Retinal detachment
Retinal detachment results from the separation of the two layers that make up the retina. Retinal detachment is most often caused by the opening of one or more retinal tears.
Symptoms
Warning signs are sometimes felt:
– Perception of flashes of light linked to traction on the retina.
– Visualization of numerous floating bodies, indicating intraocular hemorrhage during retinal tearing.
The detached area of retina is no longer functional. This results in an amputation of the visual field and a partial loss of vision, culminating in blindness when the detachment becomes complete and total.
Factors contributing to detachment are :
– Myopia
– trauma to the eye
– A history of retinal detachment in the other eye
– Cataract surgery
– Certain eye inflammations
Treatment
In the event of a retinal tear, preventive treatment with laser photocoagulation reduces the risk of progression to retinal detachment.
At the stage of retinal detachment, surgical treatment is the only option. Emergency surgery is usually performed under local anaesthetic.
The procedure lasts between 20 and 90 minutes.
Depending on the characteristics of the detachment, different surgical techniques of varying complexity are used: either external surgery with suture of an indentation with cryoapplication, or internal surgery with vitrectomy.
Very often, a gas bubble is introduced into the eye at the end of the procedure, to reapply the holes or tears in the retina while the healing process continues.
Depending on the location of the dehiscence, the head must be positioned for a few days.
The gas is gradually absorbed in around 1 to 2 weeks. Air travel is contraindicated for as long as the gas persists.
In cases of particularly severe retinal detachment, it may be necessary to inject silicone oil into the eye to ensure reapplication. This silicone oil is usually removed after a few months.
Evolution
In the vast majority of cases, reapplication of the retina is achieved. Recovery of vision cannot be judged for several months, depending on the type of detachment and how long it has progressed.
Post-operative treatment consists of eye drops and positioning.
Work, sport and driving are not recommended for a period of 15 to 20 days.
Recurrence of the detachment is possible. They require additional surgery.
In a small number of cases, it is not possible to reattach the retina, due to its rigidity and tendency to retract.
