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Rhegmatogenous Retinal Detachment |
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Usually it Just Happens, Not Even
Trauma |
The retina becomes detached when it becomes anatomically
displaced from the inside of the eye. Normally, the retina
lines the inside of the eye, much the way wallpaper lines the
inside of a room. There are two types of retinal detachment;
rhegmatogenous retinal detachments and traction retinal
detachments.
Rhegmatogenous retinal detachments are the more usual form of
retinal detachment and commonly occur in healthy eyes. In this
type of retinal detachment, a hole or tear forms in the retina,
allowing fluid from the center of the eye to migrate to the
potential space underneath the retina. Symptoms of a retinal
detachment include acute onset of floaters, flashes or loss of
peripheral field.
A retinal detachment is potentially blinding and efforts are
made surgically to reattach the retina to prevent total
blindness. There are several procedures which may be used to
repair a retinal detachment. Operating on the outside of the
eye, a scleral buckle is placed around all or a portion of the
eye. The scleral buckle acts to reduce the internal diameter of
the eye which also reduces internal traction on the retina. A
vitrectomy may also be employed, operating on the inside of the
eye, to remove the vitreous and also relieve forces pulling on
the retina. Either may be used alone or in combination with the
other. In any case, intraocular gas may be placed in the eye.
The gas acts as a “cork” to block migration of fluid from the
center to the subretinal space. Depending upon the location of
the hole or tear, the patient may be required to maintain a
specific head position after the operation.
Major risks of surgery are the same as all intraocular
procedures. There is the potential risk of blindness from
infection although the rate is less than that of cataract
surgery. Recurrent retinal detachment is possible and
reoperations are not uncommon. Progression of cataract may be
noted, increase in myopia and double vision are also possible,
but these complications are less serious.
The goal of retinal detachment surgery is to repair the
detachment to prevent blindness. Location and size of a retinal
detachment are factors that may influence the timeliness of
surgery. Visual prognosis is best if the macula (functional
center of the retina providing central vision) is unaffected at
the time of surgery.
Written by Randall V. Wong, M.D., retina
specialist/ophthalmologist, Fairfax, Virginia.
Randall V. Wong, M.D.
Summer 2008
Source: www.Totalretina.com
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