DEAR DOCTOR K:
My father was diagnosed with a detached retina. The doctor said this isn’t uncommon in older people, and that he could have gone blind without treatment. What are the symptoms of, and treatments for, this condition, so I can protect myself?
Detached retinas can indeed lead to permanent blindness if they are not treated promptly. The good news is that, compared to when I was in medical school, today’s treatments are much more effective.
Your retina is the light-sensitive layer of special cells at the back of your eye. When light passes into your eye, it falls on the retina. There, the light is converted into nerve impulses that are relayed to the brain. When your brain interprets these impulses, you “see.”
Normally, your retina lies directly on top of other cells and blood vessels that support and nourish it. If the retina separates from these underlying cells and vessels, it cannot function properly.
Retinal detachment typically starts when a tear or hole develops in the retina. Then some of the vitreous fluid, which fills the inside of the eye, leaks through the opening, gets behind the retina and separates it from the nourishing tissue just beneath it. (See illustration.)
The symptoms you have depend on where the retina detaches. You may experience a sudden blurring or loss of vision, or you may feel as if a curtain has been drawn over one side of your eye. If ever you have these symptoms, call your doctor or your ophthalmologist (eye doctor) immediately.
Other symptoms may include floaters or brief flashes of light. Floaters are fairly common and usually do not mean you have a retinal detachment. Nevertheless, if the floaters are suddenly much more prominent and persistent than usual, get it checked out. Likewise, brief flashes of light are more often caused by migraines than by retinal detachment. Nevertheless, if they are more severe than usual — particularly if you don’t have a headache and nausea, which usually occur with migraines — check it out.
Several techniques are available to treat retinal detachment:
- Scleral buckling. A tiny hole is made in the sclera, the tough layer beneath the retina. Any vitreous fluid that has leaked behind the retina is drained through this tiny hole, allowing the detached retina to fall back into its normal position. Next, a small tuck or indentation is made in the sclera and secured with a silicone buckle.
- Cryotherapy. The retinal tear is sealed with a freezing probe.
- Laser photocoagulation. The retinal tear is sealed with a laser beam.
- Pneumopexy. A bubble of special gas is injected near the area of retinal detachment to press the retina back into place.
- Vitrectomy. Part of the vitreous fluid is removed near the detachment and replaced with a sterile saline solution or some other fluid.
Never hesitate to contact your doctor or eye doctor immediately if you have symptoms that could indicate retinal detachment. It’s better to be safe than sorry.