Retinal detachment is an acute eye disease. If there is any suspicion, an ophthalmologist should be consulted immediately to prevent possible blindness.
What is a retinal detachment?
Retinal detachment within the human eye is a relatively rare disease. However, once a retinal detachment has occurred, it represents an absolute ophthalmological emergency, since progression in the direction of the visual center can often be observed. Immediate extensive surgical measures are then required to preserve the patient’s vision. See phonecations for All You Need to Know About Capsule Rupture.
There are various causes of a retinal detachment, but overall they are usually easily treatable. Most of the affected patients are between 40 and 70 years old. So this is a typical disease of old age.
The retina lies at the back of the eye on a section of tissue made of pigment and contains sensory cells called rods and cones. These rods and cones are interlocked with the cells of the pigment tissue in a special way, this interlocking serves to maintain suction forces within the eye. The retina is responsible for transmitting the received optical sensory stimuli to the brain. If it detaches from the pigment tissue on which it lies, this is referred to as a retinal detachment.
If tensile forces act on the connection points between the retina and pigment tissue, these connections are interrupted and there is a risk of vision loss. People affected by a retinal detachment are usually between 50 and 70 years old. This means that the retinal detachment is in most cases age-related, with the group of short-sighted patients having a greater risk of being affected by a retinal detachment.
Tears can form in the retina as we age because the vitreous body of the eye changes over time. Adhesions may also form at the tears, causing the vitreous to pull the retina with it as it begins to shrink. This pulling effect can be so strong that a net house detachment occurs. Some previous illnesses that also affect the eye can also be the cause of a retinal detachment.
These diseases include, for example, diabetes, Coats ‘ disease , Lyme disease and tuberculosis. In these diseases, the fluid exchange in the eye is disturbed. This leads to deposits that drive a wedge between the retina and the underlying tissue layer. As a result, a retinal detachment occurs. A tumor of the eye can also be the cause of a retinal detachment, as it can displace the retina.
Symptoms, Ailments & Signs
Typical features of a retinal detachment are expressed through changes in visual perception. Flashes of light that appear in the field of vision can primarily be seen in the dark. If those affected move their eyes, the tensile force is transferred to the strained retina and triggers these photopsias.
In more severe cases, patients suffer from so-called soot rain, which sometimes also shows similarities with flying swarms of mosquitoes. Tears or even bleeding lead to their own dynamics in their movement pattern. They do not remain in the same position as in the case of cell clumps in the vitreous body. If vision decreases completely in certain zones, doctors speak of a visual field loss (scotoma).
This phenomenon often spreads slowly. Those affected describe a slowly growing shadow that increasingly covers the field of vision. The course of propagation is usually opposite to the position of detachment. A falling, dark curtain indicates problems in the lower retina. Such manifestations are considered an emergency and require immediate treatment by an ophthalmologist.
All the symptoms described are not necessarily found in isolation. A combination with each other is within the realm of possibility. Some symptoms only appear for a short time. Flashes of light that occur spontaneously and have no further consequences are particularly characteristic of a detachment at the outer edge of the retina.
Minor damage often goes unnoticed. If the sharpest point of vision (macula) is affected, patients suffer from extremely severe visual impairments due to distortions and blurring. The position of the amotio retinae therefore remains decisive for the overall severity of the symptoms.
Diagnosis & History
In the patient himself, a retinal detachment first becomes noticeable through irritation of the field of vision. Those affected suddenly see small flashes of light, dots, wafts of fog or lines. The signs of a retinal detachment can also become noticeable in the form of a kind of “soot rain”.
It is also possible to perceive shadows or a dark curtain. If such visual disturbances occur, an ophthalmologist should be consulted immediately and without hesitation, it could be a case of retinal detachment! The doctor will use special examination methods to determine whether there is a retinal detachment and initiate further treatment measures.
Various complications can arise when treating a retinal detachment. After a successful operation, there is a risk that the retina will detach again, which makes another surgical procedure necessary. In this case, a pars plana vitrectomy, in which the vitreous body of the eye is removed, may also be necessary.
In rare cases, materials used for the treatment of retinal detachment, such as foam fillings or bands that are fastened around the eyeball, can trigger intolerance and immune reactions on the part of the body. In such a case, the materials must be removed again. In a pars plana vitrectomy, the vitreous humor of the eye is replaced with gas or silicone oil.
The latter can lead to cataracts in the patient and must always be removed from the eye after a year. In principle, with all interventions on the retina there is a risk of secondary glaucoma, in which the intraocular pressure increases. Even with successful treatment of a retinal detachment, the patient’s vision in the affected eye remains impaired.
If inflammation or a tumor is the cause of the retinal detachment, the successful treatment also depends to a large extent on the subsidence of the inflammation or the removal of tumorous tissue. A retinal detachment should be treated in any case, otherwise it leads to blindness of the eye.
When should you go to the doctor?
Sudden loss of vision should be reported to a doctor immediately. If vision decreases significantly within a few minutes or hours, there is an acute health condition that must be presented to a doctor immediately. Without prompt medical consultation, there is a risk of further loss of vision. In severe cases and without treatment, the affected person can become blind.
Blurred vision, impaired perception, or an inability to see certain objects requires prompt evaluation and treatment. If the usual outlines of people or buildings in the immediate vicinity can no longer be clearly defined, there is a disease of the eye that requires immediate action. If the affected person can no longer clearly recognize or assign movement patterns of people or passing cars, there is cause for concern. If the affected person has the feeling that there is a swarm of mosquitoes in front of their field of vision or if they report other peculiarities of visual perception, they should consult a doctor.
Distortions or color changes in vision are other signs of an existing irregularity. If the person concerned reports a black curtain that he perceives in front of his field of vision, a doctor must be consulted. From the patient’s point of view, the curtain seems to be slowly coming undone and this continuously worsens vision.
Treatment & Therapy
If the suspicion that a retinal detachment has occurred is confirmed, then surgical treatment of the affected eye is usually unavoidable. Which type of treatment the ophthalmologist ultimately decides on depends on the exact causes and the extent of the respective retinal detachment.
If there are only small tears in the retina, these can be repaired with the help of laser probes. Cold probes are also sometimes used. If the vitreous body has retreated inwards and thus pulled the retina with it, then it has to be dented artificially. This is accomplished through the use of silicone seals.
If the vitreous is already too deformed, it may have to be removed and replaced with other suitable materials, such as a special silicone oil.
The vast majority of cases of retinal detachment can be cured with surgery, although a few patients may experience a permanent deterioration in vision after a retinal detachment.
Outlook & Forecast
If left untreated, the retinal detachment will progressively worsen, resulting in blindness. The sooner diagnosis and treatment begin, the better the prognosis usually is. In addition to the specific cause of the retinal detachment, the affected area of the retina also proves to be very important for the prognosis. Approximately fifty percent of all retinal detachments can be avoided with preventive measures.
The tear-related (rhegmatogenous) retinal detachment has the best prognosis – almost all rhegmatogenous retinal detachments can be corrected by surgery. If a retinal detachment lasts longer, this can promote a so-called proliferative vitreoretinopathy. This is a reactive increase in tissue around the vitreous body. The result is severe visual impairment – blindness is not excluded.
Another complication can manifest itself in the involvement of the second eye. For example, if one eye has a retinal detachment due to a tear (rhegmatogenous), there is a twenty percent risk that a retinal detachment will also develop in the other eye over time. Therefore, risk patients from the age of forty should undergo a retinal check about once a year.
In the case of retinal holes in healthy eyes, it seems advisable to treat them prophylactically via laser or cold application. In any case, an ophthalmologist should be consulted immediately if symptoms of a retinal detachment suddenly deteriorate or reappear.
An important prerequisite for successful treatment of a retinal detachment that has occurred is the timely consultation of an ophthalmologist. For this reason, every alarm signal, no matter how small, should be taken very seriously. If you suddenly experience visual disturbances or visual impairment, there is no reason to think twice.
You should see a doctor as soon as possible because it could be a retinal detachment. People over 40 and diabetics are advised to see an ophthalmologist once a year, who can identify possible changes in the retina and initiate treatment before retinal detachment occurs.
Overall, it can be said that retinal detachment has lost its horror nowadays. If the above advice on how to behave when a retinal detachment is suspected is carefully observed, in the vast majority of cases impairment of vision as a result of a retinal detachment can be prevented by treatment in an ophthalmological practice.
After surgical treatment of the retinal detachment, check-ups by the ophthalmologist take place at regular intervals. The first examination takes place a few days after discharge from the hospital. The control appointments extend over several months.
Depending on which surgical procedure is used, postoperative pain may occur after the procedure. However, they can usually be treated well with the administration of painkillers. In addition, the patient receives an eye ointment or eye drops afterwards. How long they have to be administered depends on the respective findings.
The patient does not have to carry out any special rehabilitation measures. However, he should refrain from lifting heavy loads and refrain from sporting or similar physical activities. The same applies to moving your eyes back and forth quickly, such as when reading. On the other hand, watching television is possible without any problems, as are going for walks, washing your hair and showering. However, any restlessness or rubbing of the eyes should be avoided. During the first week, the patient wears a bandage or goggles during the day.
Caution is particularly important in the first six weeks after the operation, because the risk of complications is highest during this period. If symptoms such as deterioration of vision, darkening or flashes appear, treatment by an ophthalmologist or an eye clinic must be sought immediately.
You can do that yourself
A retinal detachment is always a medical emergency that requires immediate specialist evaluation and treatment. In the field of self-help in everyday life there is no way to treat a retinal detachment yourself. Precisely because it is important to treat a retinal detachment as quickly as possible, any consideration of waiting or taking medication such as painkillers is not advisable.
Therapy for retinal detachment consists of an operation that is as quick as possible to repair the detachment. There is no other way to prevent vision loss. In this respect, the possibility of self-help is limited to recognizing possible symptoms of a retinal detachment and then acting quickly.
In principle, a retinal detachment can affect anyone and does not necessarily have to be announced in advance. Nevertheless, people who belong to an endangered group of people due to individual risk factors should know which symptoms can indicate a detachment of the retina.
After a successful operation, patients have to attend all follow-up examinations regularly in everyday life and take medication, such as for intraocular pressure, according to plan. Consistent cooperation from the patient’s point of view is the best way to prevent retinal detachment in the area of self-help.