layer of the eye. The eye acts much like a camera. The front part of the eye focuses light onto the retina. This is similar to a lens in a camera. The retina lines the back two-thirds of the eye and acts much like the film of a camera. A retinal detachment occurs when the retina is pulled away from its normal position lining the back part of the eye. When the retina is detached, it does not work properly and the vision is quite blurred. This blurred vision will lead to total blindness if the retina is not surgically repaired. The retinal detachment is caused by the vitreous gel pulling on the retina causing a retinal tear. This retinal tear allows vitreous fluid to percolate through the tear and separate the retina from the back of the eye.

Symptoms

There are a few symptoms that may indicate a retinal detachment. These include:

  1. Flashing lights
  2. New floaters
  3. A curtain across your field of vision

These symptoms may be a warning sign of retinal detachment. If these signs are noted, patients should seek the care of an ophthalmologist as soon as possible. The diagnosis can be made by careful dilated retinal examination.

Treatment

The best treatment for a retinal detachment is to prevent it. If a patient has the symptoms and signs noted above and seeks care immediately, the problem may be diagnosed early. If it is indeed early, then there may only be a retinal tear or very small detachment. Under these circumstances, laser surgery or freezing treatments can be applied to the area around the tear or small retinal detachment, preventing a large retinal detachment. This treatment can be done in the office with little or no discomfort.

A retinal detachment requires surgery to physically place the retina back into its proper position. There are many types of surgery to repair a retinal detachment. The decision of which type of surgery is indicated depends on the characteristics of the retinal detachment itself and the patient. Treatments include pneumatic retinopexy, scleral buckle procedure, and vitrectomy procedure. These can be used alone or in combination.

Visual Outcomes Post-Operatively

For a patient with a retinal tear and no large detachment, vision is usually not affected by the retinal tear or the treatment of the tear. The treatment again can be done as an outpatient with little discomfort. Treatment for a larger retinal detachment is usually more involved and requires more time to heal. If the central vision has been detached, the vision after reattachment may not return to normal. After the surgical procedure to repair the detachment, it may take many months for full recovery of vision. Frequent follow-ups will be needed with the eye surgeon in the post-operative period.

Summary

Retinal tears and retinal detachments are treatable conditions. The signs and symptoms include floaters, flashing lights, and visual field loss. Early diagnosis and treatment is preferred. As with any surgery, complications can occur and are reviewed prior to surgery. Most detachment can be repaired successfully with one or more operations.

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