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Retinal Detachment – This is Serious!

When you hear about someone that has just suffered a detached retina of an eye, you know that it’s something serious.

Indeed it is, since the person is probably no longer able to see through that eye if it has not been treated.

Retinal detachment occurs when the light sensitive layer at the rear of the eye, the retina (that translates the images from the lens to the brain) breaks or peels away from the outer wall of the eye. If surgery is carried out quickly then sight in the eye can be saved.

Symptoms

The sudden occurrence of “floaters” in the eye, so called because the eye seems to see specks or small clumps of matter that are not really there.

Floaters occur naturally with everyone and are not usually anything to be concerned about.  They are microscopic pieces of debris that develop over time slowly.  If they suddenly appear in great number however, they could be an indicator of a tear in the retina, which then can progress to a retinal detachment.

Bright flashes of light that are not of course really happening should be considered as early  | Riskswarning signs – signs that should NOT be ignored.  Flashes can occur in some individuals by a process called Posterior Vitreous Detachment.  The vitreous is the jelly inside the eye, which over time can peel off the back of the eye called the retina.  Sometimes the vitreous is attached on the retina and as it tries to peel off, it tears the retina with it.

Approximately 15% of people that see flashes will go on to develop a retinal tear.  The good news is that 85% will not, but what is imperative is to get a dilated retina examination by a therapeutically qualified optometrist or an ophthalmologist.  Going to a general medical practitioner is of no use, as they will have to refer you on anyway.

Causes

In individual cases of detached retina, no immediate cause can be proffered, however there are risk factors involved as well as certain eye conditions that point to increased risk.

Generally perhaps THE main cause is from the natural deterioration in the viscous gel (the vitreous) inside the eye that changes with age and shrinks, pulling the retina from the outer wall. As mentioned before this is called a posterior vitreous detachment, which then can lead to retinal detachment.

Physical actions such as the eye being hit with a squash or tennis ball, or damage near the eye by something sharp can induce retinal detachment.

The fact that the condition is found in particular families suggests there are hereditary forces at play.

Other causes associated with diseases of the eye:

•    Cataracts do not cause retinal detachment by themselves; however those cataracts that require surgery can lead to retinal detachment due to the very process of the surgery required.

•    Advanced diabetes can lead to retinal detachment because sufferers frequently have imperfect blood vessels

•    Uveitis, with the major form being iritis, an inflammation of the iris, being thought to occur through immune deficiency, and consequently treated using corticosteroids.  In cases of chronic inflammation the vitreous can be affected which in turn shrinks and can tear the retina.

Risks and conditions of risk

Older people, Caucasian males, advanced diabetes sufferers all have a propensity for risk of retinal detachment.

Contact sports, especially boxing can induce retinal detachment.

Sudden whiplash, such as a car accident, bungee jumping or every an aggressive roller coaster ride in predisposed individuals can induce a retinal detachment.

Conditions that increase risk include myopia or nearsightedness, retinal detachment in one eye already and degenerative myopia.

Risk does not of course mean that there is a likelihood of retinal detachment occurring – far from it. Likewise those without any indication of risk or conditions are not necessarily exempted.  The incidence of retinal detachment is approximately 1 in 10,000 people but if one is nearsighted or myopic the risk can increase to over 5%.

Patients that are near-sighted or have myopia should have regularly dilated retinal examinations even without any symptoms.

Treatment

If treatment is not carried out the prognosis is often complete retinal detachment.

If surgery is completed before the central and highly sensitive part of the retina, the macula, comes away, then it is probable that the surgery will prove successful, with a figure close to 85% .

There are several surgical procedures including laser surgery, freezing, pneumatic methods, use of silicon bands and temporary replacement of the internal gel with specialised gases and oils.

The treatment chosen will be one preferred by a particular ophthalmic surgeon to match the patient’s circumstances and chances of recovery.  Retinal detachment is best looked after by an ophthalmic surgeon specialising in surgical retinal methods.

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

Comments (4)

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  1. Kelly Stilwell (http://kellystilwell NULL.com) says:

    This was helpful. I have had several tears and a couple of detachments. I had cataract surgery and am nearsighted, but didn’t know this increased the chances of my having a detachment. Thanks.

    • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

      This is true Kelly. It is imperative that you have regular eye care from a practitioner that can rule out retinal detachment accurately

  2. Daren Bowden says:

    Can someone help me
    I had a car accident in July last year
    I got hit from behind a 50 miles hour
    This hurt my neck and back
    After the accident
    I got flotters
    Is this a corse of the accident as well
    Thanks

    • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

      Daren you need to be seen by a retinal specialist. If you are located in Sydney I can recommend a few.

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