New hope for reti­nal de­tach­ment

Go! & Express - - People -

RETI­NAL de­tach­ment is some­thing not ev­ery­one is fa­mil­iar with, yet, if not treated early, it could lead to im­pair­ment or com­plete loss of vi­sion. The retina, a thin mem­brane at­tached to the back sur­face of the eye, acts like the film in a cam­era. As light en­ters the eye, it passes through the cornea and lens and fo­cuses onto the retina.

The retina then trans­forms the light energy into vi­sion and re­mits the in­for­ma­tion back to the brain through the op­tic nerve.

It is es­sen­tial that the retina be nour­ished by the choroid, which is a layer be­hind the retina.

It is when the retina peels away from the choroid and floats in the vit­re­ous cav­ity that it loses its func­tion. The causes for the de­tach­ment are var­ied. The vit­re­ous, which fills most of the vol­ume of the eye, tends to shrink with age and cataract re­moval ac­cel­er­ates the shrink­age.

Should the retina be thin as a re­sult of age, high my­opia, in­jury or hered­i­tary fac­tors, the pull of the shrink­ing vit­re­ous can pro­duce reti- nal tears and this in turn could progress to reti­nal de­tach­ment.

Sec­ondary de­tach­ments, which do not have tears or holes in the retina, can be caused by other eye dis­eases, such as tu­mours, se­vere in­flam­ma­tions, or com­pli­ca­tions of di­a­betes.

The only suit­able treat­ment for sec­ondary de­tach­ments would be to treat the dis­ease which caused it. This may then al­low the retina to re­turn to its nor­mal po­si­tion.

Symp­toms can in­clude float­ing black spots or flashes of light in the vi­sion of mid­dle-aged and older per­sons, though in most cases these symp­toms may not be se­ri­ous. But in some eyes, the sud­den ap­pear­ance of spots or flashes of light could in­di­cate a sub­stan­tial shrink­age of the vit­re­ous with tears in the retina.

In such cases, it is highly rec­om­mended that a com­pre­hen­sive med­i­cal eye ex­am­i­na­tion be con­ducted by an oph­thal­mol­o­gist, in or­der for the in­side of the eye to be in­spected.

An ex­am­i­na­tion of this sort is best car­ried out as soon as symp­toms man­i­fest as fresh reti­nal tears are gen­er­ally treat­able by laser pho­to­co­ag­u­la­tion be­fore there is a chance of them lead­ing to a more se­ri­ous reti­nal de­tach­ment.

Other symp­toms might be­gin with­out no­tice­able floaters or light flashes, but rather pa­tients could no­tice a wavy or watery qual­ity in their over­all vi­sion, or the ap­pear­ance of a dark shadow in part of their vi­sion.

Fur­ther de­vel­op­ment of the reti­nal de­tach­ment will blur cen­tral vi­sion and can cre­ate sig­nif­i­cant loss in one eye un­less the de­tach­ment is re­paired. Treat­ment as soon as pos­si­ble is es­sen­tial. Suc­cess­ful reat­tach­ment of the retina con­sists of seal­ing the reti­nal tear and pre­vent­ing the retina from pulling away.

Var­i­ous pro­ce­dures are avail­able, but the fi­nal choice will de­pend on the sever­ity of the de­tach­ment and the oph­thal­mol­o­gist’s judg­ment.

Laser pho­to­co­ag­u­la­tion, freez­ing (cry­opexy) and sur­gi­cal re­pair are three op­tions avail­able and with 90% suc­cess rate, it is good to know that these tech­niques do gen­er­ally work well.

Some­times, how­ever, more than one op­er­a­tion is re­quired.

Should the retina be suc­cess­fully reat­tached, then the eye will re­tain some de­gree of sight and blind­ness will be pre­vented.

It is im­por­tant also to note that the de­gree of vi­sion which fi­nally re­turns about six months af­ter suc­cess­ful surgery will de­pend on a num­ber of fac­tors.

One of these is the length of time for which the retina had been de­tached, or if there is a fi­brous growth on the retina’s sur­face.

Around 40% of suc­cess­fully treated reti­nal de­tach­ments have achieved ex­cel­lent vi­sion, while the re­main­der have vary­ing amounts of read­ing and/or trav­el­ling vi­sion.

Sadly, due to con­tin­u­ous shrink­age of the vit­re­ous and fi­brous growth de­vel­op­ment on the retina, it is not pos­si­ble to reat­tach all reti­nas.

GOOD RE­SULTS: Laser pho­to­co­ag­u­la­tion, freez­ing (cry­opexy) and sur­gi­cal re­pair are three op­tions avail­able in treat­ing the con­di­tion and have a 90% suc­cess rate

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