Retinal Detachment

Retinal detachment occurs when the neurosensory retina is displaced from the underlying layer beneath, known as the Retinal Pigment Epithelium (RPE). There are 3 main causes of retinal detachment- rhegmatogenous retinal detachment caused by a hole in the retina, traction retinal detachment- caused by pulling on the retinal surface either from scarring or from the vitreous attachments, and exudative retinal detachment, caused by a systemic condition affecting the RPE such as Cancer-related diagnoses or inflammatory conditions.
The most common form of retinal detachment is rhegmatogenous retinal detachment which is caused by a hole in the retina- typically in the peripheral retina. Symptoms of a retinal detachment are distorted vision, flashing lights, floaters, and a shadow occupying some or all of the vision in the affected eye. Diagnosis is made by examining the retina and identifying both the configuration of the detachment and the presence of the holes causing the detachment- often there may be more than one.
Treatment of rhegmatogenous retinal detachment aims to relieve the tractional forces around the hole and drain the subretinal fluid. There are 3 main treatment strategies a retinal specialist will consider when evaluating a rhegmatogenous retinal detachment.
Pneumatic retinopexy is an office procedure where a gas bubble is injected into the eye and the patient positions their head for the next few days. A scleral buckle is an operative procedure that requires an operating room where the eye surgeon places a silicone element on the outside of the eye that presses on the eye relieving the tractional forces. The tear is typically treated with cryotherapy. Pars plana vitrectomy is an operative procedure also requiring an operating room where the vitreous is removed through 3 small incisions in the sclera and the retina is reattached by removing the tractional forces from within the eye and draining the fluid internally then treating it with laser photocoagulation.




