UNDERSTANDING RETINAL DETACHMENT

Retinal detachment is a serious eye condition where the retina, a thin layer of tissue at the back of the eye, peels away from its underlying supportive tissue. This separation disrupts the retina’s normal functioning, leading to potential vision loss if not promptly treated. Understanding the causes, symptoms, diagnosis, and treatment options is crucial for effective management and prevention of this sight-threatening condition.

CAUSES AND RISK FACTORS

The primary cause of retinal detachment is the presence of a tear or hole in the retina, which allows fluid to seep underneath, separating it from the underlying tissues.

Rhegmatogenous Retinal Detachment: This is the most common type and is caused by a tear or break in the retina. Ageing is a significant risk factor because the vitreous, a gel-like substance inside the eye, shrinks and can pull on the retina, leading to tears. Other risk factors include severe myopia (near sightedness), previous eye surgery, or trauma.

Tractional Retinal Detachment: This occurs when scar tissue on the retina’s surface contracts, pulling the retina away from the back of the eye. It is often seen in people with diabetes mellitus, which can lead to diabetic retinopathy, a condition where abnormal blood vessels grow on the retina’s surface.

Exudative Retinal Detachment: This type is caused by inflammation, injury, or vascular abnormalities that result in fluid accumulation under the retina without any tears or breaks. Conditions such as inflammatory disorders, tumours, or age-related macular degeneration can lead to this type.

WARNING SIGNS OF RETINAL DETACHMENT

Retinal detachment is a serious condition that can lead to permanent vision loss if not promptly treated. Recognizing the warning signs early is crucial for seeking timely medical intervention. Here are the primary warning signs to watch out for:

Sudden Appearance of Floaters

Floaters are small specks or threads that drift through your field of vision. While floaters are common and usually benign, a sudden increase in their number can be a warning sign of retinal detachment. These floaters are caused by tiny clumps of gel or cells inside the vitreous, the clear gel-like substance that fills the inside of your eye.

Flashes of Light

Experiencing sudden flashes of light, particularly in your peripheral vision, is another common warning sign. These flashes can resemble lightning streaks and occur due to the vitreous pulling on the retina. The sensation can be more noticeable in dark environments.

Blurred Vision

A sudden decrease in vision clarity or blurring of vision can indicate retinal detachment. This blurriness often occurs in just one eye and can affect any part of your visual field.

Shadow or Curtain Over Vision

One of the most serious warning signs is the perception of a shadow or curtain descending over your field of vision. This effect can start in a small area and spread across the vision field as the detachment progresses. It typically starts from the peripheral (side) vision and moves towards the central vision.

Loss Of Peripheral Vision

Noticing a reduction or loss of peripheral (side) vision is a significant warning sign. This can be experienced as a darkening or shadow moving inward from the edges of your vision.

If you experience any of these warning signs, it is crucial to seek medical attention immediately. Retinal detachment is a medical emergency, and prompt treatment is essential to preserve vision. Early diagnosis and treatment can significantly improve the outcome and prevent permanent vision loss. Regular eye examinations, especially if you are at higher risk due to factors like severe nearsightedness, previous eye injuries, or family history, can help in early detection and management.

WHAT WE SHOULD DO?

Seek Immediate Medical Attention: If you experience any of these symptoms, contact an eye care professional immediately.

Avoid Strenuous Activity: Refrain from heavy lifting or vigorous exercise until you are evaluated by a doctor.

Keep Calm and Stay Still: Try to stay calm and avoid moving your eyes excessively to prevent further damage.

Prepare for an Eye Exam: Be ready for a comprehensive eye examination, which may include tests like ophthalmoscopy, ultrasound, or optical coherence tomography (OCT).

Follow Medical Advice: Adhere strictly to the treatment plan provided by your eye care specialist, which may include surgery or other interventions to repair the retina.

DIAGNOSIS

An eye examination is essential for identifying retinal detachment. An ophthalmologist will perform several tests, including:

Diagnostic Procedures for Retinal Detachment

Detecting retinal detachment early is critical for effective treatment and preventing permanent vision loss. A comprehensive eye examination can identify signs of retinal detachment. The following diagnostic procedures are commonly used by ophthalmologists:

 Visual Acuity Test

A Visual Acuity Test measures how well you can see at various distances. During this test, you will be asked to read letters on a chart (commonly known as a Snellen chart) from a specified distance. Each eye is tested separately, with and without corrective lenses if you wear them. The test determines the smallest letters you can read on the chart, indicating the clarity and sharpness of your vision. A decline in visual acuity may signal an underlying issue, such as retinal detachment, especially if it occurs suddenly.

Dilated Eye Exam

A dilated eye exam involves the use of special eyedrops to widen (dilate) the pupils, allowing the doctor to get a better view of the retina and other structures at the back of the eye. After administering the drops, which take about 15 to 30 minutes to fully dilate the pupils, the ophthalmologist uses a magnifying lens to inspect the retina for any tears, holes, or areas of detachment. The dilation provides a more comprehensive view, making it easier to detect abnormalities that might not be visible with non-dilated pupils. This examination can also reveal other eye conditions, such as macular degeneration or diabetic retinopathy.

Ophthalmoscopy

Ophthalmoscopy is a diagnostic procedure utilized to inspect the rear portion of the eye, encompassing the retina, optic disc, and blood vessels. The doctor uses an ophthalmoscope, which is a handheld instrument equipped with a light and several lenses. The ophthalmoscope allows for a detailed examination of the retina. The procedure can be performed directly, with the doctor looking through the pupil, or indirectly, using a special lens held close to the eye. Indirect ophthalmoscopy, often performed with the aid of scleral depression (pressing on the sclera or white of the eye), provides a wider view of the retina, which is especially useful for detecting peripheral retinal tears or detachments.

Ultrasound Imaging

Ultrasound imaging of the eye, also known as ocular ultrasonography, is used when retinal detachment is difficult to visualize due to opacities like vitreous Hemorrhage (bleeding into the vitreous). This non-invasive test involves placing a small probe on the closed eyelid after applying a gel to facilitate sound wave transmission. The probe emits high-frequency sound waves that bounce off the internal structures of the eye and create detailed images of the retina and surrounding tissues. These images can help the ophthalmologist identify the location and extent of a retinal detachment, as well as other possible abnormalities such as tumours or foreign bodies within the eye. Ultrasound is particularly useful in emergency settings where a clear view of the retina is obstructed.

TREATMENT

Laser Surgery (Photocoagulation): A laser is used to seal the retinal tear by creating small burns around it, preventing fluid from passing through.

Cryopexy: Freezing is used to reattach the retina by creating a scar that helps secure the retina to the eye wall.

Pneumatic Retinopexy: A gas bubble is injected into the vitreous cavity to push the retina back into place.

Scleral Buckling: A piece of silicone material is sewn onto the sclera (white of the eye) to push the wall of the eye against the detached retina.

Vitrectomy: Removal of the vitreous gel to relieve traction on the retina and replace it with a gas bubble or silicone oil.

A specialized hospital like Dr. Rani Menon Maxivision Eye Hospitals in Thrissur provides hope and enhance the quality of life for those affected by retinal detachment. Schedule a consultation with our experts. Our compassionate team at Dr. Rani Menon Maxivision Eye Hospitals is here to assist with all your diabetes-related health concerns, tailored to the type of diabetes you have.