Retinal Detachment

What is Retinal Detachment?

Retina is the nerve layer located at the back of our eye and allows us to see. Detachment of the retinal layer for any reason may cause sudden loss of vision.

Myopes constitute a high risk group in terms of retinal tears and detachment. Retinal tears are more common in glaucoma patients.

If retinal detachment occurs in one eye, it may occur in the other eye with a 10% probability. Care should be taken in terms of symptoms.

As a result of aging or degenerative diseases, deterioration of the vitreous tissue begins. The existing gel consistency changes, liquefies, coagulates and gradually separates from the places where the vitreous is attached to the retina. This separation is called posterior vitreous detachment. Vitreous detachment usually results without any problem in people with intact retina. In some cases, the retina is torn in one or more places. Fluid starts to enter from this tear and separates the retina from its location. This condition is called retinal detachment. When the retina is detached, it cannot function.

Retinal detachment, a serious vision-threatening eye problem, is the separation of the retinal nerve layer from the pigment epithelium layer underneath. It usually develops when fluid leaks between these two layers following a tear or hole in the retina. This separation is similar to the separation of a damp wallpaper from the wall.

Retinal tear and subsequent retinal detachment are very serious diseases. The disease does not get better by itself. If left untreated, it may cause serious visual loss up to blindness. Flashes of light and floaters in the eye do not necessarily mean retinal detachment, but an ophthalmologist should be consulted as early as possible.

Some retinal detachments are detected during a normal eye examination. A more careful examination is required to detect a retinal tear or an early retinal detachment. Those with a family history should have frequent eye examinations and be knowledgeable about the findings.

The more advanced the detachment, the lower the success rate after surgery. Therefore, it is important not to delay when you notice the symptoms.

What are the Symptoms of Retinal Detachment?

Retinal detachment is an urgent disease that can result in vision loss. Therefore, its symptoms are important. These symptoms are as follows:

• Flashes of light when the eye is open or closed (as in posterior vitreous detachment).
• Flash bursts
• dark coloured spots falling down from above, resembling soot with fly swarms
• Sudden appearance of a greater number of flying objects.
• Grey-black curtain developing from any direction in the visual field.
• Blurring or loss of vision that does not go away with blinking

After a while, a visual field defect appears in the detached area, vision becomes blurred, and sometimes a moving grey curtain is perceived.

If one or more of the above symptoms are present, a retinal examination should be performed immediately.

How is Retinal Detachment Diagnosed?

Eye examination is performed by dilating the pupil. Vitreous and retina are examined in a wide area. On slit lamp examination, cells are frequently seen in the anterior chamber and anterior vitreous. Fundus examination reveals tears in the retina. The tears may be oval, horseshoe or half-moon shaped. If the torn retinal layer passes over a blood vessel, a haemorrhage into the eye is visible. The torn and detached retina appears puffy and white in colour and fluctuates freely with eye movements. Ultrasonographic examination is performed to detect detachment that cannot be detected on fundus examination especially due to haemorrhage.

In retinal detachment with peripheral involvement, narrowing of the visual field is observed. With macular detachment, the central vision of the patient deteriorates. In some severe cases, vision decreases up to hand movements.

Intraocular pressure in the eye with retinal detachment is lower than the healthy eye. On slit lamp examination, cells are frequently seen in the anterior chamber and anterior vitreous. The detached and detached retina appears fluffy and white in fundus examination and fluctuates freely with eye movements.

How is retinal detachment treated?

The aim is to prevent retinal tears before retinal detachment develops. In some cases, retinal tears can be followed without any treatment. In some thin and structurally disturbed cases that may cause a tear in the future, it can be controlled by laser photocoagulation technique. This procedure is a painless procedure and can be performed in office conditions without much discomfort. The laser adheres to the pigment layer under the retinal nerve layer in the area where it is applied, thus preventing fluid leakage. Laser treatment is performed for the problematic area at that moment. If tears occur in another area of the same eye one day, the patient may face the risk of intraocular detachment. For this reason, patients with retinal problems are frequently examined under the eye.

In patients with retinal detachment, the only treatment is surgery. The surgical method may vary according to the number, size, location, shape and duration of the retinal detachment.

Giant retinal detachments that may occur as a result of diabetes, trauma, etc. are intervened with a special surgical technique called vitrectomy. All vitreous is removed from the eye to prevent the retina from pulling or stretching. In patients with incomplete resolution of the detachment, second or third surgeries may be required at intervals. As with any surgery, vitrectomy has some risks. However, if retinal detachment is not treated, it results in permanent vision loss or blindness.

The patient may have some discomfort after surgery. Light flashes and flying objects may be seen for a while after the surgery. If a gas bubble is applied into the eye, the patient may need to keep his/her head in a prone position for a while. Patients who are also given gas bubbles should not travel by plane or go to high altitude places until the gas disappears.

What Will You Feel During Retinal Detachment Operation?

If the detachment is not treated at an early stage, adhesions may occur in the retina, which adversely affects the outcome of the operation.

The aim of the operation is to reattach the detached retina and close the tears by reattaching them.

Various methods can be used for this purpose. However, the important thing here is to intervene as urgently as possible.

After the retina is detached, the only treatment option is surgery. The earlier the surgical treatment called vitrectomy is performed, the more favourable the visual acuity will be. Vitrectomy operation takes 30 minutes – 1 hour. Since local anaesthesia is applied, the patient is in constant communication with the patient.

How to Prevent Retinal Detachment?

The most important risk factor for spontaneous retinal detachment is aging. People with a family history of retinal detachment should be careful as they may also have the problem. Eyes with high myopia constitute another risk group for retinal detachment. In high myopes, the retinal layer is structurally very thinned. The retina tears especially in thinner areas and retinal detachment may occur as a result of this tear.

Therefore, it should be kept in mind that a retinal tear may have developed in patients with high myopia, especially in patients with high myopia, when there is an increase in the flight of flies, the appearance of dots like thousands of soot falling and the presence of severe flashes of light.

The disease can be controlled by applying laser treatment to the eye without surgery during the period when only the retinal tear is present. There may be bleeding from the retinal vessels during tear formation. In this case, retinal detachment must be suspected. Ultrasonography is an extremely important test in differentiating this.

Retinal detachment may not always have an underlying cause and when it does not involve the visual centre, it may not cause sudden visual changes and may be insidious. Usually retinal detachment starts after a tear.

How is retinal detachment operated?

If the tears causing retinal detachment are numerous, large, located differently than usual, if the tear cannot be detected, if there are other accompanying diseases (such as intraocular haemorrhage) or if time has passed, vitrectomy surgery may be necessary. In vitrectomy surgery, retinal detachment is treated through the eye.

Complications that may be encountered if the treatment is not accepted

Retinal detachment is an eye problem that seriously threatens vision. It can occur at any age, more often in middle age and older. If not treated urgently, it can cause partial or complete loss of vision.

What is the price of retinal detachment surgery?

The price of retinal detachment surgery varies depending on the underlying cause and the operation to be performed. The treatment plan to be created by our specialist ophthalmologist depending on the detailed examination results may vary from person to person.

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The above information is for informational purposes. If you have any medical concerns or questions, please make an appointment with our ophthalmologists.