Retinal Detachment Treatment in Tampa, FL

The retina is a nerve layer at the back of your eye that senses light and sends images to your brain. The eye works like a camera. It has two parts, a lens, and a film. The film layer lines the back wall of the eye and is called the retina. The area responsible for the central vision is called the macula. There is a gel called the vitreous which is very firmly adherent to the retina. The vitreous liquifies over time and eventually separates from the back wall of the eye as a normal part of aging.

A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred, just as a photographic image would be blurry if the film were loose inside the camera. A retinal detachment is a very serious problem that almost always causes blindness unless it is treated.

Almost all patients with retinal detachments require surgery to return the retina to its proper position.

Causes

A clear gel called vitreous (vit-ree-us) fills the middle of the eye. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye. Usually the vitreous separates from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Liquefaction of the vitreous in young nearsighted patients with retinal holes allows the migration of liquified vitreous underneath the retina. Fluid may pass through the retinal tear, lifting the retina off the back of the eye, much as wallpaper can peel off a wall. (retinal detachment). This condition may be treated with a laser if localized (small), scleral buckle, vitrectomy, or a combination of treatments.

The most common cause of retinal detachment is caused by the separation of vitreous from the back wall of the eye as a normal part of aging (posterior vitreous detachment). The vitreous may pull hard enough on the retina that it creates a full-thickness tear in the retina. The liquified vitreous enters the tear and separates the retina from the back wall of the eye. Multiple treatment options exist for this condition and the treatment is tailored to the individual’s specific needs.

The following conditions increase the chance of having a retinal detachment:

  • Nearsightedness
  • Previous cataract surgery
  • Glaucoma
  • Severe injury
  • Previous retinal detachment in your other eye
  • Family history of retinal detachment
  • Weak areas in your retina that can be seen by your ophthalmologist

Symptoms

These early symptoms may indicate the presence of a retinal detachment:

• Flashing lights
• New floaters
• A shadow in the periphery of your field of vision
• A gray curtain moving across your field of vision

These symptoms do not always mean a retinal detachment is present; however, you should see your ophthalmologist as soon as possible. Your ophthalmologist can diagnose retinal detachment during an eye examination in which he or she dilates (enlarges) the pupils of your eyes. Some retinal detachments are found during a routine eye examination. Only after careful examination can your ophthalmologist tell whether a retinal tear or early retinal detachment is present.

Types of Retinal Detachment

Chronic Retinal Detachment

Retinal detachments which are chronic (not new) are at higher risk for the development of a condition called proliferative vitreoretinopathy (PVR). PVR refers to the development of scar tissue underneath or on the surface of the retina. Retina has the consistency of wet tissue paper. PVR has the contractile strength similar to a rubber band under tension. As you might imagine, the development of PVR overlying or underneath the retina may lead to new tears within the retina. New tears can lead to a worsening of pre-existing retinal detachment or retinal redetachment after an initially successful surgery. Multiple treatment options exist for this condition and treatment is tailored to the individual’s specific needs.

Tractional Retinal Detachment

A tractional retinal detachment (TRD) occurs in the context of retinal vascular diseases such as diabetic retinopathy. It is characterized by the development of new blood vessels which grow from the retinal surface, into the vitreous, form scar tissue, and exert tractional (pulling) forces on the surface of the retina. The tractional forces may distort the surface of the retina resulting in blurry or distorted vision. The treatment of choice for this condition is vitrectomy with meticulous removal of the tractional forces (scar tissue).

There are multiple different types of retinal detachment. Retina specialists tailor the treatment plan based on the patient’s unique situation and anatomy.

Retinal Tears

Most retinal tears need to be treated with laser surgery or cryotherapy (freezing), which seals the retina to the back wall of the eye. These treatments cause little or no discomfort and may be performed in your ophthalmologist’s office. Treatment usually prevents retinal detachment.

Types of Surgery and Risks

Types of Surgery

There are several ways to fix a retinal detachment. The decision about which type of surgery and anesthesia (local or general) to use depends upon the characteristics of your detachment. In each of the following methods, your ophthalmologist will locate the retinal tears and use laser surgery or cryotherapy to seal the tear.

The Risks of Surgery

Any surgery has risks; however, an untreated retinal detachment usually results in permanent severe vision loss or blindness. Some of the surgical risks include:

  • Infection
  • Bleeding
  • High pressure in the eye
  • Cataract

Most retinal detachment surgery is successful, although a second operation is sometimes needed. If the retina cannot be reattached, the eye will continue to lose sight and ultimately become blind. The more severe the detachment, the less vision may return.

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