Retinal detachment is a serious eye disorder that can lead to permanent vision loss. It occurs when the inner layer of the retina (neurosensory retina) spontaneously separates from its outer layer (pigment epithelium). The retina is the ocular layer responsible for receiving light and sending images to the brain, providing the clear vision we need to read, drive… Retinal detachment is more common in people over 40 years of age and, although it can affect both sexes, it is more common in men than in women.
Causes of retinal detachment
Risk factors
Retinal detachment usually requires two requirements for it to occur: the degeneration of the vitreous, the gel that occupies the inner part of the eye, after the lens and before the retina; and retinal break or tear. There is no pain or discomfort. They are at greater risk of retinal detachment:
– People with myopia, especially if it is severe (more than 6 diopters).
– Complication in cataract surgery.
– If there is a retinal detachment in the other eye.
– Family history of retinal detachment.
– People of advanced age.
– If there is abnormal growth of the eye.
– If there is eye trauma.
– If you suffer from diabetes.
Symptoms of retinal detachment
Floaters and flashes
Signs that warn that there is a risk of retinal detachment are:
– The vision of “floaters” (myodesopsias) or an increase in them. They are small spots that appear to be in the front of the eye but are actually floating inside the eye. They are conglomerates of gelatinous substance from the vitreous that project onto the retina. They are usually seen on a flat surface and in one color.
– The appearance of flashes in the field of vision (flickering lights or flashes of light).
– If there is a defect in the visual field such as a black curtain.
– If there is inflammation inside the eye.
– Blurred vision in the central part.
If you have any of these symptoms and the floaters were not seen before or the flashes of light cannot be attributed to a migraine, it is key to go to the emergency room immediately.
Diagnosis of retinal detachment
Fundus examination
The ophthalmologist can diagnose retinal detachment by checking the fundus of the eye with the ophthalmoscope after dilating the pupil (mydriasis) artificially with mydriatic eye drops. It is key to regularly go to the ophthalmologist for a check-up, especially if you are at risk. In this case, the minimum number of reviews is one per year. Those who do not have eye problems should see an eye doctor at least every year.
Retinal detachment treatment and medication
Preventive laser
If there is a tear in the retina and, therefore, there is no detachment yet, the ophthalmologist may suggest photocoagulation, a preventive treatment using laser; or cryotherapy, application of cold.
If there is detachment, surgery should be applied as soon as possible to try to preserve vision. The patient must be in absolute postural rest.
The surgical options are:
– Pneumatic retinopexy. It is an outpatient procedure and uses an intravitreal gas bubble to adhere the retina and close the retinal break. The tear is closed with a laser 24 hours after gas insertion. It is performed under topical anesthesia and in aseptic conditions.
– Scleral or extrasclear surgery. It closes retinal breaks through the sclera, the white, fibrous outer layer of the eye.
– Vitrectomy. Requires operating room and local anesthesia. It eliminates vitreous traction and repositions the retina and then performs an endolaser retinopexy.
It is crucial to strictly follow all the recommendations after surgery and, in the event of possible complications, go immediately to the emergency room.
Prevention of retinal detachment
Periodic eye checkups
To prevent retinal detachment, people at risk should undergo frequent ophthalmological check-ups, at least once a year. Obtaining an early diagnosis makes it possible to consider preventive laser treatment if there are tears in the retina even if a detachment has not yet occurred. It is key to go to the specialist if “floaters” appear or the number of those already perceived increases, if light flashes or a black curtain are perceived.
Impact sports (football, basketball, rugby, boxing…) or activities that may cause eye trauma should be avoided. It is also advisable to avoid eye strain by spending time outdoors and directing your eyes to the horizon. Avoid spending many hours a day looking at screens (computer, tablet or mobile phone).
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