Retinal detachment: ways to address

What is it?

The retina is the thinnest component of the eye with a complex structure which allows to perceive light impulses. The retina coordinates the optic systems of the eye and the visual sections of the brain – it acquires and transmits information.

Retinal dystrophy is usually caused by disruptions in the vascular system of the eye. It is mostly aged people who suffer from this disorder as their vision gradually deteriorates. Dystrophy of the retina affects the photo receptor cells which ensure distance sight and colour perception. In its initial stages, retinal dystrophy may have no symptoms and quite often the patient does not even suspect of this dangerous disorder.

There are three types of retinal separation:

• Regmatogenous (primary) retinal separation is connected with retinal perforation.

• Traumatic retinal separation is connected with eye injury.

• Exudative (secondary) retinal separation is caused by such diseases as tumors of the retina and the uvea, as well as by various inflammatory diseases.

Risk of retinal separation is increased in case of myopia, after surgical operations on the eyeball, eye injuries, and dystrophic changes in the retina. Initial changes in the retina are usually undetectable for patients. Therefore, an ophthalmic examination is necessary at least once a year.

Retinal detachment		Total retinal detachment

The main causes of dystrophy of the retina

The causes of the development of dystrophy of the retina may vary but basically these are general diseases (diabetes mellitus, atherosclerosis, hypertension, diseases of the kidney and the adrenal gland) and also local ailments (myopia, uveitis), as well genetic predisposition.

Retinal separation

The main reason for retinal separation is its ruptures that may be caused by the following factors: long-lasting or chronic inflammation of the iris or the uvea, advanced myopia that can lead to atrophic changes in the fundus, injuries, strenuous physical activity (jumps, falls, lifting heavy weights etc), or other eye diseases (e.g. diabetic retinal pathology, neoplasms, hemorrhages).

Symptoms of retinal separation

• Decreased visual acuity.
• Narrowed visual fields.
• Floating dots.
• Seeing spots or dimout.
• Sudden loss of side vision.
• Deformation and movement of visible scrutinized objects.

How is retinal separation diagnosed?

In order to confirm or disprove the diagnosis of retinal separation, it is necessary to undergo a thorough examination of the visual system. The EXCIMER Eye Clinic has modern computerized equipment for precise diagnostics, which allows specialists to get the full information concerning a patient`s vision.

Examination for retinal separation includes the following procedures:

• examination of visual fields (perimetry) in order to assess the retinal periphery areas;
• electrophysiological examination: vitality assessment of retinal nervous cells and the optic nerve;
• ultrasound examination of the inner ophthalmic structures: A-scan, B-scan;
• fundus examination (ophthalmoscopy).

It is essential to remember that retinal separation may be diagnosed only by an ophthalmologist. It is vitally important to start treatment as soon as possible because it leaves more chances for successful treatment.

Treatment of retinal separation

Surgical treatment

The main purpose of surgery for retinal separation is adhesion of the retina to the underlying tissues. A surgical operation may be performed with the help of extrascleral ballooning or sealing (the treatment purpose is to achieve adhesion of the retina to the uvea; then the retina is strengthened with the help of laser) and vitrectomy (removal of cicatrices, blood, or pathologically changed tissues from the vitreous body).

Surgical treatment for retinal separation is performed in the EXCIMER Clinic within one day and does not require hospitalization. However, after the treatment the patient is advised to limit visual load and physical activity to some extent. Yet the rehabilitation period is short, and you will be able to resume your habitual activities within several days.

Laser surgery

The main aim of laser surgery for retinal separation is postoperative constraint on the retinal rupture. Laser impact leads to a sudden rise in temperature, which causes tissue coagulation. Owing to this, the operation is bloodless. Laser has very high precision characteristics; it is used for creating adhesion between the retina and the uvea (e.g. the retina is strengthened).

For this manipulation, a special lens with antireflecting coating is placed on the patient`s eye. This allows the rays to penetrate the eye completely. Laser rays are sent through special light guides, and the surgeon can control the operation through a stereomicroscope and focus the laser ray.

If the retina is strengthened in a timely manner, this prevents its further destruction. Peripheral prophylactic laser coagulation is primarily a prophylactics measure; in other words, it decreases the risk of retinal separation relapses. Visual acuity after the operation mostly depends on possible presence of concomitant eye pathologies that influence the patient`s visual ability.