What is retinal detachment?

Retinal detachment is a serious eye condition that occurs when the retina, the part of the eye where images are formed, separates from its surrounding tissue and blood vessels that supply oxygen and nutrients to it. You could lose your vision permanently if medical help is not sought immediately.

Retinal detachment may occur if you:

  1. Are severely near-sighted
  2. Suffered an eye injury or cataract surgery
  3. Have a family history of retinal detachment
  4. Over 40 years of age

If detected in its earlier stages, a retinal tear can be prevented from detachment. The most common methods to repair a tear in retina are:

  1. Laser surgery or photocoagulation – An intense laser beam directed at the retinal tear creates burns around the tear, causing scars that weld the retina to its underlying tissue.
  2. Cryopexy or freezing – A freezing probe is applied to the outer surface of your eye, right above the retinal area to be treated. The scar that develops from freezing tissue that binds the retina to the surrounding tissue.
  3. Vitrectomy – Large retinal tears are treated by removal of the vitreous solution (between the lens and retina) and replacing it with saline solution.

If your retina has become detached, your doctor will recommend additional procedures:

  1. Pneumatic retinopexy – A small gas bubble is injected between the eye lens and retina, which rises and creates pressure against the retina, leading to sealing of the tear.
  2. Scleral buckling – Your doctor will sew a silicone band (buckle) around the white of your eye, which pushes the sclera towards the retinal tear until the tear heals. The band remains attached permanently. The procedure may require laser treatment to seal the tear.

Let us take a detailed look at laser treatment for retinal tears.

Why do you need laser treatment for retinal detachment?

Retinal tear or detachment requires surgical procedures to repair it because without treatment, the condition will progress to blindness in the affected eye. Retinal detachment limits the blood supply to retinal cells, leading to lack of oxygen. Greater the time lag in seeking treatment, higher is your chance of developing permanent vision loss.

Laser treatment allows you to take corrective action against retinal tears in the early stages itself, and preventing the retina from complete detachment. Laser surgery offers other advantages over other forms of treatment like no risk of infection from laser beam, treatment is provided in an outpatients setting, and the laser offers greater precision in targeting the affected area.

Which specialist should you consult if you have any of the signs and symptoms?

You will not feel pain due to a retinal tear or detached retina, which makes it important for you to look out for the following symptoms:

  1. Dark spots (small flecks or threads) floating in your field of vision
  2. Flashes of light in one eye
  3. Darkening of peripheral (side) vision
  4. Blurred or distorted vision

Visit your ophthalmologist at the earliest if are experiencing any of the above symptoms. S/he may further refer you to a retinal specialist for diagnostic confirmation and treatment.

What are the screening tests and investigations before the surgery?

Your specialist will conduct a thorough eye exam to understand the extent of damage. Your ophthalmologist will also use an ophthalmoscope (a magnifying glass with light) to view the back of your eye. The instrument allows your doctor to view retinal holes, tears or detachment. In case of a poor retinal view, an ultrasound test may be used that creates images on a video monitor from sound waves bouncing off the retina and other eye structures.

What is the procedure for laser surgery for retinal tear/detachment?

Focal laser photocoagulation seals the retina layers together and prevents eye fluid from leaking through the tears and holes and causing separation of the layers. Your doctor will begin the procedure by applying eye drops to dilate the pupils and numb the eye to be treated. Laser treatment is performed at the doctor’s office in a regular patient chair. You would be awake through the length of the surgery.

To correct your retinal tear, your doctor will apply a high-energy laser beam to heat small points on the retina that will create scar tissues. These scar tissues will bind to the underlying wall of the eye.

The laser treatment would take around 30 minutes for completion and you can go home after the surgery.

What are the known complications of the surgery?

You could experience blurred vision soon after the procedure, though it is temporary and should be resolved in few weeks’ time.

What precautions or steps are necessary to stay healthy and happy before and after retinal detachment laser surgery?

Ensure that you arrange to be driven back after the procedure. Continue your eye drops and medications as instructed by your doctor, both before and after the surgery. Your doctor will advise you on the permissible and avoidable activities immediately after the procedure. Refrain from vigorous activity for two weeks after the laser treatment to allow reinforcement of the bonds created during the surgery.

What are the dietary and physical activity requirements before and after retinal laser surgery?

There are no special preparations required before laser treatment. You can eat normally and take routine prescribed medications before the surgery.

How can you prevent the disorder from happening or recurring?

You cannot prevent retinal detachment from taking place. However, you can keep track of alarming signs that may suggest a detached retina. Consult your ophthalmologist for an eye exam as soon as you notice abnormal changes. Undergo an eye checkup once a year, especially if you have a diabetic condition or are nearsighted.


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