The extent to which the vision will recover depends on the location of the retinal detachment. In 90% of the cases, it is possible to get the retina reattached after one or more surgeries. In specific cases, the introduction of gas combined with subsequent cryocoagulation or lasering of the retinal hole may be sufficient. During this period there should be no major fluctuations in pressure because the gas can expand: no flying or diving allowed. At the end of the operation, sometimes some gas is left in the eye to keep the retina in place. Furthermore, the hole is closed off with a silicon fragment. During or after surgery, the retinal hole is treated with a cold application (cryocoagulation) or with laser to achieve a thorough adhesion of the retina to the underlayer. Sometimes the eye will be punctured to release fluids. A tiny band (cerclage) is applied around the eye. This surgery is sometimes done in young patients. As long as a gas mixture is present in the eye, flying and diving are not allowed.ĭepending on the condition of the patient, the type of surgery and the preference of the surgeon, the surgery can be performed under general or local anesthesia. Sometimes the head must be kept in a certain position for a few days after surgery. The retina may have to be pressed firmly in place with the use of gas, silicon oil or other means. Surgery in which the vitreous humor is removed is called a vitrectomy. In this case, it is usually necessary to remove the vitreous humor, as it might actually be attached to the retina, thus pulling loose the underlying layers. When moisture has come under the retina, the laser cannot produce scarring, because the fluid keeps the retina from sticking to the deeper layers. If laser treatment is not possible, the patient will be referred to a retinal surgery center for surgical treatment (see below). The treatment is performed on an outpatient basis in OMC Amstelland. This also prevents moisture from getting underneath the retina. These scars will attach the retina to the underlying layers, preventing the holes of getting larger.
When the holes are not too large and the retina has not yet or hardly been released, the green laser can be used to make scars around the holes. There are several possible treatments, depending on the situation and the judgment of the ophthalmologist. This examination is painless and not dangerous. In the event of a vitreous hemorrhage, it can be determined if the retina is out of place or not, with the help of a specially designed ultrasound device. This will ensure quick referral to an ophthalmologist, who will instill pupil dilating eye drops in order to inspect the retina properly. With the abovementioned symptoms it is advisable to consult a GP/optometrist. It cannot be observed externally whether a retinal detachment has occurred. It is important to know that this condition is not painful.
Sudden loss of vision through retinal detachment occurs after a hemorrhage in the vitreous humor. Loss of vision is caused by the release of the center of the retina, or because the released part of the retina lies in front of its center. Sometimes a retinal detachment will occur without the sighting of spots and flashes, but one will notice a decline in the visual field (seeing a “curtain” or “shadow”, or “looking over a wall”). To determine if vitreous humor and retina are in order, an examination must be carried out by an ophthalmologist. These phenomena may indicate changes in the vitreous humor.
Often during middle and/or older age, people may suddenly see dark floating particles (floaters/mouches volantes) and/or lightning flashes. Once a hole has formed, fluid can enter between the retina and the deeper layers of the eye. Due to the shrinkage of the vitreous humor during life, cavities can be caused in the retina. These tears or holes are caused by the changes within the vitreous humor. A retinal detachment is caused by the presence of one or more tears in the retina.
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