Understanding Retinal Detachment for Patients
Retina is the light sensitive layer in the eye that lines the inside part of the eye and sends visual impulse through optic nerve to brain. Retina sometimes can get detached from its position and loses its capacity to send visual impulses.
There are different types of retinal detachment (RD).
1. Rhegmatogenous RD: Tear/Break in retina allows fluid to get under the retina and lifts it up. This is most commonly seen retinal detachment
2. Tractional RD: Scar tissue over retinal surface contracts and causes retina to seperate.
3.Exudative RD: Frequently caused by retinal inflammatory or noninflammatory disorder causing retina to detach.
Risk factors for rhegmatogenous RD:
There are different types of retinal detachment (RD).
1. Rhegmatogenous RD: Tear/Break in retina allows fluid to get under the retina and lifts it up. This is most commonly seen retinal detachment
2. Tractional RD: Scar tissue over retinal surface contracts and causes retina to seperate.
3.Exudative RD: Frequently caused by retinal inflammatory or noninflammatory disorder causing retina to detach.
Risk factors for rhegmatogenous RD:
- High myopia
- Peripheral retinal degenerations like lattice degeneration, snail tract degeneration
- Family history of RD
- Post cataract surgery
- Following eye injury
Risk factor for tractional RD:
- Proliferative diabetic retinopathy
- Post vein occlusion
- Retinal vasculitis
- FEVR
- Sequelae of ROP
Symptoms of rhegmatogenous retinal detachment:
Appearance / increase in number of floaters, flashes of light. Decrease in vision like appearance of curtain over field of vision. Treatment of rhegmatogenous RD is emergency and immediately consult retina specialist
Treatment of rhegmatogenous Retinal detachment:
Requires surgery to settle back retina into position and tamponade for few days to months. One type is external tamponade through scleral buckle where band is attached outside the eye to gently push of eye against detached retina and cryo/laser therapy to retinal laser. Another way is vitrectomy where sutureless incisions are made and vitreous gel is removed and tamponade like gas/silicone oil is kept in that area.
95% of patients with RD surgery can be successfully treated. Sometimes a second surgery may be needed. Visual outcome may not be known upto several months after surgery.
Visual prognosis is good if retinal detachment is repaired before macula is detached or before 24 to 48 hours of detachment.
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