Detached retina occurs when the thin retina becomes separated from its underlying supportive tissue due to injury, complications of diabetes, aging, or other retinal disorders. The gel-like material (vitreous) inside the eye leaks through a retinal hole or tear and collects underneath the retina, causing loss of vision that can be permanent if not repaired promptly. Depending on the severity of the detachment, Dr. Bianco uses a variety of approaches to repairing the retina, re-positioning it in the back of the eye, and making sure it stays in place after surgery. Minor repairs can be done in the office, while more severe cases require treatment in the operating room. Dr. Bianco says, “retinal re-attachment is a really successful surgery. It’s been proven to have great results over the past several decades.”
How does retinal detachment happen?
Everybody has fluid (vitreous fluid) in the back of their eye. Retinal detachment is usually an age-related change where the vitreous fluid, which is about 99% water, moves and shifts around. It eventually moves away from the retina, and so patients present with floaters in their vision.
In some patients, the vitreous fluid pulls too hard when it moves, and it can tear a hole in the retina. That can cause slight vision loss or shadows. We can use a laser to fix the tear.
How is a retinal detachment treated?
First, we remove the fluid in the back of the eye by draining it. Then, we laser around the tear to fix it. Then, to keep the detached piece in place where we want it, we fill up the back of the eye with a small amount of gas that pushes the retina back into the eyewall.
The procedure takes place in an operating room, and patients are generally ‘down’ for about a week. It’s critical for patients to keep their head down during recovery so that the gas in the back of the eye pushes the retina upward to the back of the eye (the eyewall).
Who does it happen to?
Generally, retinal detachments are an age-related problem, occurring in folks who are between 40-80. Many genetic dispositions and medical conditions can increase the likelihood of a person suffering a retinal detachment—for example: nearsightedness. Diabetics are also a group more prone to retinal detachments. Their detachments are due to scar tissue buildup.
Can retinal detachments be traumatic?
Yes, though it is a small percentage of retinal detachments. A hard hit to the eye can cause a more immediate, intense retinal detachment, because traction forces within the eye will pull the retina. This can happen to young, active people—especially athletes.
What does recovery of retinal detachment repair look like?
Patients leave the operating room with an eye patch. However, they only need to wear the eyepatch for the first day. The gas bubble will be inside the eye from the first day onward, but will slowly dissolve over time.
Patients are cautioned to take it easy for a week and keep their heads down. After the first week, they can pick their head up and look ahead. Generally, a full recovery and total healing takes about 6-8 weeks.
How urgent of a problem is a retinal detachment?
Retinal detachments need to be addressed quickly. We try to see patients the same day they call us, but if not, only a few days at most.
The good thing about retinal detachments is that patients notice their symptoms right away (in the form of shadowy vision). We want to fix the retina and get it back into the proper position ASAP so they can function properly and see again.
It is not good to wait with an urgent eye care problem, because the other eye can begin taking over and trying to compensate for the lack of clarity in the injured eye. This is not good for either eye.
What is chronic retinal detachment?
CRD is the name we give to patients who present with a retinal detachment maybe 3-4 months after the initial detachment. The term refers broadly to patients who don’t go to the doctor right away. We treat it as an urgent issue, but it’s not an acute injury if the patient visits us months or years after the fact.