The retinal detachment is an emergency in which a thin layer of tissue (retina) at the back of the eye starts to detach from the underlying tissues
The retinal detachment separates this layer from the layer of blood vessels which provides oxygen and nutrients. The greater the retinal detachment is, the greater the risk of permanent loss of vision in the affected eye.
Warning signs of retinal detachment may include one or more of the following:
Sudden onset of floaters in different forms (flies, spiders web, cloudy spots or small specks floating in our field)
Flashing lights in many different forms (flashes, lightnings) that many times can be seen either in the dark or in light conditions.
Decreased vision with loss of the field of vision as a black curtain that is constantly evolving and progressively impeding the central vision.
You need to immediately contact a specialist ophthalmologist who can help you find the right approach as this is an emergency that requires immediate treatment and/or surgery.
Symptoms
Retinal detachment should be noted to be painless.
But warning signs appear almost always before or at the same time as the damage occurs.
The sudden appearance of many spots that seems to move through in your field
Flashing lights in one or both eyes
Blurred vision
Gradually reduced lateral (peripheral) vision
A shadow like curtain around your field of vision
When Should You See a Doctor?
Seek medical attention immediately if you experience signs or symptoms of retinal detachment. The retinal detachment is a medical condition in which you can permanently lose part of your vision.
Causes
There are three different types of retinal detachment:
Rhegmatogenous: These types of retinal detachment are the most common. There is usually a break which is caused by a hole or tear in the retina and allows the fluid of the eye to pass and be collected underneath the retinal layer. The retina then is pulled away from the underlying tissues. The areas in which the retina is detached, by losing blood supply and nutrition stop working and that is causing vision loss.This most common cause of detachment is mainly due to the normal aging of our tissues. The gel-like material that fills the inside of your eye, known as the vitreous, may change in consistency and shrink or become more liquid. Normally, the vitreous separates from the surface of the retina without complications - a common condition called posteriorvitreous detachment(or PVD). One complication of this separation can be a small tear.As the vitreous peels off the retina, it may be strongly attached on the retina and this force can create a retinal tear. If left untreated, the liquid from the vitreous can pass through the break in the space behind the retina, causing then a detachment.
Tractional: This type of detachment can occur when scar tissue grows on the surface of the retina, causing traction and pulling retina away from the back of the eye. This kind of detachment is usually seen in people who have poorly controlled diabetes or other proliferative retinal diseases.
Exudative: In this type of detachment, fluid accumulates under the retina, but there are no holes or breaks on its surface. The exudative detachment may be caused by age-related macular degeneration, trauma to the eye, tumours or inflammatory disorders of the eye or the retina.
Risk factors
The following factors increase the risk of retinal detachment:
Aging - retinal detachment is more common in people over 50
Prior other ocular diseases or disorders, including different types of retinopathy, uveitis or other peripheral retinal degeneration (such lattice Degeneration).
Treatment
Application of Argon laser photocoagulation in case small breaks or holes are found without at the time collection of fluid beneath the retina. This thermal painless laser is used to circumvent the lesion so that it will not evolve and create further detachment. In this case, at least two to four weeks of follow-up is recommended to make sure there is no progression of the disease.
Surgical treatment (vitrectomy): its purpose is to repair the break or hole and at the same time to reposition retina to its normal anatomical position, ie to place the detached retina back on the eye wall. This is achieved by placing silicone oil or gas tamponade where is appropriate to achieve maximum anatomical and functional restoration of the detached area. Depending on the type of the tamponade the recovery period can vary from 2 weeks, for easier cases, to 8 weeks with gas tamponade and over 3 months with silicone oil treatment.
