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眼睛解碼

The Roles of Different Eye Care Professionals

Squint

Glaucoma

What are floaters?

Eye care for children and young adults

兒童護眼常識小冊子

Diabetic retinal diseases

Chalazion

Care of contact lens

Allergic conjunctivitis

親子護眼小冊子

戰勝黃班病小冊子

戰勝青光眼小冊子

青光眼手術

Retinal Detachment

Dry Eye Syndrome

白內障

LASER and laser pointers

Tear Gas and Pepper Spray

Precautions on the use of steroid eyedrops & ointment

Retinal Detachment

Introduction

The retina is a thin, light-sensitive tissue that lines inside the back of the eyeball. Like the film in a camera, the retina converts optical image into nerve impulses that will be transmitted via the optic nerve and perceived as vision in the brain. In most causes retinal detachment is caused by retinal break(s) in the retina which allow fluid to enter beneath the retinal space which results in separation of the retina from the back of the eyeball.

Since the detached retina is partially deprived of blood and nutrition supply, it will degenerate and will not function properly. The vision will be impaired and may progress to blindness if left untreated.

Different types of retinal detachment

There are three different types of retinal detachment:

(1) Rhegmatogenous -
Retinal detachment is caused by retinal break. The cause is related to age, short-sightedness and the process of vitreous degeneration. This type of retinal detachment is the most common type.

(2) Tractional -
In this type of detachment, scar tissue on the retina's surface contracts and causes the retina to separate from the RPE due to proliferate vitreoretinopathy or proliferative diabetic retinopathy).

(3) Exudative -
It is frequently caused by eye diseases including inflammatory disorders and injury/trauma to the eye. In this type of retinal detachment, fluid is secreted into the area underneath the retina, but there is no break in the retina.

Normal Retina Retinal Detachment

Symptoms of retinal detachment

Most patients of primary retinal detachment suffer from vision disturbance with no eye redness or pain. It can deteriorate within short period. In the beginning flashing light can be seen, flying dots (floaters), and black shadows seem to move around the visual field. Another symptom is the appearance of a curtain covering part of the visual field. If the detachment involves the macula, the central vision is affected with marked blurred vision and distortion of images. The extent of decrease of vision depends on the location, extent and duration of retinal detachment, and the clarity of vitreous.

Who is at risk for retinal detachment?

Retinal detachment can occur at any age, but it is more common in people over 40 years of age. It affects men more than women.

Retinal detachment is also more likely to occur in people who have:

High myopia
History of retinal detachment in the fellow eye
Family history of retinal detachment
History of eye surgery
Eye diseases or disorders, such as retinoschisis, uveitis or lattice degeneration
Eye injury

Treatment

Spontaneous resolution of retinal detachment is rare. The usual treatment for retinal detachment is surgery. The procedure includes a combination of cryotherapy, laser therapy, insertion of buckle and / or encircling band, pars plana vitrectomy with injection of gas or silicon oil. The surgical aim is to reattach the retina in order to recover vision. The exact procedure varies with the conditions of patients. Sometimes a patient may need a second or a series of different surgical procedures.

Cryotherapy	Laser treatment
Scleral buckle, Encircling band

Pre-operative preparation

Patient should rest in appropriate posture as advised by eye doctor to prevent extension of detached area, or formation of a new break, which may increase difficulty of the operation or affect the progress of recovery
A written consent is required
Fasting 6-8 prior operation is required for general anesthesia

Post-operative care

In the early post-operative period, the patient should follow the doctor's instruction on bed rest in appropriate head/ body posture
Patient should avoid bowing down, tampering with the bandage or rubbing the operated eye
Avoid running water to come in contact with the eye. Beware of dirty water entering the eye while shampooing
In the recovery period, besides taking the medication on time, patients should also take easily digestible food with good nutritional value to enhance recovery
Fruit and vegetables can prevent constipation
Strenuous exercise like diving and those with head shaking motions such as springboard diving, diving or bungee jumping should be avoided
Attend follow up appointment as doctor advice
If your vision get worse or experience signs of infection such as fever and chills, redness, swelling and increasing pain, seek medical advice as soon as possible
When there is a gas in the eye during the post operatively period, do not travel by air or travel to high altitude. Your vision will usually improve gradually when the eye is recovering well and the gas is being absorbed.
When there is a gas in the eye during the post operatively period, and if you need any other surgical procedure(s), you must inform the surgeon and anesthetist for special precaution and management.

Prevention of retinal detachment

Avoid heavy weightlifting
Avoid strenuous activities
People with high myopia should receive eye examination regularly, especially for those high myopic people with unhealthy fundus
Prevention of eye trauma

Disclaimer: The content of this article is for reference only and does not serve diagnostic or treatment purposes nor does it serve as any recommendation towards the use of particular eye treatment products.