09May

Retinal Detachment/Tears – Everything You Need To Know

If you are worried you might be suffering from retinal issues, take it seriously and go see your doctor. Read on to find out about causes and symptoms of this condition.

What is Retinal Detachment / Tear?

The retina – not to be confused with the pupil or iris at the front of the eye – is a layer of tissue which surrounds the back of the eye and is sensitive to light. The retina connects with blood vessels and the optic nerve and helps process the light that enters the eye and ultimately transfers the information to the brain.

retinal detachment causes

On the inside of the eye the retina is next to the vitreous humor, the gel like substance which makes up the bulk of the eye and helps it keep its shape. On the outside the retina attaches to the choroid which contains connective tissues and provides a path for oxygen and blood flow to the retina.

If the retina becomes pulled away from the choroid for some reason, this is called Retinal Detachment. Since the choroid provides oxygen for the retina, when detachment occurs it is very dangerous as the retina needs oxygen to allow you to see.

A retinal tear on the other hand is a cut or tear in the retina which leads to retinal detachment and so has a similar affect.

How to Tell if You Have a Retinal Detachment

There is no pain associated with a retinal detachment but there are clear symptoms that you will observe quickly after the detachment occurs.

Look out for :

  • An abundance of floaters appearing rapidly. This is one of the most dangerous and most extreme ways for floaters to appear as cells begin to degrade and break away into the vitreous humour.
  • Flashes of light appear in the eye with the detachment. This may be accompanied by seeing spots afterwards.
  • A dark area which appears in your field of vision. A small patch of your vision will be affected and go black.

It is very important that you see a doctor immediately if you experience these symptoms as this condition is very serious and can quickly result in blindness. The symptoms may not appear to be that serious at first but they will likely worsen as time goes on and are the warning signs of a more serious problem which you can’t see (the detachment).

Rapid onset of floaters, flashes of light and dark areas in your vision are signs of a retinal tear. See you doctor immediately!!

What are the Causes?

retinal tearThe most common cause of this condition is simple aging. As the body ages the vitreous fluid may naturally start to shrink or contract from the passage of time, as you pass 40 detachment becomes more likely with each year. When this happens the interior of the eye is no longer full and the retina starts to pull in to fill the space. When it eventually does pull in it can cause the retina to tear or become detached.

Injury and knocks to the head or eyes can also result in detachment, usually from a tear. The tear allows for the vitreous to leak in between the retina and the choroid, causing separation.

Certain illnesses which cause swelling and inflammation around the eyes, including diabetes, can bring on the condition. Swelling can cause the area around the eye to become misshapen causing a pull or push on the retina.

If you have eye issues like surgery or trauma, other diseases or a family history you are more likely to experience detachment and should be on the lookout for the warning signs.

Diagnosis and Treatment

Unless it is very small, the issue should be apparent to your ophthalmologist during an exam. They may do a physical exam with an opthalmoscope, which simply shines a light into your eye with a lens to provide a real examination of the problem area.

You could also receive another test, an ultra-sonogram (much like is used in pregnancy), which uses sound instead of light to map the inside of your eye and look for issues.

ultrasonogram eyes

Ultrasonogram for the eyes

Both tests are safe, non-invasive and simple to perform and should find any problems quickly.

If caught early, a tear does not always lead to detachment. This is preferable, as after detachment has occurred the treatment is a bit more difficult.

If a tear forms without detachment the tear must simply be closed and the problem will hopefully be solved. This can be done without major surgery with either a laser or freezing.

Both procedures rely on creating scar tissue around the tear which will help close and secure the hole. It is best to speak with your doctor about the procedure as they will have the most relevant information on your issue.

When separation has occurred the treatment options are different. There are three main procedures and I will list them from least to most invasive.

gas bubble in eye

Example of a gas bubble in an eye

Gas Bubble Injection – Pneumatic Retinopexy is when a gas bubble is injected into the eye and left to rest against the affected area. If there is a tear this blocks further leakage and also presses the retina back to the choroid allowing the body to heal itself. You will need to keep your head still as the healing progresses but afterwards the gas will simply be absorbed by the body and there is nothing to remove.

 

 

 

 

 

Scleral Buckling – The sclera is the outside white part of the eye. In the procedure, material (usually silicone or sponge) is sutured onto the sclera to create an indent in the eye. This pushes the outside of a small portion of the eye inwards towards the detachment to relieve the pressure. This is perfect if the cause of the detachment is age related shrinking of the vitreous as it creates a smaller area for the vitreous fluid to fill, solving the problem.

Vitrectomy – By far the most extreme option; this process cuts into the eye and removes some or all of the vitreous fluid. The detached area is examined and any excess tissue removed and then the eye is refilled, either with gas,  liquid or oil. Gas or liquid will eventually be absorbed and replaced by natural vitreous fluid but oil will have to be removed later. This method also removes all floaters from the eye as floaters are found in the vitreous fluid. It is important to note that this is the most extreme option and most likely to result in complications.

Prevention and Staying Healthy

There is no sure fire way to prevent retinal tears or detachment but there are things you can do to keep your eyes healthy and hopefully minimize your chances of running into problems.

Proper diet – A healthy diet with the right vitamins for keeping your eyes happy is always a good idea. It will also help prevent or deal with diabetes which can be a cause of the problem.

Avoid Dangerous Activities – A simple accidental bump may be enough to cause a tear, but avoiding high risk activities like contact sports and keeping your eyes and head safe are a safe bet.

Check with your Doctor – Regular checkups with your doctor to examine your eyes and stay on top of the problem can prevent detachment and other complications by catching them early. If you ever have inflammation or injury around your eyes, go get it checked out.

 

 

Ref

http://www.nei.nih.gov/health/retinaldetach/retinaldetach.asp Accessed May 4, 2014.

http://www.mayoclinic.org/diseases-conditions/retinal-detachment/basics/definition/con-20022595 Accessed May 3, 2014

 

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