- The “retina” is like the wallpaper on the inside of the eye.
- “Detachment” is the term used when the wallpaper comes off of the wall.
- This problem requires treatment, usually surgery.
- Typical retinal detachment surgeries are scleral buckle and/or vitrectomy.
[insert illustration for retinal detachment]
Retinal Detachment (RD) due to retinal holes or tears (rhegmatogenous retina detachment) occurs in approximately 1:10,000 in the general population, but is more common in near-sighted (myopic) individuals and after cataract surgery. Trauma can sometimes cause RD as well (less than 2% of the time). The classic symptoms of RD are floaters, flashes, and blurred vision, often described as a ‘curtain’ over the field of vision. Retinal detachments happen because: 1) the gel in the middle of the eye, called “vitreous,” is partly stuck to the retina, which is the wallpaper of the eye. In a child, this gel is like a cast of jello. With age, it turns to liquid, (patients note floaters at this stage); 2) the partly liquid gel may separate from the retina at some point in life (patients notice flashing lights when this happens), and this can sometimes cause a tear or hole in the retina; 3) fluid in the vitreous passes through the tear and accumulates under the retina, causing it to detach from the wall of the eye, (patients notice a curtain over part of their vision when this happens).
Treatment involves identifying where the tears or holes are in the retina, then sealing these off and allowing the retina to reattach.
The standard operation to reattach the retina is a scleral buckle, perhaps better termed scleral indentation, because in this operation, the entire wall of the eye is pushed inwards to touch the detached wallpaper. The buckle is a small piece of silicone that is attached to the outside of the eyeball to force it inwards. This enables the detached retina to stick to it more easily, especially after the fluid under the detached retina is removed (by perforating the eyeball from the outside with a tiny hole (in essence it is like pushing in the wall to reattach to the separated wallpaper).
The success rate of scleral buckle is in the upper 90s%. If scleral buckle is not successful or if the detachment is more complex,** vitrectomy may be necessary. Vitrectomy is an operation to remove the gel from the inside of the eyeball, and forcing the retina to reattach from the inside of the eye.