Retinal Detachment, by Abdul Rasheed Khan, M.D.
October 14, 2011 § Leave a comment
In the world of ophthalmology and vitreo-retinal surgery, retinal detachment refers to a medical condition where the retina pulls away from the blood vessel layer that supplies it with nutrients and oxygen. Considered an urgent situation that requires immediate medical attention, retinal detachment deprives the retinal cells of oxygen and places the afflicted individual at extreme risk of permanent vision loss in the affected eye. For this reason, anyone experiencing symptoms or warning signs of the disease should seek emergency care as soon as possible.
In many cases, retinal detachment occurs without any underlying cause. However, certain injuries and illnesses play a significant role in the development of the disorder, including diabetes, trauma, or an inflammatory disorder. Retinal detachment occurs most often due to posterior vitreous detachment, a related condition that affects the structures surrounding the retina. People with risk factors such as a family history of retinal detachment, uncontrolled diabetes, previous eye surgery, and extreme nearsightedness are more likely to develop the disorder.
Although retinal detachment involves no pain, there are still a number of warning signs. In particular, the appearance of small bits of debris in the field of vision, often taking the form of pieces of hair or string, may be an indicator of a retinal tears and/or a retinal detachment. Similarly, bright flashes of light in the peripheral vision and blind spots in the visual field often precede retinal detachment.
When a patient arrives with symptoms of retinal detachment, doctors typically perform a variety of tests to check retinal response, including the refraction test, electroretinogram, fluorescein angiography, and slit-lamp examination. The majority of patients require immediate surgery to repair the detachment. Common surgeries to repair detached retinas include cryopexy, which uses intense cold to form an adhesive scar between the retina and the underlying tissue layer, and laser surgery, which seals lacerations in the retina. In the case of more severe retinal detachments, the surgeon may need to perform advanced procedures. One such technique, the scleral buckle method, places an indentation in the wall of the eye, allowing it to meet the hole in the retina. Another technique, the virectomy procedure, releases tension on the retina by removing scar tissue. This then prompts the retina to settle back into its proper position using various forms of tamponade, such as gas or silicone oil.
The prognosis for retinal detachments is relatively good, with a high repair success rate. However, some people experience a loss in the quality of vision depending upon the length of the detachment, especially if the macula detaches as well.
About the Author: An experienced physician, board-certified ophthalmologist and retina specialist, Dr. Abdul Rasheed Khan completed his fellowship training in Vitreo-Retinal Surgery at the Ochsner Clinic Foundation in New Orleans. Before launching his career, Dr. Khan began his education by being selected in in the prestigious Advanced (Accelerated) Medical Scholars Program at Louisiana State University in Shreveport, where he went on to earn his Doctor of Medicine. Dr. Khan currently works in private practice in the Chicagoland and Dallas Metroplex areas.