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Prof. Dr. Safiye YılmazProf. Dr.Safiye YılmazGöz Hastalıkları Uzmanı

Retinal Detachment

The most common cause is the separation of vitreous fluid from the retina with increasing age. If a retinal detachment does not treat for a long time, the risk of permanent vision loss in the affected eye is increases.

Retinal Detachment

What is retinal detachment?

The retina is the vascular nerve layer in the back of the eye that consisting of 10 separate layers, where the visual cells of the eye are located. When the detachment develops, these layers separate from each other. In order for the visual function to be fulfilled in a healthy way, all layers must be adhered to each other and protected in a healthy way.

If we liken our eye to a balloon, there is a gel in the consistency of egg white, which we call vitreous, inside the eye, whatever air must be inside so that the balloon can maintain its shape, and this gel ensures that the eye remains voluminous and maintains its shape. The majority of this gel consists of water.

When a tear occurs anywhere in the retina (sometimes there are retinal detachments without a tear, but it often occurs following a tear),the fluid in the vitreous circulates between the posterior layers of the retina and separates the layers from each other. Retinal detachment separates retinal cells from the layer of blood vessels that provide oxygen and nutrition.

If a retinal detachment does not treat for a long time, the risk of permanent vision loss in the affected eye is increase. The areas where the retina detaches lose blood flow and stop working, causing vision loss.

What are the symptoms of retinal detachment?

  • The appearance of the floating foreign objects suddenly in your field of vision, and occur a curtain-like shadow,
  • Photopsy in one or both eyes,
  • Blurred vision painlessly,
  • Decreasing side (peripheral) vision gradually.

What are the causes of retinal detachment?

The most common cause of tear detachment is aging. As she grew older, the vitreous gel’s consistency may change and become more liquid. Normally, the vitreous rests in the eye, leaning against the retina.

As she grew older, it can be separated from the retinal surface innocently without any risk. While this separation is taking place, the vitreous begins to form easily inseparable pulls on the retinal surface where there is strong adhesion, this pulling causes light flashes in the person. As a result of these withdrawals, a tear may occur in the retina. The tear can only be treated with laser in the early period when the tear occurs. However, in the following periods, the fluid in the vitreous circulates through the tear to the posterior layers of the retina and separates the layers from each other.

Apart from torn retinal detachment, in the tractional type of detachment, detachment occurs not because of a tear, but because of a tissue that will cause shrinkage on the retinal surface. In such a detachment, it causes the layers of the retina to move away from each other with the shrinkage that occurs. Tractional detachment typically occurs in people with poorly controlled diabetes.

Another less common retinal detachment is exudative type detachment. In this type of separation, fluid accumulates under the retina, but there is no hole or tear in the retina. Exudative dehiscence may result from age-related macular degeneration, eye injury, tumors, or inflammatory disorders.

Causes of Retinal Detachment

The causes of retinal detachment are as follows;

  • Aging - retinal detachment is more common in people over 50. It is the factor that creates the risk of deterioration of the vitreous gel with age.  A person with a previous history of retinal detachment in one eye always has a higher risk of having it in the other eye.
  • If there is a family history of retinal detachment, the risk is increased.
  • In patients with extremely high myopia, the retina is thin and this thin retina is more easily torn.
  • Previous intraocular surgeries, such as cataracts.
  • Serious eye injury, blow to the eye.
  • Other previous eye diseases or disorders, including retinoschisis, uveitis, or peripheral retinal thinning.

Retinal Detachment Treatment İzmir, Turkey

Treatment of retinal detachment when detected at an early stage. Our treatment in our Izmir hospital is to laser the torn edge and to prevent the fluid in the vitreous from spreading between the retinal layers. However, if the patient came to us at the stage of detachment, the treatment is surgery.

Retinal Detachment Surgery

Depending on the type of detachment, it can be in the form of wearing a band from the outside, or it is also performed with the vitrectomy technique, which is the intraocular surgery we prefer more often. In intraocular surgeries, the liquid that has leaked between the retinal layers is removed, the tear is lasered, and a buffer such as gas or silicone is placed in the eye for a while. If silicone is put in, silicone is taken back after a while, and the gas will disappear by itself.

Early treatment is very important. The longer the fluid under the retina stays this way, the more the visual cells will be damaged. It may take several months for your vision to improve after surgery. You may need a second surgery for successful treatment. Some people never regain all of their lost vision.

How is the recovery after retinal detachment surgery?

Although the structural healing characteristics of the person are actually effective in the recovery after retinal surgery, the recovery after retinal surgery is 2-3 months on average. If gas is put into the eye, the gas will disappear spontaneously within 2-6 weeks, depending on the type of gas put into it.

If silicone is placed, silicone can remain for up to 1 year depending on the condition of the disease, starting from 2 months at the earliest, and basically, full recovery and clear vision are after silicone removal. Do not touch your eyes with water, especially in the first week after retinal surgery.

Do not smoke and do not stay in smoking areas. Do not walk around in dirty environments with dusty soil. You can start your job from the 2nd week, but on the condition that you continue the treatment given at the workplace. If you have vascular problems such as diabetes and high blood pressure, be careful to keep them under control as these diseases will also affect the healing of retinal tissue.

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