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YOU NEED TO KNOW ABOUT RETINAL DETACHMENT

Posted Apr 20 2010 12:00am
Apr
20

           Retinal detachment will affect about one out of 10,000 people each year in the United States.  The retina is a thin layer of light-sensitive nerve fibers and cells that covers the inside and back of the eyeball.  For us to see, light must pass through the lens of the eye and focus on the retina.  The retina then acts like a camera, taking a picture and transmitting the image through the optic nerve to the brain.  The vitreous fluid, the gel-like material that fills the eyeball, is attached to the retina around the back of the eye.  If the vitreous changes shape, it may pull a piece of the retina with it, leaving a retinal tear.  Once a retinal tear occurs, vitreous fluid may seep between the retina and the back wall of the eye, causing the retina to pull away.  This results in a retinal detachment.

          There are three different detached retina types: rhegmatogenous, tractional and exudative.  A rhegmatogenous detached retina is a tear or break in the retina that allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE).  The RPE is the pigmented cell layer that nourishes the retina.  A rhegmatogenous retinal detachment is the most common detached retina type.  In the tractional type of detached retina, scar tissue on the retina’s surface contracts and causes the retina to separate from the RPE.  This type of retinal detachment is less common.  Last, the exudative type of detached retina is frequently associated with retinal diseases, including inflammatory disorders and injury or trauma to the eye.  In this retinal detachment type, fluid leaks into the area underneath the retina, but there are no tears or breaks in the retina. 

          Common symptoms of a detached retina include floaters, which are little “cobwebs” or specks that float about in your field of vision, light flashes in the eye, “curtain” over the field of vision, blurred vision and partial or complete central or peripheral vision loss.  Pain is not a symptom of a detached retina.  These possible symptoms are not always a sure sign. However, a detached retina is a medical emergency.  Anyone experiencing possible symptoms should see an eye care professional immediately.  In most cases, doctors are not sure why a person develops a detached retina, but they do know that certain factors increase the chances of a person developing it, including older age, male gender, Caucasian ethnicity, sickle cell anemia, severe high blood pressure, diabetes and certain eye conditions.  Eye conditions that put someone at risk for a detached retina include nearsightedness, retinal detachment in the other eye, retinoschisis, uveitis, lattice degeneration, cataract surgery, family history of retinal detachment, degenerative myopia and eye injury.  

          Prompt treatment of a torn retina can prevent the retina from detaching.  If the retina has a tear or hole, but has not become completely detached, your ophthalmologist may recommend a special type of laser treatment (photocoagulation) or freezing (cryopexy).  If the retina is detached, surgical repair is necessary.  With modern treatment, more than 90 percent of those with a retinal detachment can be successfully treated.  In some cases, however, a second detached retina surgery is needed.  The visual outcome is not always predictable.  Your best defense for this disorder is awareness.  Know the warning signs of a retinal detachment, seek immediate eye care if you experience any of the warning signs, have regular dilated eye exams if you are very nearsighted or if you have a family history of retinal problems and always wear safety eye wear during sports or other hazardous activities.  Also, be sure to have your eye doctor examine your eye after any serious eye injury.   If a retinal detachment is found early, about 85 percent can be successfully reattached.  About 40 percent of the people whose reattachments are successful have excellent vision.  The remaining 60 percent will have varying degrees of vision.  These varying degrees depend upon several other factors including the length of time the retina was detached and if there was scar tissue growth. If a retinal reattachment is unsuccessful, you will eventually lose sight in that eye.

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