If you imagine that your eye is like a camera, then the retina is the film. When rays of light enter the eye and are focused on the retina by the cornea and lens, the retina reacts. However, just like a picture cannot be developed if the camera has defective film, vision is not possible in an eye with a defective retina. A retinal tear is considered quite serious because the vitreous liquid leaks through the tear, and pools under the retina.
Retinal surgery offers hope and the chances of successfully restoring vision are dramatically improved when intervention occurs as soon as possible following the onset of symptoms.
Very small detachments of the retina can be repaired by laser surgery, also called photocoagulation. In this procedure, the surgeon directs a laser beam into the eye through the pupil, which causes the area around the retinal tear to “scar” and welds the retina to the underlying tissue. Another technique frequently employed is one where local anaesthetic is applied to numb the eye and the eye surgeon applies a freezing probe to the outer surface directly above the tear. The scar caused due to freezing helps secure the retina to the eye wall.
Large retinal detachments, however, need to be repaired surgically. The two major surgical treatments for retinal detachment are scleral buckling and pneumatic retinopexy.
In Scleral Buckling, a sponge or length of silicon plastic is placed on the outside of the eye and sewn in place (the scleral buckle is very small and not visible after surgery), pushing the sclera toward the tear in the retina. In Pneumatic Retinopexy, the surgeon injects a gas bubble inside the vitreous cavity. The bubble pushes the retina against the wall of the eye, allowing the tear to seal against the eye wall.
The efficacy of a retinal repair procedure depends on the gravity of the tears and detachment and extent of scar tissue formation in the retina. If there is no impact to the central portion of the retina, vision will be good. If the macula (central part of retina)is detached for a long time, some vision will return but it will be far from normal and after several months of healing after surgery will it be possible to assess how much vision will return.
What can one expect in the long term?
In most patients with Retinal Detachment, the retina can be attached in a single operation but for some patients, multiple procedures may be needed. 10% detachments cannot be repaired and in such cases, patients will have low vision or no vision at all in the eye. If you have any questions about Retinal Detachment surgery, please do contact us at Aayush Eye Clinic and we shall examine and advise you on the treatment options.