Eye diseases are known to adversely affect quality of life. Geographical location, accessibility to facilities and socio-economic status of an individual play a role in occurrence eye diseases. At Aakash hospital, our highly qualified doctors and well trained service staff make the patient feel at home. A comprehensive healthcare plan is another concept emphasised at Aakash for providing preventive, diagnostic & curative health care which is timely and of high quality for our patients. The ophthalmology department at Aakash, provides quick and cost effective treatment for various eye diseases.
Retinal Detachment Surgery
Retinal detachment is a disorder of the eye in which the retina separates from the layer underneath. Symptoms include an increase in the number of floaters, flashes of light, and worsening of the outer part of the visual field and without treatment permanent loss of vision may occur.The retina is a thin membrane of nerve tissue that lines the back of the eye. When part or the entire retina comes off (detaches from) the back of the eye, it is called retinal detachment.The nerve cells in the retina normally detect light entering the eye and send signals to the brain about what the eye sees. But when the retina detaches, it no longer works correctly. It can cause blurred and lost vision. Retinal detachment requires immediate medical care. If done soon enough, surgery can save lost vision.
There are three types of retinal detachment:
Rhegmatogenous retinal detachment
If you have a rhegmatogenous retinal detachment, you have a tear or hole in your retina. This allows fluid from within your eye to slip through the opening and get behind your retina. The fluid separates the retina from the retinal pigment epithelium, which is the membrane that provides your retina with nourishment and oxygen, causing the retina to detach. This is the most common type of retinal detachment.
Tractional retinal detachment
Tractional retinal detachment occurs when scar tissue on the retina’s surface contracts and causes your retina to pull away from the back of your eye. This is a less common type of detachment that typically affects people with diabetes mellitus. Poorly controlled diabetes mellitus can lead to issues with the retinal vascular system, and this vascular damage can later lead to scar tissue accumulation in your eye that could cause retinal detachment.
In exudative detachment, there are no tears or breaks in your retina. Retinal diseases such as the following cause this type of detachment:
- an inflammatory disorder causing fluid accumulation behind your retina
- cancer behind your retina
- Coats’ disease, which causes abnormal development in the blood vessels such that they leak proteins that build up behind your retina
What causes retinal detachment?
Retinal detachment usually happens because there's a tear in the retina. The most common cause of a tear is posterior vitreous detachment (PVD). Vitreous gel fluid flows through the tear, pools beneath the retina, and lifts the retina off the back of the eye.Retinal detachment can also happen without a retinal tear. Scar tissue buildup in the eye may pull on the retina. This is called traction. Or, fluid can build up under the retina for a different reason than a retinal tear.Some of the reasons that make a person more likely to get a retinal detachment are an eye or head injury, nearsightedness, eye disease, and diabetes.
What are the symptoms?
Many people see floaters and flashes of light before they have symptoms of retinal detachment. Floaters are spots, specks, and lines that float through your field of vision. Flashes are brief sparkles or lightning streaks that are most easily seen when your eyes are closed. They often appear at the edges of your visual field. Floaters and flashes do not always mean that you will have a retinal detachment. But they may be a warning sign, so it is best to be checked by a doctor right away.
What does the surgery involve?
Surgery choicesCommon methods of repairing a retinal detachment include:
- Pneumatic Retinopexy: In this procedure, your eye doctor injects a gas bubble into the middle of the eyeball. The gas bubble floats to the detached area and lightly presses the detached retina to the wall of the eye. The eye doctor then uses a freezing probe (cryopexy) or laser beam (photocoagulation) to seal the tear in the retina.
- Sceral buckling surgery: Your eye doctor places a piece of silicone sponge, rubber, or semi-hard plastic on the outer layer of your eye and sews it in place. This relieves pulling (traction) on the retina, preventing tears from getting worse, and it supports the layers of the retina.
- Vitrectomy: This is the removal of the vitreous gel from the eye. Vitrectomy gives your eye doctor better access to the retina and other tissues. It allows him or her to peel scar tissue off the retina, repair holes, close very large tears, and directly flatten a retinal detachment.
What happens after the surgery?
Immediately after the operation, you can expect:
- The eye will be covered with an eye pad and perhaps a protective eye shield.
- You may need to stay in hospital overnight or, occasionally, longer.
- Your eye may be uncomfortable for several weeks, particularly if a scleral buckle has been used.
- Your vision will be blurry – it may take some weeks or even three to six months for your vision to improve.
- Watery eyes
- Expect a ‘gritty’ feeling on the surface of your eye if stitches have been used.
- Avoid rubbing or pressing on the eye.
- You may need to wear an eye pad for protection at night while your eye is healing.
- Make sure to follow all directions for medications, such as eye drops.
- Avoid vigorous activity for some weeks following surgery.
What are the complications of retinal detachment surgery, if any?
Risks and complications depend on the procedure used, but can include:
- Cataract formation (loss of clarity of the lens of the eye)
- Glaucoma (raised pressure in the eye)
- Haemorrhage (bleeding) into the vitreous cavity
- Vision loss
- Loss of the eye, although with modern surgical techniques this is a very unlikely outcome