Retinal DetachmentRetina is the nerve layer covering the inner side of the back wall of the eye. The liquid leakage between the nervous retina layer and the pigmented layer at the base of ther retina – retinal pigment epithelium (RPE) is called retina ldetachment. The liquid leaks from a hole or a tear in the reina.
The symptoms are seeing lightning or flying spots or spider web, blurry sight, a moving shadow. If the macula is also detached then the central vision gets blurry. Every seen lightning is not indicative of RD but a perdon with this symptom should be checked by an ophthalmologist.
RD is an extreme serious eye problem, cannot heal by its own and when left untreated it can cause vision loss.
There are 3 types of RD:
1. Rhegmatogeneous RD (RD with tear)
2. Tractioneous RD
3. Exudative (serous) RD
Rhegmatogeneous RD is the most common form. Sixty percent of patients have visual symptoms as flying spots, lightning and spider web. Forty percent of patients have none of these visual symptoms but visual field narrowing. Eye pressure is decreased in RD.
Tractioneous RD is seen most common in diabetic retinopathic eyes, in perforated eye injuries and retinopathy of prematurity.
Exudative (serous) RD is seen most common in malign hypertension, posterior scleritis, Harada disease, collageneous venous diseases, pregnancy and pregnancy toxemia, malign melanoma, tumors with metastases an choroidal hemangioma.
Retina is thoroughly examined by indirect opththalmoscopy and varius lenses after pupil widening with eyedrops.
Some retinal tears can be treated with laser. Also degenerated retina and risky retinal fields can be photocoagulated by Argon laser as a precaution.
Laser photocoagulation is a painless procedure. Even in a photocoagulated retina RD may occur, the patient should be aware of the symptoms and examined regularly.
RD is treated surgically, retinal tear is treated according to its type and location. Scleral buckling, Argon laser photocoagulation, pneumotic retinopexy and vitrectomy are various options.
The anatomical success rate is 90% in RD surgery however the rate of visual gain is 35-60%. Visual gain may take long time after surgery, sometimes no visual gain can be observed.