Detached Retina, Ablatio Retinae
Retinal detachment is a condition, in which the retina is partly released from its underlying layers and can no longer function at that location. Usually, people with retinal detachment suddenly see dark floating particles and flashes of light. It is a serious condition that leads to blindness when it is not treated.
The entire space in the eye between the lens and the retina is filled with vitreous. Aging changes the composition of the vitreous. The vitreous shrinks slightly and gradually pulls back from the retina. This is a normal aging process. At a given moment, the vitreous lets go of the retina. As a result, cracks in the retina and bleeding in the eye can occur. Due to such a crack, moisture can get under the retina, causing the retina to be released. This is called retinal detachment. Apart from age, there are other factors that increase the risk of retinal detachment:
- When someone in the family has had retinal detachment too.
- After cataract surgery.
- When someone had retinal detachment to the other eye.
- When someone had a blow to the head or the eye in an accident.
The symptoms of retinal detachment are often preceded by symptoms of the disease which caused the retinal detachment. The retinal detachment itself can have the following signs and symptoms:
- A dark blur in the field of vision. At places where the retina is loose, it no longer functions. With that portion of the retina, nothing can be seen anymore; vision is dark in those places. In the first stage, when only a small part of the retina is loose, a black spot or a dark blur is usually seen aside in the field of vision (left, right, top or bottom). This is because a retinal detachment usually begins at the edges of the retina. But, as the detachment extends, the black spot becomes larger and is nearing the center of the field of vision.
- Blurred vision. As long as the macula is still in place, a person can see sharply. However, if this also detaches, one will only see blurred.
- A retinal detachment is not accompanied by pain. Patients wait for this reason too long before they contact their doctor.
- Blindness. If the retinal detachment is not fixed, the eye becomes blind.
Retinal detachment is determined by the ophthalmologist after performing the following examinations:
- Vision test. Examination of the visual acuity at distance.
- Visual field test. In case of retinal detachment, parts of the field of vision fail and certain places don’t perceive.
- Opthalmoscopy. After dilating the pupil with eye drops, the ophthalmologist can look at the retina. The doctor will see that the retina is loose.
There are several methods to treat retinal detachment:
- Operation with laser beam. A laser beam is used when the holes are not too big, and the retina has not yet or hardly been released. The laser creates scars around the holes. These scars attach the retina to the underlying layers.
- Surgery for further retinal detachment. In this operation, a strap is applied around the eye. This strap supports the retina and causes the vitreous not to pull as hard on the retina. After the operation, gas is sometimes left in the eye in order to keep the retina in place. This gas dissolves gradually.
- Vitrectomy for retinal detachment. It may sometimes be necessary to remove the vitreous. This is because the vitreous can be attached to the retina and thereby detach it from the underlying layers. It may be necessary to press the retina firmly in place by means of gas, silicone oil or other means.
About ninety percent of the operations succeed in getting the retina back into position and keeping it that way. Sometimes, multiple operations are required. Successful intervention usually restores the field of vision (the environment). Recovery of visual acuity is dependent on several factors. The most important factor is whether the retinal detachment has reached the center of the retina (the macula). If this is the case, recovery will be incomplete.
It is possible that before and/or after retina surgery, posture advice is given by the retina surgeon. How often and how long a posture must be assumed, depends on the retinal condition and retinal surgery.
Tips to spare the eyes:
- Working on the computer is less strenuous if lateral daylight is ensured and no artificial light is falling on the screen. Preferably keep a distance of forty to fifty centimeters between the eyes and the screen.
- Constantly looking up from a document to the computer screen is tiring for the eyes. Rather place the document on a stand next to the screen.
- Try to give the eyes fifteen minutes rest every two hours.
- In case of wearing contact lenses, meticulous hygiene is the best way to prevent infections.
- Let the eyes be checked for glaucoma every two years by an ophthalmologist from the age of forty years.
- The term ‘ablatio retinae’ is derived from the Latin word ablatio (detachment).
- The prevalence of retinal detachment is 0.3%.
- Retinal detachment occurs most frequently in people aged 40 to 70 years.
- Men are more likely to have this condition than women.