Medical & Surgical Ophthalmology

Retina and vitreous

Retinal detachment

What is a retina detachment?

Retinal detachment (RD) is a pathology in which an accumulation of fluid occurs between the two layers of the retina: the inner or neurosensorial retina and the retinal pigment epithelium (outer retina), generating a space where previously there was none and causing a detachment of the retina.

Why does a retina detachment occur?

Over the years, the vitreous humour (gel found inside the eye) contracts, pulling on the retina and producing small tears. When these breaks occur on the surface of the retina, the vitreous can leak through them, and separate one layer of the retina from another, causing the retinal detachment.

In cases such as eye trauma, tumours, myopia (nearsighted), diabetic retinopathy or severe eye inflammation, retinal tears are Produced without the need for a contraction of the vitreous humour. Sometimes, the retinal vessels can break and also cause the so-called vitreous haemorrhage.

This is the detachment of the retina

How does retinal detachment manifest?

The tear in the retina does not cause pain, but if it is not treated it can end up causing retinal detachment, which also occurs without pain, but with visual symptoms:

Retinal detachment treatments

At the beginning of the disease, when the retinal breaks have already occurred but it has not yet become detached, a preventive treatment of said detachment can be carried out, through laser photocoagulation of the retinal lesions. This photocoagulation seals these lesions so that the vitreous does not infiltrate between the two layers of the retina.

Another preventive treatment for very peripheral lesions that photocoagulation does not reach is cryotherapy, which freezes the injured tissue to seal it.

In the event that the retinal detachment has already occurred, the only effective treatment is surgical: vitrectomy (remove the vitreous humor, perform photocoagulation of the lesions, and fix the detached retina in place) or scleral surgery (positioning a silicone band in the outermost layer of the eye, the sclera, which allows it to invaginate to facilitate healing of the lesions).

Retinal detachment prevention

It is recommended that patients with risk factors (who have myopia (nearsighted), previous retinal detachment in the other eye, or the existence of relatives who have suffered this pathology), undergo annual ophthalmological check-ups to early detect lesions in the vitreous or in the retina, and thus prevent retinal detachment.

On the other hand, the sudden appearance of floating flies or a sudden increase in their number, as well as the appearance of light flashes, are a reason for urgent consultation with your ophthalmologist or an ophthalmological emergency department.

Summary

Debut

It does not have a specific age of appearance.

Symptoms

Floating flies, black curtain in the field of vision, loss of visual acuity, flashes of light.

Revision

In patients with risk factors, it is recommended to perform an ophthalmological review every year.

Prevention

Laser photocoagulation when there are small lesions in the retina, or when the risk is very high.

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