Retinal detachment. Causes and treatment. 9

Retinal detachment is cited as a risk factor in normal vaginal childbirth. It is a potential indication for a Cesarean section. Leading eye diseases expert reviews retinal detachment diagnosis and treatment.

What is retinal detachment? Why does retinal detachment happen? Dr. Anton Titov, MD. What factors determine the prognosis in patients with retinal detachment. What is response to treatment? Dr. Francesca Cordeiro, MD. Retinal detachment is when there is a hole or a tear in the retina. This means that fluid can leak behind retina. Fluid comes from the front of the eye in the vitreous chamber. Fluid flows through the hole into the retina. The part of the retina that senses light comes away from the rest of the retina. That problem is seen by the patient as a falling of the curtain. A curtain comes down over patient’s vision. It is a very recognizable problem by a patient. Because the patient suddenly loses their vision. They invariably want to do something about it. One of the things that is very difficult to predict is who is going to do well with the surgical operation to treat retinal detachment. We do know that the retina detaches and it sometimes involves the macula. So the macula is important. Sometimes you think of a pinhole camera. All the light rays going through the camera are focused to one central point. The same thing happens in the eye. The macula is where you have your sharpest definition of the image. You may have a retinal detachment that involves the macula. Dr. Francesca Cordeiro, MD. The prognosis is less good. Because that whole very complex structure has come away from its support structure. Therefore you don’t know if a patient necessarily will fully recover their vision. There is some evidence that suggests this. Any separation of retina at the macula area means that your patient will never go back to the best possible vision. But this is how you treat macular degeneration. Because usually the tear of the retina is coming from a particular side of retina. Or it comes from the periphery of the retina. Usually you hope that the patient presents very quickly to the eye specialist. Dr. Anton Titov, MD. You hope to see a patient before their macula becomes detached. That increases the awareness and the prognosis for improvement in the vision. For patients with retinal detachment sometimes they have a repeat retinal detachment. Dr. Francesca Cordeiro, MD. Yes. Dr. Anton Titov, MD. How often does retinal detachment recur after the treatment? Because sometimes it’s a recurring problem. Retinal detachment shouldn’t happen again after treatment. But sometimes it repeat retinal detachment happens. The patients who are at risk for repeat retinal detachment are those patients who are very near-sighted. If are very short-sighted that your eye geometry changes. Yes. Stretching of the retina occurs. The retina being thinner means that short-sighted patients are more susceptible to retinal detachment. They do possibly have more risk of repeated retinal detachments. However, a lot of the time nowadays the retinal detachment treatment procedure involves intraocular surgery. There are some ways of doing this retinal detachment repair. You insert a buckle on the outside of the eye. In this way you secure that bit of the retina that was detached. But often, you would do a vitrectomy. You take the jelly out of the eye. At the time of eye surgery you will have a very good look around the eye. You will check that no potential holes exist in the retina. There are no little holes in the retina that could have been missed. Dr. Francesca Cordeiro, MD. A surgeon has to ensure that holes in the retina don’t cause a problem. Dr. Anton Titov, MD. That is one way of ensuring that you don’t have a repeat retinal detachment.