Retinal Tears involve a rip or tear in the tissue comprising the retina. They usually arise from degenerative changes in the peripheral retina.
Retinal Detachments are a separation of the retinal tissue from the inside wall of the eye. Similar to wallpaper coming lose from a wall, the retinal tissue may develop folds or come completely away from its proper position along the interior of the eye resulting in loss of vision.
The area of retina that is detached does not see light very well and the vision is blurred or lost. A retinal detachment may progress quickly and lead to complete loss of vision of the eye if not treated.
A detached retina is a very serious problem. It almost always causes blindness unless it is treated.
If your family has a history of retinal detachment, you are at
risk, so you should be familiar with the signs and symptoms of this condition and you should have regular and complete eye examinations.
Floaters, flashes, shower of spotsa are the important signs that you should have prompt examination of the retina and its periphery
to search for any retinal tears.
If a retinal break can be discovered before a retinal
detachment develops it can be treated with the laser to seal the break and prevent a retinal detachment.
The risk of spontaneous retinal tears and detachments increase as we grow older. Usually the vitreous separates from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through the retinal tear, lifting the retina off the back of the eye, much as wallpaper can peel off a wall.
Nearsighted individuals are at an increased risk for retinal tears and detachments. Retinal detachment can occur more frequently after surgery for cataracts. The estimated of risk of retinal detachment after cataract surgery is around 1 percent. Persons who have experienced a blow to the head or injury to the eye are also at risk for retinal tears or detachments.
If you have had a retinal detachment in one eye, you are at increased risk of developing one in the other eye. But there is only about a one in ten chance of this happening.
Retinal detachments do not happen as a result of straining your eyes, bending or heavy lifting.
An eye is like a camera. The lens in the front of the eye focuses light onto the retina. You can think of the retina as the film that lines the back of a camera. The retina is a nerve layer at the back of your eye that senses light and sends images to your brain.
A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred, just as a photographic image would be blurry if the film were loose inside the camera.
Flashing lights, floaters, a shadow in the periphery of your field of vision and a gray curtain moving across your field of vision are the early symptoms of a retinal detachment.
An eye examination with dilated pupils will allow the determination of the source of your symptoms. Only after careful examination doctor can tell whether a retinal tear or early retinal detachment is present.
There are several options for treating a retinal tear or detachment. If immediate help is sought for a retinal tear, it may be possible to repair the retina before it detaches.
Laser photocoagulation can repair smaller retinal tears. The laser creates small burns around the edges of the tear, producing scars. These scars seal the borders of the tear and prevent fluids from leaking toward the retina, thereby helping avoid detachment. Laser surgery can be performed on an outpatient basis, requires no surgical incision and causes less damage to surrounding tissue.
Cryopexy uses extreme cold to cause scar formation and seal the edges of a retinal tear. It can be performed on an outpatient basis, but requires local anesthesia to numb the eye. The eyes can be re dans swollen for some time after cryopexy.
Liquid silicone may be injected to replace the vitreous fluid to maintain the normal shape of the eye and hold the retina and eye wall in alignment.
Very small detachments of the retina can be surrounded by laser treatment or cryotherapy. Large retinal detachments, however, need to be repaired surgically.The decision about which type of surgery depends upon the characteristics of your detachment.
There are some surgical methods for the treatment:
Scleral Buckle is the most common surgery for repairing retinal detachment. The buckle closes the tear and helps reduce the traction on the retina, which prevents further vitreous pulling and separation. When you have several tears or holes or an extensive detachment, your surgeon may create an encircling scleral buckle around the entire circumference of your eye. Although scleral buckling is generally successful, sometimes the retina fails to reattach. A reattached retina doesn't guarantee normal vision. Sight isn't likely to return to normal if the macula was detached.
Pneumatic Retinopexy is a surgical technique used for a relatively uncomplicated detachment when the tear is located in the upper half of the retina. Doctor injects a bubble of expandable gas into the vitreous cavity. Over the next several days, the gas bubble expands, sealing the retinal tear by pushing against it and the detached area that surrounds the tear. You may have to hold your head in a cocked position for a few days after surgery, to make sure the gas bubble seals the retinal tear. And it may take several weeks for the bubble to disappear completely. But the success rate of pneumatic retinopexy isn't as good as that of another procedure .
Vitrectomy is a special surgical procedures applied in the treatment of some retinal pathologies. Bleeding or inflammation clouds the vitreous and blocks the view of the detached retina. In other instances, scar tissue makes it impossible to repair a retinal detachment with pneumatic retinopexy or scleral buckling alone. In these situations, removing the clouded vitreous or scar tissueis recommended.
In vitrectomy a variety of delicate instruments are passed into the eyeball through small openings in the sclera. These instruments include a light probe that illuminates the inside of your eye, a cutter to remove vitreous or scar tissue, and an infusion tube that replaces the volume of removed tissue with a balanced salt solution to maintain the normal pressure and shape of the eye.
After completing the vitrectomy, a surgeon may perform a scleral buckling procedure and may fill the inside of your eye with air, gas or silicone oil to help seal the retina against the wall of your eye.
Vitrectomy surgery typically lasts more than an hour but may take several hours in more complex cases. .After surgery, patient may experience some discomfort and a scratchy sensation in your eye. Severe pain is unlikely. Strenuous activities are avoided. It takes about 10 weeks for your eye to heal fully. But some people don't recover any lost vision.
The complications of vitrectomy are similar to those for other types of retinal detachment surgery. They include a retinal tear, recurring detachment of the retina, a cataract or an infection. Any of these complications can lead to partial or complete loss of vision in the affected eye or, rarely, loss of the eye itself.
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