Retinal Detachment

This is a serious condition that if left untreated will result in permanent blindness possibly with chronic pain.

How does it occur?

Retinal detachment is usually caused by the onset of a tear or hole in the retina. Fluid then passes through this hole from the vitreous gel into the space underneath the retina lifting the retina off the wall of the eye and resulting in loss of vision in the area that is detached.
If this is treated in the early stages, vision can be completely restored to normal, however if the central vision is lost at the time of presentation to the doctor then a variable amount of vision will be lost, depending on the length of time and the degree to which the retina is detached.
The results of surgery are generally very good -between 80 to 90% of retinas can be repaired with 1-2 operations.
Occasionally, particularly in the case where the detachment is of long-standing nature or significant scar tissue on the surface of the retina has formed, the prognosis is not nearly as good.

The treatment includes one or more of the following surgical options:

1) Laser treatment - can be done successfully if the detachment is localized.

2) Pneumatic retinopexy - this involves the injection of gas into the eye, the gas bubble within the eye will then push the retina flat -this may require prolonged positioning in different positions depending on where the detachment is located -positioning may be upright, on the side, or even face down. Positioning may last between two to 10 days.
Approximately 60% of retinal detachments can be treated in this manner.

3) Scleral buckling - this involves the placement of a silicone band around the eye in order to indent the wall of the eye. Intraoperative hemorrhage and other complications including worsening of myopia or shortsightedness, chronic ache around the eye, as well as occasional double vision have been associated with scleral buckling.

4) Pars plana vitrectomy - involves the removal of vitreous gel from the center of the eye. The tear resulting the detachment is treated with laser after removing fluid from beneath the retinal detachment. Possible complications of this procedure include cataract formation, infection-although the incidence of this is very low - and failure of the procedure to achieve fattening of the retina, which of course is a possibility with any of the above maneuvers.

Peter Hopp M.D.