Many people have heard of a retinal detachment and are familiar with the term enough to know that it is a serious condition. Retinal detachments potentially cause blindness, but modern technical advancements allow eye surgeons to repair detachments and restore eyesight to many people. A retinal detachment is a medical emergency and must be managed immediately. Approximately one out of every 15,000 people in the United States suffer from a retinal detachment.
What is the retina?
The retina is the thin layer lining the inside of the eye that perceives light. Similar to the film in a 35 mm camera, the function of the retina is to receive the image focused on it from the lens at the front of the eye. The retina then transports the visual information to the brain via the optic nerve. The retina is attached to underlying layers of tissue inside the eye. However, trauma or stretching of the retina may cause the retina to detach from the underlying layers.
Why are nearsighted people more at risk?
The greatest concern for a highly myopic (nearsighted) individual is the increased risk of developing a retinal detachment. Overall, retinal detachments are infrequent, but they are more likely in someone with higher levels of nearsightedness. Anatomically, the length of the nearsighted eyeball is increased by up to a few millimeters compared to a normal eye. This additional eye length stretches the lining inside the eye (the retina). Just like pulling on both ends of a thin facial tissue, you can only stretch it so far before a tear develops. These same dynamics can occur in the eye. The retinal tissue inside a myopic eye is able to withstand some stretching, but it is under more tension as a result of the stretching. Depending on the level of retinal stretching, the retina may tear spontaneously or as the result of trauma to the eye.
Early detection is the key!
The good news is that retinas at increased risk for detachment can often be identified ahead of time during a comprehensive ocular examination. Frequently, your eye doctor is able to identify areas of thinning or stress on the retina prior to a detachment. If the risk of a retinal detachment is severe, a surgeon may use a laser to “tack down” areas of the retina to reduce the risk. Most eye doctors strongly recommend that anyone with a myopic prescription of – 6.00 or higher have a dilated ocular exam at least once a year to help identify this risk in advance.
Symptoms of a retinal detachment
Assuming that it is not caused by trauma, a retinal detachment does not cause pain. Individuals with a retinal detachment describe seeing lightning-bolt or arc-like flashes of white light in their peripheral vision. A severe retinal detachment will also make the eyesight go “black” in the field of view that corresponds to the detached area of retina. If a significant area of retina is detached, the individual may describe their eyesight looking like a curtain or a veil obscuring a large part of their vision. Most retinal detachments occur in the peripheral retina, causing the shadows and flashes of light to appear in the peripheral parts of the vision. The detached areas of retina no longer transmit visual information to the brain, causing blindness in those areas. Rare detachments of the entire retina cause total blindness.
Diagnosis of a retinal detachment occurs with a doctor’s careful examination of the retina. Both locations of Primary Eyecare have the latest in diagnostic technology with Optomap Digital Retinal Imaging. This technology allows our eye doctors to see almost 80% of a patient’s retina in one view, rather than the usual 15% seen with typical retinal photography. A patient’s symptoms of flashes of light (or obscured vision) will alert the doctor to specifically examine the retina for a tear or detachment. The doctor may take photographs of the retina and perform a computerized visual field examination to aid in the diagnosis.
Risk factors for a retinal detachment include:
- Significant myopia (–6.00 diopters or higher)
- Aging—most common over age forty
- Trauma—recent or old trauma to the eye or head
- Previous eye surgery, such as cataract surgery or refractive surgery
- A history of a retinal detachment in one eye increase the odds of a subsequent detachment in the other eye
- A diagnosis of degenerative peripheral retinal tissue, such as lattice degeneration or retinoschisis
- Ocular tumors or metastasis
- Family history of retinal detachments
If you have questions about retinal detachments or you feel you are at risk, please don’t hesitate to contact us. Our optometrists always strive to provide you with the very best in patient care.
ALL RIGHTS RESERVED: Copyright © 2011 | Dr. Joseph DiGirolamo, OD | The Big Book of Family Eye Care