Retinal detachment
Think of the eye as a camera. The film in this machine is called the retina.
The retina is a very thin membrane, resembling a net (in ancient Greek “amphibos”), covering the interior of the eye cavity. It’s located at the back of the eye, and it aggregates the photoreceptors, which create a complex network, and which convert the bright stimulus into the nerve signal for processing in the brain through the optic nerve. Retinal detachment is when the retina is detached.
What is retinal detachment and how does it occur?
Retinal detachment is when the retina detaches from its position. The retina is normally attached to the underlying choroid. Its detachment occurs most often due to a crack (either in myopia, which due to thinning of the retina are more predisposed, or after injury). The crack is created by the traction of the vitreous. This type of detachment is called rhegmatogenous.
A rarer type of detachment is the tractional retinal detachment, which occurs in diabetic patients, where fibrovascular membranes have formed on the surface of the retina, which gradually shrink and pull it out of its normal position.
Even more rarely exudative retinal detachment occurs due to inflammation, tumors, or pathological vessels of the retina or the underlying tunic.
Risk Factors for Retinal Detachment
The following factors increase the risk of retinal detachment:
Age – Retinal detachment is more common in individuals over the age of 50.
- High levels of diabetes mellitus.
- Previous retinal detachment in one eye.
- Family history of retinal detachment.
- High myopia.
- Previous eye surgery, such as cataract removal, intravitreal injections, or prior vitreoretinal surgery.
- Previous severe eye trauma.
- History of other ocular conditions or disorders, including retinopathy, uveitis, or other degenerative diseases of the peripheral retina (e.g., lattice degeneration).
An essential element of any surgical procedure, especially cosmetic surgery, is providing the patient with sufficient time for information.
Symptoms of Retinal Detachment
The symptoms of retinal detachment include photopsia (sudden flashes of light resembling camera flashes or lightning), myodesopsia (moving black spots or “floaters”), and loss of part of the visual field, which the patient may perceive as a gray or black curtain or veil in their vision. Another symptom may be blurred vision, which does not improve with blinking or the use of eye drops and could be associated with Dry Eye Disease.
If you experience any of these symptoms, do not hesitate to contact the Eye-Lid Ophthalmology Center, where Dr. Nikolaos Trakos will assess your condition and diagnose the problem. Although the above symptoms do not necessarily indicate retinal detachment, the patient must urgently seek help from an ophthalmologist. If these symptoms are neglected and retinal detachment is present, it may be too late for effective treatment.
Why choose Dr. Trakos?
Dr. Trakos’ contribution to the field of anterior segment and cataract surgery, as well as to the treatment of vision problems, has changed the lives of many people by improving their sight and quality of life
How is Retinal Detachment Treated?
Retinal detachment is an emergency medical condition, as if left untreated, it can lead to total vision loss.
The most important part of the retina is the macula, located at its center, which is responsible for the best possible vision.
If detachment threatens the macula, immediate surgical repair is required. If retinal detachment is diagnosed after the macula has detached, significant vision loss has already occurred, as the macula contains a large number of photoreceptors that lose their connections. Therefore, retinal detachment, which usually occurs in the peripheral retina, should not be allowed to extend to the center, i.e., the macula. Even in such cases, it is necessary to surgically reattach the retina.
If, at the first signs—such as flashes and floaters—the patient visits Dr. Nikolaos Trakos, and a retinal tear is identified without leading to detachment, laser treatment can be performed to seal the tear. This results in scarring and stabilizing the retina in the area of the tear, preventing detachment and ensuring long-term stability.
Dr. Trakos uses the most advanced laser technology, the NAVILAS system, a modern marvel of technology. With the use of navigation and digital design, the laser targets and seals the retinal tear. The laser can recognize even micro-movements of the eye, and if the patient changes their gaze, it stops for safety reasons and resumes when appropriate.
If part of the retina has detached, surgical intervention is required, which can be performed either externally using a silicone graft or internally using an endoscopic method where the vitreous humor is removed (a procedure known as vitrectomy). Both methods yield excellent results and are usually performed under general anesthesia or sedation.
Specifically, the external method is one of the most common approaches to treating retinal detachment. In this method, a silicone graft is sutured to the wall of the eye, at the location of the tear, applying pressure to the retina from outside to inside. This seals the tear and restores the detachment by allowing the body to absorb the subretinal fluid.
As for vitrectomy, it is chosen as a treatment method when certain types of detachment exist, such as tractional detachment (where fibrous tissue due to inflammation or neovascularization pulls and detaches the retina). During this procedure, the vitreous body (the gel that normally fills the eye) is removed. The retina is then flattened using air or heavy liquid and reattached to its original position with an endolaser. Finally, the retina is stabilized in place by injecting a special gas (which is naturally absorbed within a few weeks) or, in more severe cases, silicone oil (which must be surgically removed after a few months). Vitrectomy, with its excellent outcomes, is becoming the preferred method for retinal detachment treatment.
Τελικά ο αμφιβληστροειδής σταθεροποιείται στη θέση του με την τοποθέτηση ειδικού αερίου (που απορροφάται μόνο του σε μερικές εβδομάδες), ή σε σοβαρότερες περιπτώσεις λαδιού σιλικόνης (που όμως πρέπει να αφαιρεθεί χειρουργικά μετά από λίγους μήνες).
Η υαλοειδεκτομή με τα πολύ καλά αποτελέσματα της τείνει να γίνει η μέθοδος εκλογής για τις αποκολλήσεις του αμφιβληστροειδούς.
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