What is the reason for retinal tears and holes?
Retina has a contact with vitreous gel inside of the eye. Vitreous gel is homogeny, tight, support the retina and pushes outer tissues such as choroids and sclera in a healthy eye. Vitreous gel’s viscose and homogeny structure may change in some special cases. High myopia, eye trauma, and intraocular inflammation diseases may vitreous gel turn easily to liquid form. This supportive feature of the retina may lose in this transition which can cause to start detaching from the retina. When detaching it pulls retina and leads to retinal tears. Liquid-form vitreous get into this torn tissue and lead to retinal detachment.
Why is Retinal Detachment dangerous and urgent?
Retinal Detachment might lead to blindness. Cells will not be able to nourish itself and die because the retina detached from the layer to which is attached. If retinal detachment moves to macula it might cause vision loss. Even it is replaced perfectly with an operation, cells might die due to the elapsed time and it becomes impossible to have the previous vision in the most successful surgeries.
Retinal Detachment Cases That Need Treatment
In Patients who have;
- Retinal detachment in the other eye.
- Other retinal detachment diseases in the family.
- A family history of retinal detachment.
- Retinal Tears
- Plans for the eye surgery.
- Profession that has a high risk of head or eye trauma.
Retinal detachment is observed in 1 person out of 10.000 every year. As it is a big threat to vision, it is also possible to see almost at any age. If it is not treated on time it may cause complete vision loss or part of the vision.
Retinal detachment is nerve layer separated from pigment epithelium layer so liquid weeps between those two layers because of tears or holes. Retinal detachment is mostly seen in high myopia patients. Retina layer became unshaped and thinner when eye’s front and back diameter increased. Due to other reasons, the retina can get thinner such as family and degenerative diseases. Vitreous gel started to lose homogeny and turn to liquid form. During this period, it starts to come off from the retina and that is called Vitreous Retinal Detachment.
Causes and Symptoms of Retinal Detachment
Unshaped and thin retinal layer can cause jag on the retina. This jag feels like lightning or flashing. Those flashes can take one day long or longer. Some of the patients do not even feel them. If there is a vein passing through this tear on the retina, it might cause bleeding so patients will see like soot rain. Vitreous gel’s viscose and homogeny structure may change and turn easily to liquid form.
Vitreous supportive feature is lost in the transition to liquid form than it starts to split from the retina. When it is splitting it pulls retina and retinal tears might occur. Vitreus gel starts leeking through this tear and and cause retinal detachment. Retina loses function and patients feel black spot or curtain in front of their eyes.
Retinal detachment sometimes stays on the same spot but it usually moves around. Central vision is lost when macula separated from tissue and eyeball shrinks when retinal detachment takes a long time. Sudden hits to the eye might cause retinal detachment also diabetes and family history, degenerative diseases might cause retinal detachment without tear or hole on the retina.
Pupils enlarge with eye drop and doctor search for tear or hole in the eye with microscope. Ultrasonography can be done if it is needed.
The facts of Retınal Detachment
Retinal Detachment can cause blindness so the indications are important:
- flashes with your eyes oper or closed.
- Seeing flying substance in front of your eye
- Black-gray curtain in vision
- Blurry vision and lost vision that can not disappear with a blink.
Patients must go for retina exam if they have any of these facts as soon as possible.
Treatment of retinal tear
Early diagnosis is very important for retinal tear before it turns to retinal detachment. Sudden flashes and flying substance in front of the eye are symptoms ofthe retinal tear. Patients must go for retina exam if they have any of these symptoms as soon as possible. Doctor might find the tear on the retina while examination and have to treat with the laser beam to seal the tear.
What is the treatment of retinal detachment?
Surgery is needed if retinal detachment is grown. Operation method shows differences fothe r shape of tear, size, place and duration.
Scleral Buckling Technique:
This is the oldest method applied in retinal detachment surgery. Hard silicon piece is placed on the tear to push it back to the retina wall. After this procedu,re all the fluid which has accumulated is absorbed.
If Retinal detachment has many tears, big tear or undetected place might need vitrectomy operation during which the doctor can easily interfere the detachment inside of the eye. Small holes thru which vitreus fluid is cleaned using with aspiration prob sticks and light sourses are made on the eyeball. The fluid under retina is absorbed and , tears are treated with a laser beam. A tampon material which could be made of air, gas or silicon oil is placed to keep the tears closed . Patients have to wear an eye patch and sleep in specific position after the operation.