Retinal Detachment Surgery

Retinal detachment surgery is an eye surgery performed at our eye care clinic. A retinal detachment occurs when the retina is pulled away from its normal position in the back of the eye. The retina sends visual images to the brain through the optic nerve. When detachment occurs, vision is blurred. A detached retina is a very serious eye problem that almost always causes blindness unless it is treated.

The retina normally lies smoothly and firmly against the inside back wall of the eyeball and functions much like the film in the back of a camera. Millions of light-sensitive retinal cells receive optical images, instantly "develop" them, and send them on to the brain to be seen. If any part of the retina is lifted or pulled from its normal position, it is considered detached and will cause some vision loss.

The vitreous is the clear collagen gel that fills the back of the eye between the retina and the lens. As we get older the vitreous may pull away from its attachment to the retina at the back of the eye. Usually the vitreous separates from the retina without causing a problem. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through the retinal tear and lift the retina off the back of the eye much like wallpaper can peel off a wall.

Retinal detachment can occur at any age, but it is more common in midlife and later. Conditions that can increase the chance of a retinal detachment include eye problems such as nearsightedness, previous cataract surgery, glaucoma, severe trauma, previous retinal detachment in your other eye, family history of retinal detachment, or weak areas in your retina that can be seen by your ophthalmologist.

Symptoms include:

  • Floaters
  • Light Flashers
  • Grsy curtain or veil moving across your field of vision

The symptoms described above may not necessarily mean that you have a detached retina. However, if you experience one or more of these symptoms, contact your eye care clinic for a complete exam.

  • Treatment

Retinal tears will usually need to be treated with laser surgery or cryotherapy (freezing), to seal the retina to the back wall of the eye again. These treatments cause little or no discomfort and may be performed in your ophthalmologist's office. This eye laser treatment will usually prevent progression to a retinal detachment. Occasionally retinal tears are watched without treatment.

Retinal detachments may require eye surgery to return the retina to its proper position in the back of the eye. There are several ways to fix a detached retina. The type of surgery and anaesthesia (local or general) to use depends upon the characteristics of the retinal detachment.

In each of the following methods, your ophthalmologist will locate any retinal tears and use laser eye surgery or cryotherapy (freezing) around them to seal the tear.

Pneumatic retinopexy describes the injection of a gas bubble into the vitreous space inside the eye enabling the gas bubble to push the retinal tear back against the wall of the eye and close the tear. Laser or cryo-surgery is used to secure the retina to the eye wall around the retinal tear. Your ophthalmologist will ask you to maintain a certain head position for several days. The gas bubble will gradually disappear.

A scleral buckle or flexible band is placed around the equator of the eye to counterbalance any force pulling the retina out of place. Often the ophthalmologist will drain the fluid from under the detached retina allowing the retina to return back to its normal position against the back wall of the eye. This procedure is performed in the operating room, usually on an outpatient basis.

  • After Surgery:

You can expect some discomfort after retinal eye surgery. Your ophthalmologist will prescribe any necessary medications for you and advise you when to resume normal activity. You will need to wear an eye patch for a short time. If a gas bubble was placed in the eye, your ophthalmologist may recommend that you keep your head in special positions for a time. A change of glasses may be necessary after the retina has been reattached.

  • Taking Care of Yourself At Home

Be guided by your surgeon, but general suggestions for care of your eye after the operations include the following:

  • Your eye may be sore for several weeks, although this is less likely following a vitrectomy in which modern fine-gauge instruments have been used.
  • Your vision will be blurry – it may take some weeks or even three to six months for your vision to improve.
  • Your eye may tear excessively.
  • It is normal to experience a ‘gritty’ feeling on the surface of your eye – this is caused by the tiny stitches.
  • Avoid rubbing or pressing on the eye.
  • You may need to wear an eye pad for protection at night while your eye is healing.
  • Make sure to follow all directions for medications, such as eye drops.
  • Avoid vigorous activity for some weeks following eye surgery.
  • Obey all instructions on head positioning.
  • See your surgeon immediately if you experience severe pain.

  • What Are The Risks of Surgery?

Any surgery has risks; however, an untreated retinal detachment will usually result in permanent severe vision loss or blindness. Some of these surgical risks include infection, bleeding, high pressure inside the eye, or cataract. Most retinal detachment surgery is successful, although a second operation is sometimes needed. If the retina cannot be reattached, the eye will continue to lose sight and ultimately become blind.

  • Long Term Outlook

Around nine out of ten retinal detachments are successfully repaired with a single operation. In the remaining cases, the retina detaches again and needs another operation. The final success rate is over 95%. Permanent reduction in vision may occur.

Whether or not your vision returns depends not only on the success or failure of the operation, but also on the duration, extent and location of the detachment. Vision may take many months to improve and in some cases may never fully return. The more severe the detachment, and the longer it has been present; the less vision may be expected to return. For this reason, it is very important to see your ophthalmologist or eye care clinic at the first sign of trouble.

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