The origin of retinal detachment is usually a tear or hole which allows the passage of fluid into the subretinal vitreous space. The tear occurs by the traction the vitreous exerts on certain weak areas of the retina.
There are predisposing factors for the onset of retinal detachments, the main ones being:
- Myopia with retinal lesions.
- Vitreous detachment.
Symptoms usually appear immediately:
- Flashes of light (lightning, fireworks …): they are a manifestation of traction on the retina.
- Abrupt increase in the intensity and number of floaters: this are manifestations of alterations in the vitreous.
- Vision of a black area in the visual field: This symptom occurs when the retina has already been detached.
- Image distortion and decreased central vision occurs when the detachment affects the central area of the retina (the macula).
The appearance of any of these symptoms are a cause for alarm and requires an urgent visit to the clinic.
The “best prevention” includes periodic check-ups, to allow an early detection of any predisposing injury. When the there has already been a tear, it tends to be convenient to preventively apply an argon laser to prevent the detachment of the retina.
Unlike other diseases there is not much that the patient can do to prevent retinal detachment.
Depending on the size and nature of the detachment, there are several surgical options for its treatment:
- Laser photocoagulation:Involves the application of an argon laser that produces a “welding” in the zone surrounding the area that has been detached. When the “burns” heal, the two layers of the retina become sealed, preventing the vitreous humour to be introduced between them.
- Vitrectomy: It is a surgical procedure that involves the removal of part of the vitreous humour which is inside the eye, between the lens and the retina. Then a “heavier” liquid which enhances the replacement of the detached retina is introduced. In the same intervention an intraocular laser is applied to seal the retina. The procedure ends with the injection of an expandable gas that pushes on the retina during the postoperative period.
- Cryotherapy involves the application of cold to produce small scars in areas where there is a retinal break. These scars act similarly to those generated by the argon laser (photocoagulation); creating an adhesion between the two layers of the retina.
- Pneumatic retinopexy: It is the introduction of a gas bubble, which exerts pressure on the retina breakage. It is often used in combination with cryotherapy, argon laser photocoagulation or vitrectomy. Although in some cases it is applied separately.
- Scleral buckling: A silicone band is placed (cerclage) around the sclera (outer layer of the eye), the goal is to pressure outside the eyeball to facilitate the closure of the retinal break.