Retinal Detachment is the disease of the eye in which the Retinal layer separates from its underlying layer due to the presence of unnatural fluid in Subretinal Space. For proper functioning of retina, it needs to be attached to its underlying layer which provides blood and nutrition to Retina. Once retina is detached it needs to treated urgently as loss of nutrition results in permanent damage over time.

Posturing is lying or sitting in a particular position with regards to your head. Posturing method and duration will be advised by your surgeon depending upon the type of Retinal Detachment, which might last up to 2 weeks after the surgery.

If the surgeon decides that you need to posture, then there are a few things which you must plan prior to surgery. Staying face down for several days can be difficult and can be made more difficult if you have other associated problems such as arthritis. It is important to discuss with your surgeon these other conditions which might restrict your posturing.

Usually posturing is needed about 45 minutes of every 60 minutes. The time spent off posturing must be utilized for eating, toilet and instilling medicines. Trying out different posturing positions can avoid stiffness and boredom.

Surgery is usually very successful at reattaching the retina. The extent to which your detailed central and peripheral vision will improve depends upon the extent of detachment prior to surgery, whether the macula was detached at the time of surgery or not and for how long the detachment was present before it was treated.

If your macula remained attached, then the chances are very good that you will recover a very good central vision. If your macula had detached but your treatment was carried out quickly then central vision can return but it may be distorted and wavy. Many people find that they adapt to this distortion over time.

Unfortunately for some people, the operation may be successful at reattaching the retina but it may not bring back detailed central vision or areas of peripheral vision. This can happen in any circumstance but the risk is higher the longer the retina has been detached without any treatment.

Majority of Retinal Detachments occur because of a hole or tear formation on the retina. This retinal tear allows the fluid in the eye to pass through it and occupy a spaces underneath the retinal tissue causing it to detach from its underlying surface.

Tears usually occur when the Vitreous Gel which occupies middle portion of our eye undergoes separation. Although this process called as PVD is natural but in very few individuals it pulls the retinal tissue along causing it to break.

A direct blow or trauma to the eye can cause Retinal Detachment however a trauma to head without any eye injury does not lead to this.

Other Eye conditions such as Diabetic Retinopathy can form a scar tissue over the surface of retina, once this scar tissue undergoes contraction it can lead to retinal pull over that region leading to retinal break and subsequently Retinal Detachment.

Thirdly an uncommon cause of Retinal Detachment is leakage of fluid from the vessels beneath the retinal tissue without an actual presence of retinal break or tear. This is seen in cases of Eye inflammations and Tumour.

FLOATERS :

Floaters are caused by bits of Debris in vitreous gel which cast a shadow onto the retina. Floaters are very common and most people can expect to have a few as they get older. Individuals who are myopic or have had surgery or trauma can expect to have more floaters. These floaters can take many shapes such as rings, worms, spider webs, cob webs. They are not generally a cause of concern especially if they have been present since months or years.

However, if you notice a sudden increase in the number of these floaters in hundreds or thousands then it might indicate that some changes are happening at the back of the eye.

FLASHING of LIGHTS

Many people experience flashing of lights especially at the edges of their vision. These are caused due to retinal irritation caused by movement of vitreous gel within the eye and not by actual light entering the eye.

In most cases flashes are caused by Posterior Vitreous Detachment which is a normal process with no long term problems to vision. However, flashing lights can indicate that there is tear in the retina. You cannot tell whether flashes are being caused by retinal tear or Vitreous separation. If you suddenly experience new flashes, you must have your eyes examined by a retina specialist.

DARK SHADOWS

Once the retina detaches it can’t work properly. It appears as a black shadow or a curtain in the vision. One cannot see through or around it. As the retinal detachment progresses, more of vision is taken over by black shadows. These symptoms warrant an early examination by eye specialist.

A Retinal Detachment should be treated with surgery to reposition the retina against the back of the eye. This should be done as early as possible to attain best results. If Retinal Detachment is not treated, then the individual is likely to lose all the vision in the affected eye over a period of time. A Retinal Detachment will not get better without treatment and there is no medicine which can cure it.

Retinal Detachment surgery is complex and is individualized to each case. The type of surgery depends on the type and location of detachment and any other complicating associated factors such as other eye conditions associated with it.

After the initial assessment the surgeon will decide how quickly the surgery is required. This can be within the next 24 hours and within the next week. Usually only one operation is needed and the types of surgery described below might be combined. Most of the adults will be operated under Local Anesthesia meaning that they will be awake but will feel nothing in their eye. Children will have General Anesthesia wherein they will be unconscious for the surgery. Many people go home the same day of surgery but some may need to stay in hospital as per surgeons preference.

VITRECTOMY

Most people with Retinal Detachment will have an operation called Vitrectomy which removes Vitreous gel from the patients eye followed by filling the space with Silicone Oil or Gas depending upon the location of Detachment. The gas or Oil keeps the Retina apposed to its underlying surface.

SCLERAL BUCKLE

In some cases a Scleral Buckle might be used. This involves attaching a tiny piece of silicone material to the outside of the eye. This mechanism pushes the outside of the retina against the site of Retinal break thus sealing it and resulting in settling of Detached Retina. Cryo or Laser will be used to seal the area around the break. The buckle is generally not removed and is not visible once surgery is finished.