Retinal detachment occurs when the retina detaches from the posterior part of the eye; a subretinal liquid forms between the retina and the posterior part of the eye.
Rhegmatogenous retinal detachment
In a ‘rhegmatogenous’ retinal detachment, the liquid passes from the vitreal cavity to the subretinal space through the retinal rupture or tear. This tear or laceration is normally created by the effects of strong vitreal traction on the retina.
The process can occur over a variable period of time, from just a few hours to several days, depending on the specific case.
In the event of retinal detachment, the surgeon must employ every method possible to prevent the macula (the central region of the retina) being raised. Retinal detachment that involves the macula will lead to an important reduction in the patient’s visual capacity (reading, cognitive ability and color perception) while the detachment of the peripheral retina (that does not affect the macula) will result in a defect limited exclusively to the peripheral visual field, with central vision preserved.
Symptoms of retinal detachment
The main symptom of retinal detachment is that sight will be compromised in the field of vision affected by the detachment (scotoma).
Scotoma is often preceded by other symptoms, such as:
If one or all of these three symptoms are present, the patient should arrange an urgent examination with an eye specialist to exclude or confirm the presence of a retinal detachment.
The severity of the retinal detachment depends in the portion of the retinal involved. A detachment involving the central portion of the retina, called the macula, is extremely serious as it reduces the possibility of post-operative sight recovery. However, an intervention for peripheral retinal detachment is much more urgent, compared to the retinal detachment that involves the macula; rapid intervention in the event of peripheral retinal detachment may prevent the extension of the detachment to involve the eye’s central vision zone.
Treatment of the retinal detachment is based on surgery. Two surgical procedures are available:
- Surgery performed outside the eye: episcleral surgery;
- Surgery performed inside the eye: vitrectomy.
On occasion, the two techniques can be combined. Both techniques have a triple objective: to reduce the vitreo-retinal tractions, to seal the tear(s) and to reattach the retina.