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Eye conditions

Retinal Detachment

What is Retinal Detachment?
Retinal Detachment is that medical emergency when a layer of the retina (the screen at the back of your eye) gets separated from the layer that contains blood vessels. This leaves the retina without oxygen and nutrients which puts the affected eye at the risk of permanent loss of vision. In some people, this loss of vision does not get reversed even after surgery.

Do I have Retinal Detachment? (Signs and Symptoms)
Symptoms of a retinal tear and a retinal detachment can include the following:
• A sudden increase in size and number of floaters.
• A sudden appearance of flashes, which could be the first stage of a retinal tear or detachment;
• Having a shadow appear in the periphery (side) of your field of vision;
• Seeing a gray curtain moving across your field of vision;
• A sudden decrease in your vision.

What causes Retinal Detachment?

Retinal tears: Holes or tears in your retina are the most common cause. Eye fluid may leak through this opening causing the retina to separate from the underlying tissues. Tears in the retina can be caused by:
• Vitreous Detachment (Separation of the gel inside the eye): Usually the shrinking of the vitreous happens without causing any problems as part of the natural ageing process. But sometimes, the vitreous may pull the retina hard enough to cause it to tear.
• Trauma
• Severe nearsightedness

Tractional Detachment: A pull on your retina may occur if you have:
• Uncontrolled Diabetes
• Had a retinal surgery earlier which left a scar
• Chronic Inflammation

Risk factors
People with the following conditions have an increased risk for retinal detachment:
• Nearsightedness;
• Severe eye injury;
• Previous retinal detachment in the other eye;
• Family history of retinal detachment;
• Weak areas in the retina that can be seen by an ophthalmologist during an eye exam.

What are the tests for Retinal Detachment?
Your ophthalmologist can diagnose retinal tear or retinal detachment during an eye examination where he or she dilates (widens) the pupil of your eyes. An ultrasound of the eye may also be performed to get additional detail of the retina.
Only after careful examination can your ophthalmologist tell whether a retinal tear or early retinal detachment is present.
Some retinal detachments are found during a routine eye examination. That is why it is so important to have regular eye exams.

How is Retinal Detachment treated?
If you have had a retinal detachment, you should receive proper medical care within 24 hours. You would most probably require a surgery to prevent loss of vision.
Sometimes, if you have been detected with retinal tears, you might require a surgery that can be done on an outpatient basis, meaning that you need not stay in the hospital overnight. These are:
• Laser Surgery or Photocoagulation: With laser surgery, your eye doctor uses a laser to make small burns around the retinal tear. The scarring that results seals the retina to the underlying tissue, helping to prevent a retinal detachment.
• Cryotherapy: This is a freezing treatment in which intense cold is applied to freeze the retina around the tear. The resultant scar that is formed helps attach the retina to the eye wall.
• Pneumatic Retinopexy: If you have a retinal detachment that is small, you can undergo this procedure wherein a small gas bubble is injected in your eye. This gas bubble helps to push your retinal tear back into place against the back wall of your eye. The hole is then sealed with a laser or cryotherapy. The bubble will gradually disappear.

However, there are other times, when you have developed a full blown retinal detachment and this means that you would need a surgery .This may be:
• Scleral buckle: This treatment involves placing a flexible band (scleral buckle) around the eye to counteract the force pulling the retina out of place. The fluid under your detached retina is drained and your eye wall is gently pushed up against your retina.
• Vitrectomy: This surgery is done when you have large tears or detachments. The vitreous gel which is tugging on your retina is removed from your eye. This may be replaced with a gas bubble or an oil bubble. If a gas bubble has been used, it will get replaced naturally by your body fluid. However, if an oil bubble is used, a second surgery will be required to remove it later.

Most retinal detachment surgeries (80 to 90 percent) are successful, although a second operation is sometimes needed.

Some retinal detachments cannot be fixed. The development of scar tissue is the usual reason that a retina is not able to be fixed. If the retina cannot be reattached, the eye will continue to lose sight and ultimately become blind.

After successful surgery for retinal detachment, vision may take many months to improve and, in some cases, may never return fully. Unfortunately, some patients do not recover any vision. The more severe the detachment, the less vision may return. For this reason, it is very important to see your ophthalmologist regularly or at the first sign of any trouble with your vision.

How can I prevent Retinal Detachment?
• Use protective eye wear to prevent trauma to your eye.
• Keep a strict control over your blood sugars if you are a diabetic
• Visit your eye specialist every year especially if you are at risk for a retinal detachment.
• If you suffer from a serious eye injury, see your eye doctor right away.
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