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There's Only One Treatment for Retinal Detachment: Surgery

Posted by Joshua Udoetuk, M.D. on Feb 22, 2017 8:08:00 AM

You’ve probably heard the word “retina,” but may not know the importance of its function – or what a big deal it is when your retina becomes detached. Famously, Theodore Roosevelt suffered a detached retina after sparring in the White House with John L. Sullivan, the boxing champ. He eventually lost sight in his eye due to the injury. Now that you know a detached retina is nothing to take lightly, let’s talk about what a retina does and what to do if you’ve recently suffered an injury. 

Signs of a Detached Retina

Your retinae are largely responsible for your vision. The retina covers the interior surface of the back of your eye. It contains the rods and cones that detect light and convert that to signals carried to your brain by the optic nerve. There are three types of retinal detachment: 

  • Rhegmatogenous – With this type of detachment, a tear or break in the retina lets fluid under the retina between the retinal pigment epithelium (the cell layer which nourishes the retina). 
  • Tractional – If you have tractional detachment, which usually occurs in those with diabetes, it means that you have scar tissue on your retina’s surface that is contracting. This causes the retinal to separate from the retinal pigment epithelium. 
  • Serous (or exudative) – This type of detachment occurs due to an underlying condition causing buildup of fluid (exudate)between the neurosensory retina (photoreceptor layer) and the retinal pigment epithelium (RPE), which prevents the retina from properly functioning. There are many causes of serous retinal detachment. Blocked retinal veins can cause excessive leakage of serum though the vessel walls into the retina. Inflammatory conditions such as uveitis can also cause blood vessel walls to leak and cause serous retinal detachments. Also, patients with imbalance in blood pressure and kidney function can develop serous retinal attachment.

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The vast majority of retinal detachments are spontaneous. However, some retinal detachments can be caused by an injury to the eye or face. Symptoms of a detached retina often include:

  • Blurred vision.
  • Gradually reduced peripheral vision.
  • Flashes of light in one or both eyes.
  • The appearance of tiny specks that look as though they’re floating through your field of vision.The vast majority of retinal detachments are spontaneous. However, some retinal detachments can be caused by an injury to the eye or face. Symptoms of a detached retina often include:  

    If you’re noticing any of these, especially following an injury to the head or face, see your doctor immediately. 

    Not a Wait-and-See Injury

    In fact, the longer you wait with an unrepaired retinal detachment, the lower your chances are of recovering your vision. People who wait too long to have a detached retina repaired can permanently lose their vision – sometimes within a matter of days. As opposed to injuries that happen to other parts of the body, say the shoulder or elbow for example, you won’t be able to wait and see if it gets better. No amount of time or rest will heal a detached retina. That being said, if your doctor says that you have a detached retina, make sure you schedule the appointment for treatment promptly. 

    The Good News: Surgery Typically Is Outpatient

    No one wandetached retina bloody eye-146780719.jpgts to go through surgery and there seems to be a higher level of trepidation when a patient is dealing with eye surgery because they are done while the patient is awake. It’s important to remember you will be sedated and your entire eye will be numbed so you won’t feel anything. 

    It’s important to note that surgery isn’t the only treatment for retinal detachment – treatment options are surgical (vitrectomy and/or scleral buckle) or nonsurgical (pneumatic retinoplexy or laser retinopexy) – but when surgery is the best option, retinal detachments are typically repaired in one of three ways. 

    • Pneumatic retinopexy: This procedure can be performed in the office if your surgeon determines you are a good candidate. For this procedure, your surgeon will inject a bubble of gas into the vitreous cavity (the center part of the eye) along with a cryo (freezing) or laser treatment.

     A scleral buckling: This involves suturing silicone material to the white of your eye over the affected area. This relieves some of the force of the vitreous pulling on the retina by indenting the wall of the eye.

    • Vitrectomy: This is a procedure where your surgeon will remove the vitreous and any tissue that is pulling on your retina. He or she will then inject air, silicone oil or gas into the vitreous space to flatten the retina.

Proactive Eye Care Important

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The combination of balanced nutrition, exercise and proper care are essential to eye health. But the formula for maintaining vision also includes early detection of potential problems. From birth on, the eye examination is the best and only accurate means of detecting disorders so proper treatment can be received. Regular screening for problems that might require urgent attention has been statistically proven to reduce the incidence of vision loss.

The retina should be examined regularly so problems can be discovered before they damage vision. The retina is best examined through a dilated pupil, allowing the eye doctor a wider view inside the eye. Eye drops are used to dilate the pupil. The drops cause temporary blurriness and sensitivity to light but these side effects subside relatively quickly. 

 

Udoetuk_Joshua.pngDr. Joshua Udoetuk is a board-certified ophthalmologist at Kelsey-Seybold. He’s currently accepting new patients at Spring Medical and Diagnostic Center and at the Main Campus. His clinical interests include retinal diseases and surgery, including age-related macular degeneration, diabetic retinopathy, retinal tear, retinal detachment, macular hole and macular pucker.

 

Topics: eye condition, detached retina, ophthalmology

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