If the retina is not positioned correctly, it ends up impairing vision. Here’s when it can happen and what can be done.
The retina is the innermost membrane of the eye, which captures images from the outside as light signals and transforms them into electrical messages, sent to the brain through the optic nerve.
Placed in the back of the eyeball, it adheres to another membrane, the choroid: we speak of retinal detachment just when it rises in part or completely from the choroid.
Three types of posting
Regmatogenic, trirational and exudative retinal detachments are usually distinguished.
The regmatogenic ones are the most frequent, a consequence of one or more ruptures of the retina through which liquid infiltrates from the vitreous (gel that occupies the back of the eyeball), which raises and separates the membrane from the underlying tissue. These ruptures occur most often in the presence of myopia, trauma to the eyeball or following eye surgery, but can also result from a detachment of the vitreous from the retina.
Three-way retinal detachments, on the other hand, are due to the formation of membranes on the surface of the retina, which lift it without breaking it. They tend to occur in the presence of diabetes, retinopathy or as a complication of an operation to correct a first retinal detachment.
Finally, exudative detachments generally occur as a result of inflammation, trauma or tumors and are due to collections of fluid that form under the retina without it being broken.
Symptoms of the disorder
Retinal detachment occurs in a time ranging from a few hours to a few days. The first symptoms, which may anticipate it or be present even when it is only mentioned, are myodesopsias (or “flying flies”) and phosphenes. The former are dark spots in motion, more evident on a light background, while the latter are bright flashes perceived on the periphery of the field of vision, especially when there is little light.
In the presence of a frank retinal detachment, a scotoma appears: the visual field is obscured by a sort of floating curtain, the wider the greater the lifting of the retina. In case of complete detachment, vision is completely absent.
In general, a thorough eye examination is sufficient to identify a possible detachment or the lesions that precede it.
Surgery as soon as possible
The detached retina must be repositioned, and the sooner you intervene, the better the results that can be obtained. If the detachment is very small, cryocoagulation can be used in day hospital and local anesthesia, healing the injured part with probes at very low temperatures.
In more serious cases, however, real surgery is needed, more often under local anesthesia. There are two possible modes of intervention: from outside the eye (episcleral surgery) or from the inside (vitrectomy) and the choice is up to the surgeon.
In the intervention from the outside, with a syringe the liquid deposited under the unglued retinal membrane is aspirated, then its repositioning is helped by placing special reinforcements (such as a band or a silicone sponge) on the outer surface of the sclera (the outer white membrane of the eye).
In vitrectomy, on the other hand, the vitreous is removed and replaced with buffering substances (air, gas or silicone oil) which, injected by the surgeon, push the retina towards the choroid, favoring its relocation.
After the operation, it is necessary to follow for two to three weeks a therapy with antibiotic and anti-inflammatory eye drops and in the following months a series of periodic checks. Visual recovery is slow, gradual and strongly linked to the extent and characteristics of the detachment and the time elapsed before surgery.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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