Retinal detachment is a serious condition in which the light-sensitive layer at the back of the eye detaches from the wall of the eye. As the risk of permanent vision loss goes up the longer this is left untreated, retinal detachment is considered a medical emergency.

Fortunately, retinal detachments are treatable, especially if caught early. Usually before the detachment occurs, it starts off as a break in the retina. At this stage, treatment is more straightforward, done with a simple laser procedure and preventing the need for a major surgery.

When the retina has detached, surgery is required to treat the condition.

Available Treatments for Retinal Detachment

There are two main treatment options for retinal detachments.

1. Vitrectomy

A vitrectomy is a procedure that removes the gel-like fluid or vitreous from your eye, which is usually the culprit behind causing the retina to tear because it causes traction along the tear and allows fluid to enter the subretinal space.

After removing the vitreous, air is used to replace the fluid and this will help flatten the retina. Only when the retina is fully flattened, can laser then be performed to surround the tear and scar it down, thus preventing fluid from getting into that space again and causing the retina to detach.

At the end of the surgery, this air is usually replaced with a gas which is able to stay in the eye for a longer period of time. This allows the retina to heal in place as the gas slowly dissipates on its own.

In some patients with more severe, complex retinal detachments, the surgeon may leave Silicone Oil in the eye. Unlike gas, Silicone Oil does not dissipiate and can stay in the eye for months or even indefinitely. A second surgery will need to be performed to remove the oil, and this is usually much quicker than the first.

While gas or oil is in the eye, the vision will continue to be blurry till either the gas disappears, or the oil is removed. During the first few weeks following the surgery, there will also be specific instructions on how to posture yourself throughout the day. This is to allow the gas or oil to tamponade the breaks and gives the surgery the best chance of success.

Vitrectomies are relatively safe procedures but they still come with risks. These include, but are not limited to, the following:

• Re-detachment
• Cataract formation (if not already removed)
• Raised intraocular pressure
• Infection or inflammation
• Bleeding

2. Scleral Buckling

A scleral buckle is another way where the surgeon can reattach the retina. The choice between scleral buckling and vitrectomy surgery, largely depends on the anatomy of the eye and the detachment. In some cases, both surgeries are done concurrently and they serve to complement each other.

Unlike vitrectomies, the scleral buckle aims to push the wall of the eye back against the retina, and this is done by using a silicone band to surround the eye. This band is slipped under the muscles which move the eye, and anchored in place with sutures. After that, a small puncture wound is made in the wall of the eye to express the fluid under the retina and the band is then tightened so that the wall of the eye is pressing against the break in the retina. With the retina now reattached, the break is usually treated with cryotherapy – freezing of the tissues, and the band is then covered by the surrounding soft tissue around the eye so that it is not exposed.

During the first few days, there may be some discomfort in the eye because of the manipulation of the eye and the band pressing into the eye, but this usually resolves quickly. Other possible risks or side effects from scleral buckling surgery include:

• Persistent detachment
• Change in refractive error – Patients may become more myopic
• Double vision (usually temporary)
• Bleeding inside the eye
• Raised intraocular pressure
• Discomfort and ache

Seek help or get assessed for retinal detachment and tears today

As with many other eye conditions, retinal detachments are most easily treated in the earlier stages of their development. Less invasive treatments are typically an option only during those stages, for instance.

If you need help with your retinal detachment or want an assessment to check for one, consult an experienced healthcare professional. At Shinagawa Eye Centre, for instance, we can provide personalised advice and examinations to see whether you may need treatment.

Call us to enquire or book an appointment for an eye screening today.

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