Retinal Detachment
A retinal detachment occurs when the clear gel (vitreous humor) inside the eyeball cavity pulls away from its attachment to the retina (the nerve layer that lines the inside of the eyeball and transmits images to the brain). When the vitreous gel pulls hard enough to create a tear in the retina in one or more places, fluid can pass through the tear and underneath the retina, causing the retina to become detached from the eyewall.
Symptoms
Key warning signs are:
- Flashing lights
- New floaters involving either the central or peripheral vision
- Loss of peripheral vision
- The perception that a “gray curtain” is moving across your field of vision.
Treatments
Retinal detachments are repaired in the operating room using advanced microsurgical techniques. In some cases, a detached retina can be repaired with a scleral buckle. A scleral buckle is a device that is permanently placed around the eyeball to indent the wall of the eye, bringing the retina back into its natural position flush against the wall of the eye. In other cases, microsurgical instruments are introduced into the eye to flatten the retina, usually employing laser and a temporary bubble of gas to hold the retina in place as it heals. The gas bubble dissolves on its own over one to two months. In most cases, face-down positioning is required for a brief period of time in the immediate post-operative period. This process is known as vitrectomy, because it involves the removal of the natural vitreous gel from the eye cavity to facilitate gas placement and retinal re-attachment. In complicated cases of retinal detachment, both vitrectomy and a scleral buckle can be employed. In cases of limited retinal detachment, a gas bubble alone may be placed in the eye in the office setting with careful outpatient follow-up.