Don’t become detached – let’s stay together

26 August 2022

Our bodies are amazing machines – from head to toe they are capable of extraordinary movements and thoughts. But sometimes, the smallest of problems can turn life upside down and quickly turn in to a medical emergency.

Our eyes may be a very small part of our overall make-up but each tiny element works seamlessly to bring us incredible sight. Some components of the eye are as thin as a piece of tissue but they have very important roles to play. A perfect example of this is the retina.

The retina is a thin layer of tissue in the back of your eye which is attached to the eye wall. It acts as a bridge between the light that enters your eyes and the images that you see.

As an active layer, it is made up of millions of light receptor cells (photoreceptors) which receive and organise light information, translate it into electric signals which are sent to the brain via the optic nerve. The brain processes these signals into the images that we can see. Clever for a piece of tissue!

At the centre of the retina is the macular – a part of the eye which is responsible for central and fine-detail vision which is needed for tasks such as reading.

So the retina is pretty vital and without it, we wouldn’t be able to see anything at all as our brain would not receive any messages from the eye.

However, sometimes the retina can become separated from the wall of the eye resulting in a condition called retinal detachment. This can seriously affect your sight and cause total vision loss if not treated quickly.

If you haven’t heard of this condition before then you should read on as this month’s Optegra explainer feature covers everything you need to know about the retina, what happens when it becomes detached and what you should do if you spot any symptoms.

 

What causes a retinal detachment?

 The most common cause of retinal detachment is small tears in the retinal tissue which allow fluid to leak between the layers of tissue, causing the retina to lift away from the back of the eye and detach.

Tears happen because the retina has been pulled and torn. The most common cause of a retinal tear is the vitreous gel inside your eye coming away from the retina and this happens naturally with age. This is called posterior vitreous detachment (PVD). It’s not clear exactly why a PVD can lead to retinal detachment in some people and unfortunately there’s nothing you can do to prevent it. This is why keeping a check on symptoms is so important, as are regular eye health checks.

Very rarely, retinal detachment happens when fluid from the blood vessels behind the retina leaks between the retinal layers without there being a hole or tear present. This type of detachment happens because of inflammation or tumours in the eye.

Retinal detachments can also occur after an operation such as cataract surgery, after an eye injury or if you have a family history of the condition.

 

What are the symptoms to look out for?

 Retinal detachment is a medical emergency and needs to be assessed as soon as possible so a decision can be made about treatment. If not repaired quickly with surgery, it can cause sight loss.

If you have any of the following symptoms, you should visit your optometrist as soon as possible:

  • A sudden increase in floaters
  • Flashing lights
  • Your vision is suddenly blurred
  • Visual loss starting anywhere in the periphery and progressing towards the centre – visit A&E if necessary

 

Can a retinal detachment be treated?

 The simple answer is yes but speed really is of the essence. How well your sight recovers can depend on how much and in what areas your retina detached. Most people have a good level of vision following surgery to re-attach the retina if it is carried out quickly.

Treatment for retinal detachment includes the following, and depending on the cause of the detachment, your surgeon will advise on the most appropriate treatment specifically for you:

Vitrectomy – this involves surgically removing the vitreous, the clear gel that fills the space between the lens and the retina. Gas is then used to fill the cavity and to push the detached retina back against the eye wall. The area around the hole is sealed to form a permanent scar. The gas bubble re-absorbs spontaneously, and the scarring prevents re-detachment.

Scleral buckling – tiny silicone bands or sponge material are attached to the outside white of your eye, pushing it in towards the detaching retina and in to a position which helps the retina to reattach. This may be followed by a vitrectomy or laser eye surgery to produce a permanent seal around the retinal tears.

As with all hard-working organs, regular maintenance is key to healthy eyes. Make sure you have your eyes tested at least every two years, as your optometrist can see right into the back of your eye to check for degenerative conditions which may have no early symptoms.

By optometrist Oliver Bowen-Thomas from Optegra Eye Health Care

Optegra is a network of specialist eye hospitals across the UK and treats retinal conditions in its Yorkshire, Manchester, Surrey and Hampshire hospitals.

For more information on eye conditions and how they could affect you, please visit www.optegra.com.

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