A retinal detachment is a sight-threatening ocular emergency that needs prompt attention, such as retinal surgery. While you experience no pain or discomfort as a retinal detachment is occurring, the vision loss from this condition can be significant and irreversible. Being able to recognise the symptoms and signs of a retinal detachment can enable you to seek help from a retinal surgeon sooner rather than later.
What is the Retina?
The retina is the light-sensing tissue lining the back of your eyeball. As light enters the eye, it’s picked up by the sensory cells in the retina, which convert it into a neural signal that can be sent to the brain for processing.
The retina is crucial for vision and has high metabolic demands in order to function. This involves a rich blood and oxygen supply, as well as a system for removing metabolic waste products. To access these important requirements, the retinal layers are adhered to underlying supporting structures, including the choroid and the sclera.
What is a Retinal Detachment?
A retinal detachment occurs when the retinal layers come away from the underlying tissues. A popular analogy is to describe a retinal detachment as wallpaper peeling away from the wall. This results in the retinal tissues being unable to access the blood and oxygen supply required to function. In some cases, a retinal detachment occurs only in a small area of the eye; in other cases, a more significant portion of the retina may separate away.
A retinal detachment may be classed as “macula on” or “macula off”. This refers to whether the macula area of the retina, which is responsible for your central vision, is included in the detachment or not. The purpose of this description is to determine how urgent retinal surgery may be required. Ironically, although a macula-off detachment is more visually devastating, it can be less urgent as the prognosis is already significantly poorer.
Nonetheless, treating a macula-off retinal detachment is recommended within 7-10 days for the best possible recovery. For a macula-on situation, retinal surgeons will want to reattach the retina within 24 hours in order to preserve as much vision as possible.
In addition to a retinal detachment, various diseases can affect the retina, causing vision impairment or even blindness. These include conditions such as age-related macular degeneration, retinitis pigmentosa, and retinal tears and holes. Not all retinal diseases can be treated with retinal surgery.
Signs of Retinal Detachment
Typically, the earlier you can identify the signs of a retinal detachment, the better your chance of saving your vision.
Signs of a retinal detachment include:
- Floaters. Floaters occur when fragments of tissue or blood from broken retinal capillaries are released inside the eyeball during a retinal detachment. They may appear as little specks or squiggles floating around your vision, or as like a string of cobwebs. Floaters will appear suddenly and seem to drift around as you move your eye.
- Flashing lights. This is also known as photopsia. You may describe it as the sensation of seeing an arc of lightning out of the corner of your eye. It can be more apparent when you’re in a dark room. This phenomenon occurs as the retina pulls away from the underlying tissues, mechanically stimulating the perception of light.
- Areas of vision loss. Unsurprisingly, you will lose the ability to see in the area of the retinal separation. This may look like missing the vision at the top of your visual field, the bottom, or the sides. If your macula is still attached, you will find you can still pick out words and details when reading, but your peripheral vision will be impaired in the area of the detachment.
A common age-related eye condition known as a posterior vitreous detachment can often cause symptoms similar to a retinal detachment. The vitreous gel inside the eye shrinks and liquifies as we age, which can induce floaters and flashing lights as it tugs on the retina. These floaters may be persistent for some time. However, a posterior vitreous detachment never causes visual loss.
Despite these mutual symptoms, if you see any flashing lights or floaters, it’s important not to dismiss them as a posterior vitreous detachment until you’ve been seen by an eye care practitioner, such as an optometrist or ophthalmologist.
Treatment for a retinal detachment aims to reattach the damaged portion of the retina. There are a few techniques to achieve this, depending on the size and location of the detachment. Managing your retinal detachment may involve one or more of the following treatments:
- Pneumatic retinopexy. This involves the injection of a bubble of silicon gas into the eye. As the gas rises, it pushes the detached retina against the wall of the eyeball. The ophthalmologist will then use a freezing probe or laser to “spot weld” the retina back into position.
- Vitrectomy. A vitrectomy involves the removal of the vitreous gel from the eye. A vitrectomy is typically used in conjunction with other treatments for a retinal detachment, including pneumatic retinopexy and application of the freezing probe or laser.
- Scleral buckle. A tiny belt of silicon is attached to the outside of the eyeball (the sclera). This gently indents the wall of the eye towards the detached retina, encouraging it to reattach.
Some types of retinal detachments may not require surgery, but instead, treatment of the underlying cause. This may include detachments as a result of a growth, fluid leakage under the retina, or inflammation.
Call us on 03 9000 0389 today.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.