If a retina becomes detached from the tissue at the back of the eyeball, it is deprived of its blood supply which is carrying essential oxygen and nutrients. It must be reattached as soon as possible to prevent irreversible loss of sight. Fortunately, advances in repairing minor retinal tears have been preventing the more serious eventuality of complete retinal detachment. A retina may become detached as the result of a cyst or tumor, a hemorrhage, acute infection, extreme nearsightedness, the aging of eye tissues, or a severe blow to the eye. (Athletes, especially boxers, are particularly vulnerable to retinal detachment.) Retinal detachment can sometimes be a complication of diabetes, high blood pressure, and cataract surgery. Extremely high stress may also be a factor. A California study of 33 people who had suffered detached retinas concluded that the problem can be precipitated by highly stressful situations that cause a sudden surge in blood pressure. As pressure increases, fluid is forced from the capillaries behind the retina, causing blisters to form on the retina’s surface. When individuals are under chronic stress, the capillaries may become increasingly weakened, making the possibility of detachment an ever present danger. The first stage in retinal detachment may be a hole or tear in the retina. This damage can occur if the vitreous gel, or humor, in the center of the eye begins to shrink. As the gelliquifies, it peels away from the retina and forms the threadlike “floaters” familiar to millions of people as harmless phenomena that come and go without any consequence and for no clear reasons. When vitreous gel begins to peel away to a greater extent, it pulls on the retina and dazzling flashes of light, or “stars,” appear. If the pull leads to a small tear in the retina, blood from damaged blood vessels will enter the vitreous gel through this slight opening. The result of this seepage is a clouding of vision. Prompt diagnosis and treatment of these symptoms by a specialist can prevent an eventual emergency.
Diagnostic Studies And Procedures
Diagnosis is based on an examination of the eye with an ophthalmoscope, which gives the doctor a close up view of the retina. A technique known as indirect ophthalmoscopy, invented in the 19th century, is used to get a panoramic view of the retina, including the outer periphery. With this procedure, a doctor is able to detect tiny tears at the edge of the retina.
There are no drug treatments for detached retina. Depending on the extent of the retinal damage, several surgical treatments can be considered.
To repair a tear in the retina before it becomes detached, photocoagulation may be performed under a local anesthetic in the doctor’s office. A mirrored contact lens is placed in the patient’s eye, enabling the doctor to see where the retina is torn. The edges of the torn tissue receive laser burns. When the scar forms, it prevents any further leaking of vitreous humor from behind the retina.
This outpatient procedure, technically called cryoretinopexy, is also performed under a local anesthetic. It has the same purpose as the laser treatment. The ophthalmologist uses a small frozen probe above the retinal tear to produce inflammation that eventually creates scar tissue.
An emergency operation is required to reattach a detached retina to the wall of the eye. Various methods may be used depending on how much fluid has seeped behind the retina and for how long the retina itself has been deprived of nourishment. Surgery is performed under general anesthesia in a hospital. Although the hospital stay may be brief, physical activities may have to be severely restricted and only after several weeks is it possible to assess how much sight has been restored.
There are no alternative therapies for a detached retina, although relaxation techniques such as breathing exercises and meditation can be helpful in managing stress that might lead to retinal detachment. These techniques are especially effective during the postsurgical period when physical movement must be kept to a minimum.
To prevent injuries that might lead to retinal detachment, it’s a good idea to wear protective glasses when engaged in contact and racquet sports. Wrap around goggles should always be worn when working with such hazardous equipment as a blowtorch.
Other Causes of Retinal Detachment
Iritis, a serious eye inflammation, increases the possibility of developing a detached retina.