Retinal Detachment Needs to Be Treated ASAP


If you start seeing an abnormal amount of "floaters" in your eyes, or you start losing your sight a little at a time, as if a black veil were slowly lowering, call your ophthalmologist immediately for treatment. Sponsored by Southwest Eye Consultants

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Healthy Living in the Four Corners is brought to you by Southwest Eye Consultants.

If you start seeing an abnormal number of floaters or debris inside your eye, or you experience vision loss, like a veil covering your line of sight, you may have a retinal detachment, one of the most serious internal injuries your eyes can suffer. If left untreated, you can lose your sight and even the eye organ itself. We spoke with retina specialists Moss Fenberg and Sara Haug about the causes and treatments for retinal detachments and why it's so important to seek treatment right away.

The vitreous is a very solid substance and very adherent to the retina, and as we age, that vitreous changes consistency, becomes more liquid, and then pulls away from the posterior pole or the very back part of the retina. It's adherent in the far periphery, and it's during that change that you can have traction or pulling on the retina that can lead to a retinal tear and detachment. Very infrequently, the detachment can repair itself. I've seen that a few times, but if you have a large detachment that goes unrepaired, you ultimately can end up losing the eye, just from the fact that you aren't getting visual input because the retina, which is the nervous tissue that processes the light no longer is able to function, and you end up with loss of the health of the eye. You no longer make the aqueous solution that keeps the equilibrium within the eye.

Depending upon the severity of your torn retina, the shape of your eyeball, and other factors, treatments may include laser surgery, a vitrectomy, or a placement of a scleral buckle on the eyeball.

There's something called a vitrectomy. Vitreous is the gel of the eye and "ectomy" means removal, and so vitrectomy is removal of the vitreous. So we, instead of reattaching the retina externally by putting a band around it, we go internally into the eye, remove the vitreous, and then push the retina back in place with a bubble of gas or oil. A vitrectomy is the most common technique for retinal detachment surgery today and is associated with fewer complications. However, it's not always the approach that is best for a given patient.

The other treatment we often use is a scleral buckle, and what that does is the area where the vitreous is attached to the retina in the far periphery is the area where that traction is exerted from. So the scleral buckle is a silicone band that goes around the eye to lend support to those areas of traction. It's, we use that in cases of if you have a recurrent detachment, we use it in those cases. We use it in cases where you sometimes have scar tissue or more complicated detachment repairs. It's a silicone band, it's like a belt and it stays on for life once it's in place.

Patients often associate retinal attachment surgery with long recovery periods of little or no movement, but the type of surgery required to repair your retina will dictate your recovery plan to avoid additional tears.

So post-op instructions and precautions have evolved from the years of patients being admitted with sandbags on their eye, for hospitalization, and binocular occlusion where you didn't move your eyes at all. Those were the old days to current techniques which are that you don't have to be perfectly still. We encourage certain positioning so that the gas bubble will push in the way that we'd like it to. So if you have a detachment, for example, on your right side of your right eye, you would position to your left so that the bubble can have buoyant force up against the detachment. Post-operative precautions are generally light activity, limited heavy lifting, limited exertion, limited bouncing or jarring, so walking would be fine. Stationary cycling at low impact would be fine. Getting on a four-wheeler, riding a mountain bike, probably not the best options for you. Occupationally, patients ask, can I go back to work? It depends on the work, but in most cases, within three to four days, your eye may look a little Insightly but you typically can get back to a lot of your activity.

Whether you need minor laser surgery to repair a small tear or a full-blown scleral buckle to restore your sight, both doctors Haug and Fenberg strongly advise that you seek help right away. Don't ignore your vision loss. It won't go away.

It is common for patients to understand that chest pain is a heart attack, and loss of function may be a stroke. However, as critical as our vision is, we don't have a public awareness that is concurrent with that or that recognizes that. Patients need to understand that sudden, painless vision loss, new floaters, and flashes of light all need to be evaluated relatively urgently. You don't want to leave your vision as an its poor state. You don't want to call your friendly ophthalmologist a week after you've had a problem. It's best to try to get in within one to two days if your central vision is involved.

If you'd like to know more about the causes and symptoms of treatments for retinal detachment visit I'm Deborah Uroda for Healthy Living.


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