Treatment of retinal detachment in the eye must be done as quickly as possible because the detachment in the retina that we delay in resorting to treatment will lead to lifelong vision loss.
Introduction to the treatment of retinal detachment
The wall of the normal eyeball consists of three layers, from the outside to the inside: the sclera, the choroid, and the retina. The function of the sclera is protection (which is the white of the eye that we see), the choroid's function is nutrition, and the retina's function is vision.
The retina is the part of the eye that receives light from outside and converts it into electrical signals that go to the brain to complete the vision process, retinal detachment It is the loss of adhesion between it and the layer above it (the choroid), which reduces the nutrition of the retinal cells so it dies, and vision loss occurs.
The treatment of retinal detachment is a quick emergency situation that requires an early and immediate diagnosis. The patient must receive treatment as quickly as possible, because any neglect of treating the disease exposes the patient to permanent blindness, and treatment may not be useful at that time.
Causes and predispositions of retinal detachment
There are many pathological conditions for which retinal detachment occurs, and each of them has its own mechanism in causing this detachment.
- diabetes: It persists for a long time without strict treatment, causing damage to the vessels of the retina, leading to the risk of diabetic retinopathy.
- Extreme myopia: People who are very nearsighted (myopia: the inability to see distant objects clearly) are more likely to have a retinal detachment.
- vitreous humoral degeneration: The volume of the vitreous humor (the jelly that fills the ball of the eye) usually decreases in people over 50 years old, and in some cases this volume may decrease rapidly, especially from the back, pulling the retina with it, leading to its detachment.
- aging The most common cause of retinal detachment is the detachment of vitreous humoral.
- Retinal thinning: The thickness of the retina decreases and becomes thin.
- Retinal fissure: As the thickness of the retina separates in half (the retina becomes two layers after it was one layer).
- Severe bruising to the eye
- Previous eye surgeries: Such as cataract surgery.
- Family history of retinal detachment
Types of retinal detachment
There are three types of retinal detachment disease that differ from each other in the mechanism of this detachment, and these types are:
- Rhegmatogenous Retinal Detachment: It is the most common cause of retinal detachment, often caused by age and vitreous degeneration.
- In this type, a small hole or wound occurs in the retina through which fluid enters the space behind the retina, which leads to its separation from the choroid, and the separation increases with time due to the increase in the amount of fluid entering this hole.
- Tractional retinal detachment: This reason is common in patients with untreated diabetes for long periods, where the retinal vessels are damaged due to persistent high blood sugar, which leads to the formation of fibrosis and scars in the retina. These scars shrink and tighten the rest of the retina, leading to its separation.
- Exudative retinal detachment: There is no tear or perforation in the retina here, but fluid collects behind it due to inflammatory diseases that lead to fluid exit from the vessels behind the retina or due to cancers behind the eyeball.
Symptoms of retinal detachment
When you encounter any of the following symptoms, Bimaristan Medical Center recommends that you go to the nearest health care center as soon as possible to receive treatment for retinal detachment and preserve vision. These symptoms are:
- Suddenly shining light in the eye
- Sensation of a curtain blocking part of the field of vision in case of partial retinal detachment (half of the field may be obscured and blinded)
- The presence of black shadows at the edges of the field of view
- blurry vision
- Suddenly the sensation of seeing things, threads, and small black pieces floating and moving in your field of vision
Retinal detachment treatment in Turkey
Retinal detachment is treated based on the severity of the injury and the type of injury, so the appropriate treatment method is chosen. There are several methods for treating retinal detachment, ranging from a simple procedure in the clinic at the ophthalmologist to a surgical procedure that requires general anesthesia, and the treatment methods are:
Non-surgical procedures in the treatment of retinal detachment
These methods are resorted to in the treatment of retinal detachment in the event that there is a small wound, tear or perforation in the retina and it is not severely detached, including:
Laser treatment (laser retinal fixation): Laser retinal detachment (photocoagulation) is treated in the event that there is a perforation or tear in the retina, but it is still attached and has not separated yet.
Cryotherapy: Where the retinal detachment is treated here by applying a cold freezing probe on the outside of the eyeball in the place of the torn retina, thus forming a healing scar. The retina is restored and does not separate.
Surgical procedures for retinal detachment
Surgical treatment of retinal detachment is the most common and predominant in most cases of retinal detachment treatment. Surgical treatment includes three basic surgeries:
Air fixation of the retina (gas retinal detachment surgery): This method is considered one of the simplest procedures and may be done in the doctor's office if he has the appropriate equipment.
The ophthalmologist here numbs the eye so that you do not feel pain, then he inserts a needle into the eye and withdraws a little liquid, then injects some air (gas) to form an air bubble inside the eye, which in turn presses on the detached retina to return to its place.
Then the ophthalmologist coagulates the places of lacerations and holes with a laser or freezing. The air bubble inside the eye goes away on its own and disappears within several weeks (on average two weeks).
But the doctor will ask you to keep your head in certain positions, such as bending the head down and lying face down on the bed. You must remain on it for several days until the bubble does its work.
You should avoid strenuous work, lifting heavy weights, flying, diving or climbing mountains during the treatment with this method so that the characteristics of the air bubble do not change due to the difference in intraocular pressure and your retinal detachment relapses which leads you to perform the surgery again.
solid bend: Severe retinal detachment is treated by bending the sclera (the white part of the eye) by placing a transparent plastic strap of silicone on the outside of the sclera in order to bring the layers of the eye closer together and remove the separation.
Laser or freezing may be involved to document the healing and repair of the tear in the retina, this operation is done under general anesthesia and this silicone ligament remains for life in most cases.
Vitrectomy: This operation is carried out in the treatment of retinal detachment under general anesthesia by making holes in the sclera, and a small endoscope is inserted into one of it, and the other is a vitrectomy instrument.
The endoscope directs the doctor to withdraw all the accumulated fluid behind the retina, remove part of the vitreous humor, and install the detached and torn retina in its place, then air (or oil) is injected to form an air bubble that holds the retina in place.
Lasers or freezing may be used to repair retinal holes and tears. This procedure is similar to air fixation, except that it is performed when the retinal tear is more severe and larger and the same directions are applied to avoid changing intraocular pressure, such as a flight ban.
Bimaristan Medical Center stresses that It is necessary to hurry and immediately go to hospitals or call the emergency number as soon as you notice any of the symptoms or signs of retinal detachment in the eye.
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