What is retinal detachment?
In this condition (also referred to as cellophane maculopathy or macular pucker) a very thin layer of scar tissue forms on the surface of the central retina, resulting in distorted and/or blurred vision.
The retina is the light sensitive film at the back of the eye. Retinal detachment is a condition where the retina peels away from the inner wall of the eye. In most cases the retina detaches because a hole or a tear has formed in the retina allowing fluid to pass underneath the retina. Most retinal detachments occur as a natural ageing process in the eye but certain people are at higher risk than others. These include people who are short sighted, or those who have suffered trauma to the eye. Some types of retinal detachments can run in families.
What testing might be done?
Mr Alexander will examine both eyes following the use of eye drops that temporarily enlarge your pupils.
How is a retinal detachment treated?
The treatment involves surgery and the main aim of surgery is to seal holes in the retina and reattach the retina. The two methods used in retinal detachment surgery are (a) vitrectomy or (b) scleral buckle
A vitrectomy involves removing the vitreous gel (that has caused the retinal tear) from inside the eye. Mr Alexander will then seal the tear using either laser or cryotherapy. A gas or silicone oil bubble is then inserted into the eye to support the retina while it heals. A gas bubble slowly absorbs over 2 to 8 weeks but a silicone oil bubble will need a second operation to remove it at a later date. Your vision will be very blurred initially due to the presence of the gas or oil bubble.
To use the gas or oil bubble to its best effect your surgeon may ask you to posture and this will be covered in a following section.
(b) Scleral buckle
The retinal holes can also be sealed and supported by stitching a piece of silicone rubber or sponge to the outside of the eye. This acts as a ‘splint’ and produces a dent within the eye and pushes the outer wall of the eye up to the hole in the retina. The buckle is not visible on the outside of the eye and usually remains in place permanently.
What is posturing?
With a gas or oil bubble in the eye, Mr Alexander may ask you to posture after the operation for up to 10 days. Posturing involves placing your head in a specific position to allow the gas or oil bubble to float into the best position to support the retina. There are various posturing positions and your surgeon will advise you on the one appropriate to you. Posturing is often the hardest part of the recovery after surgery but is important and should be regarded as the second stage of the operation. You will be required to posture 45 minutes out of every hour during the day. The 15 minutes out of every hour when you are not posturing should be spent moving around or taking gentle exercise to relieve discomfort and general body ache.
What can I expect for my vision after surgery for retinal detachment?
The aim of surgery is to prevent you from going completely blind in the affected eye. You may have lost vision already from the retinal detachment and even with successful surgery your vision may not return to normal.