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Retinal detachment

Overview
Retinal detachment is an eye disease caused by the release of a thin layer in the eye called the retina. This condition is classified as an emergency and can cause permanent blindness if not treated immediately.
Retinal detachment describes an emergency situation in which a thin layer of tissue (the retina) at the back of the eye pulls away from the layer of blood vessels that provides it with oxygen and nutrients. Retinal detachment is often accompanied by flashes and floaters in your vision.

Retina of the eye is an important part that functions to process light captured by the eye. After being captured, light is converted into an electrical signal and transmitted to the brain. This signal is then processed in the brain and is interpreted as an image seen by the eye.
If the retina is detached from its position, of course vision will be disrupted. This visual impairment can occur partially or completely, depending on how much the retina is released. Retinal detachment can occur in anyone, especially people aged 50 years and over.

Symptoms:
Retinal detachment does not cause pain. Vision loss can occur suddenly, or preceded by a number of symptoms below:
  • Black spots appear that appear to float in sight (floaters).
  • Blurred vision or closed by shadows like curtains.
  • Narrow field of view
  • A flash of light on vision (fotopsia).
Causes:
Retinal detachment occurs when the retina of the eye detaches from the blood vessels that deliver oxygen and nutrients. The following are 3 conditions that can cause the retina to detach:
  • There is a small tear in the retina. This tear causes fluid in the center of the eyeball (vitreous) to seep in and accumulate behind the retina. The accumulated liquid will make the entire retinal layer detach from the base. In general, tears in the retina occur due to changes in tissue as you age. People with minus eyes (nearsightedness) or have had cataract surgery are also at risk of experiencing tears in the retina.
  • The accumulation of vitreous without a tear in the retina. This condition can be caused by injury, tumors, inflammation, and macular degeneration.
  • Scar tissue forms on the surface of the retina. This condition makes the retina attracted and released. This condition is more common in diabetics with poorly controlled blood sugar.
Risk factors
 There are a number of factors that increase a person's risk of developing retinal detachment, including:
  • Aged above 50 years.
  • Have experienced retinal detachment.
  • Have family members with the same disease.
  • Have experienced a severe injury to the eye.
  • Suffering from severe myopia.
  • Have had eye surgery, such as cataract surgery.
  • Have had eye diseases, such as inflammation of the middle layer of the eye (uveitis).

Diagnosis
To determine the diagnosis of retinal detachment, the ophthalmologist will perform an ophthalmoscopy with a special tool to see the inside of the eye. If the ophthalmoscope cannot observe the condition of the retina clearly, for example due to bleeding in the eye, the doctor will do an ultrasound of the eye.

Treatment
Treatment for retinal detachment varies depending on the patient's condition. If the retina is torn or perforated but has not been released, the ophthalmologist can apply the following actions to improve vision and prevent the retina from detaching:
  • This procedure is done by freezing tears in the retina, so that the retina remains attached to the eye wall.
  • Laser therapy (photocoagulation). The laser beam will burn tissue around the retinal tear. The laser will also help the retina stick.
If the retina is released, the doctor will treat it with surgery or surgery. The type of surgery performed depends on the severity of the patient's condition. These operations include:
  • Pneumatic retinopexy. This procedure is done by injecting gas bubbles into the eye, which will push the retina back to its normal position. This procedure is chosen if only a small portion of the retina is released.
  • In vitrectomy, the doctor will expel the vitreous and the tissues that attract the retina. Then, gas or silicon bubbles will be injected into the eye to hold the retina in position. Over time, gas bubbles will be replaced naturally by body fluids.
  • Scleral buckling. In this procedure, the doctor will place silicone from the outside of the white part of the eye (sclera). This silicone will bring the eyeball wall closer to the retina, so that the retina returns to its position. If the condition of detachment of the retina is very severe, silicon will be permanently placed around the eye. Even so, silicon will not block vision.
Prevention
Retinal detachment is not always preventable. However, the risk of retinal detachment can be reduced through the following steps:
  • Immediately check with your ophthalmologist if floaters, flashes of light, or any changes occur in the field of view.
  • Routine eye examination at least once every year. Examination should be done more often if you have diabetes.
  • Routinely control sugar levels and blood pressure, so that the condition of the retinal blood vessels remains healthy.
  • Use eye protection when exercising or when doing activities that risk injuring the eyes.
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