Retinal detachment treatment in the eye must be done as quickly as possible when we delay treatment; this will lead to lifelong vision loss.
Introduction to retinal detachment treatment
The natural wall of the eyeball consists of three layers, from the outside to the inside: the sclera, the choroid, and the retina. The function of the sclera is protection (which is the white of the eye that we see), the function of the choroid is nutrition, and the retina’s function is vision.
The retina is the part of the eye that receives light from the outside and converts it into electrical signals that go to the brain to complete the vision process. Therefore, this disease is caused by the loss of adhesion between it and the layer above it (the choroid), so the nutrition of the retinal cells decreases, they die, and vision loss occurs.
Treating this disease is a quick emergency condition that requires rapid, early, and immediate diagnosis. The patient must receive treatment as quickly as possible because any negligence in treating the disease exposes the patient to permanent blindness, and treatment may not be beneficial at that time.
Causes and predispositions of retinal detachment
There are many pathological conditions that cause retinal detachment, and each of them has its own mechanism for causing this detachment. These pathological conditions that affect susceptible people are either a direct cause of the occurrence of the disease or a predisposing factor to its occurrence, including:
- Diabetes: This lasts for a long time without strict treatment, causing damage to the vessels of the retina and leading to the risk of diabetic retinopathy.
- High myopia: People with high myopia (nearsightedness, the inability to see distant objects clearly) are more likely to develop retinal detachment.
- Degeneration of the vitreous humor: The volume of the vitreous humor (the gel that fills the eyeball) usually decreases in people over 50 years of age, and in some cases, this volume may decrease rapidly, especially from the back, dragging with it the retina, leading to its detachment.
- Aging: The most common cause of this disease is vitreous humor detachment.
- Retinal thinning: The retina decreases in thickness and becomes thin.
- Retinoschisis: The thickness of the retina separates into two halves (the retina becomes two layers after it is one layer).
- Severe bruises on the eye
- Previous eye surgeries: such as cataract surgery or cataract surgery.
- Family history of the disease
Retinal detachment types
There are three types of retinal detachment disease that differ from each other in the mechanism by which this detachment occurs. These types are:
- Rhegmatogenous Retinal Detachment: The most common cause of retinal detachment is often caused by aging and degeneration of the vitreous humor.
- In this type, a small hole or wound occurs in the retina through which fluids enter the space behind it, leading to its separation from the choroid. The separation increases with time due to the increased amount of fluids entering from this hole.
- Tractional retinal detachment: This cause is common in patients with untreated diabetes for long periods, as the retinal vessels are damaged due to continuous high blood sugar, which leads to the formation of fibrosis and scars in the retina. These scars shrink and tighten the rest of the retina, leading to its detachment.
- Exudative retinal detachment: The retina does not have a tear or perforation, but fluids collect behind it due to inflammatory diseases that cause fluids to come out of the vessels behind the retina or cancers behind the eyeball.
Retinal detachment symptoms
When you experience any of the following symptoms, Bimaristan Medical Center recommends that you go to the nearest health care center as soon as possible to receive treatment for retinal detachment and preserve your sight. These symptoms are:
- Suddenly, a bright light in the eye
- The feeling of a curtain blocking part of the field of vision in the event of partial retinal detachment (half of the field may be obscured and blind)
- The presence of black shadows at the edges of the field of vision
- Blurred vision
- The sudden feeling of seeing objects, threads, and small black pieces floating and moving in your field of vision
Retinal detachment treatment in Turkey
Retinal detachment is treated based on the severity of the damage caused to it and the type of injury, so the appropriate treatment method is chosen. There are several methods for treating the disease, ranging from a simple procedure in the clinic with an ophthalmologist to a surgical procedure that requires general anesthesia. Treatment methods include:
Non-surgical procedures in the treatment of retinal detachment
These methods are used to treat retinal detachment if there is a small wound, tear, or perforation in the retina, and it is not significantly separated, including:
- Laser treatment (laser retinopexy): Retinal detachment is treated with a laser (photocoagulation) if there is a perforation or tear in the retina but it is still attached and has not yet separated. The laser performs a photocoagulation process after directing a beam of light to the affected area, forming a healing scar at the site of the wound, preventing its detachment. Again.
- Freezing therapy: Retinal detachment is treated here by applying a cold freezing probe to the outside of the eyeball at the site of the torn retina, thus forming a healing scar so the retina repairs and does not separate.
Surgical procedures to treat retinal detachment
Surgical treatment for retinal detachment is the most common and prevalent in most cases of retinal detachment treatment. Surgical treatment includes three basic surgical operations:
Air retinopexy (gas retinal detachment): This method is considered one of the simplest procedures and may be performed in the doctor’s office if he has the appropriate equipment.
Here, the ophthalmologist numbs the eye so that it does not feel pain, then inserts a needle into the eye and withdraws a little fluid, then injects some air (gas) to form an air bubble inside the eye, which in turn puts pressure on the detached retina to return to its place.
The ophthalmologist then coagulates the areas of the tears and holes with a laser or by freezing. The air bubble inside the eye goes away on its own and disappears within several weeks (on average, two weeks).
However, the doctor will ask you to keep your head in certain positions, such as bending your head down and propping your face on the bed while lying down. You must remain there for several days until the bubble does its job.
You should avoid strenuous work, lifting heavy weights, traveling by plane, diving, or climbing mountains during treatment with this method so that the properties of the air bubble do not change due to the difference in pressure inside the eye and your retinal detachment recurs, and you need to undergo surgery again.
Scleral plication: Severe retinal detachment is treated by flexing the sclera (the white of the eye) by placing a transparent silicone elastic band on the outside of the sclera so that the layers of the eye are brought closer together, and the separation disappears.
Laser or freezing may be used to document healing and repair tears in the retina. This operation is performed under general anesthesia, and this silicone band remains for life in most cases.
Vitreous lumpectomy: This operation is performed in the treatment of retinal detachment under general anesthesia by making holes in the sclera and inserting a small scope into one of them and into the other a vitreous lumpectomy tool.
The endoscope directs the doctor to withdraw all the fluid accumulated behind the retina, remove part of the vitreous humor, and fix the detached and torn retina in its place. Then, air (or oil) is injected to form an air bubble that holds the retina in place.
A laser or freezing may be used to repair holes and tears in the retina. This operation is similar to pneumatic retinopexy, except that it is performed when the retinal tear is more severe and larger, and the same guidelines are applied to avoid changing the pressure inside the eye, such as preventing airplane travel.
Bimaristan Medical Center stresses the need to rush and immediately go to hospitals or call the emergency number as soon as you notice any symptoms or signs of retinal detachment in the eye.
Sources:
