What is a Retinal Detachment?
A detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred, like a camera picture would be blurry if the film were loose inside the camera. A retinal detachment is a very serious problem that almost always causes blindness unless it is treated.
What causes Retinal Detachment?
The vitreous is a clear gel that fills the middle of the eye. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye. Usually the vitreous separates from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through the retinal tear, lifting the retina off the back of the eye, like wallpaper can peel off a wall.
What are the warning symptoms of a Retinal Detachment?
Early symptoms such as flashing lights, floaters, or a gray curtain moving across your field of vision may be indicative of retinal detachment. These symptoms do not always mean a retinal detachment is present, but you should see your ophthalmologist as soon as possible. Only after careful examination can your eye doctor tell whether a retinal tear or early retinal detachment is present.
- Retinal Tears: Most retinal tears need to be treated with laser surgery or cryotherapy (freezing), which seals the retina to the back wall of the eye. These treatments cause little or no discomfort and may be performed in your ophthalmologist’s office. Treatment usually prevents retinal detachment. In some cases retinal tears can be observed without treatment.
- Retinal Detachments: Almost all patients with retinal detachments require surgery to put the retina back in its proper position.
There are several ways to fix a retinal detachment. The decision of which type of surgery and anesthesia to use depends upon the characteristics of your detachment. In each of the following methods, your ophthalmologist will locate the retinal tears and use laser surgery or cryotherapy around them to seal the tear.
- Scleral Buckle: A flexible band (scleral buckle) is placed around the eye to counteract the force pulling the retina out of place. The ophthalmologist often drains the fluid under the detached retina from the eye, pulling the retina to its normal position against the back wall of the eye. This procedure is performed in an operating room.
- Pneumatic Retinopexy: A gas bubble is injected into the vitreous space inside the eye. The gas bubble pushes the retinal tear closed against the back wall of the eye. Your ophthalmologist will ask you to maintain a certain head position for several days. The gas bubble will gradually disappear. Sometimes this procedure can be done in the ophthalmologist’s office.
- Vitrectomy: The vitreous gel, which is pulling on the retina, is removed from the eye and usually replaced with a gas bubble. Your body’s own fluids will gradually replace the gas bubble. Sometimes a vitrectomy is combined with a scleral buckle.
What is Macular Degeneration?
Macular degeneration is damage or breakdown of the macula of the eye. The macula is a small area at the back of the eye that allows us to see fine details clearly. When the macula doesn’t function correctly, we experience blurriness or darkness in the center of our vision. Macular degeneration affects both distance and close vision, and can make some activities like threading a needle or reading difficult or impossible.
Although macular degeneration reduces vision in the central part of the retina, it does not affect the eye’s side, or peripheral, vision. For example, you could see the outline of a clock but not be able to tell what time it is. Macular degeneration alone does not result in total blindness. People continue to have some useful vision and are able to take care of themselves.
What causes Macular Degeneration?
Many older people develop macular degeneration as part of the body’s natural aging process. The two most common types of age-related macular degeneration are “dry” (atrophic) and “wet” (exudative):
- “Dry” Macular Degeneration (Atrophic): Most people have “dry” macular degeneration. It is caused by aging and thinning of the tissues of the macula. Vision loss is usually gradual.
- “Wet” Macular Degeneration (Exudative): “Wet” macular degeneration accounts for about 10% of all cases. It results when abnormal blood vessels form at the back of the eye. These new blood vessels form at the back of the eye and leak fluid or blood blurring central vision. Vision loss may be rapid and severe.
What are the Symptoms of Macular Degeneration?
Macular degeneration can cause different symptoms in different people. The condition may be hardly noticeable in its early stages. Sometimes only one eye loses vision while the other eye continues to see well for many years. When both eyes are affected, the loss of central vision may be noticed more quickly. Some common symptoms are:
- Words on a page look blurred;
- A dark or empty area appears in the center of vision;
- Straight lines look distorted.
How is Macular Degeneration Diagnosed?
Many people do not realize that they have a macular problem until blurred vision becomes obvious. Your ophthalmologist can detect early stages of macular degeneration during a medical eye examination that includes:
- Viewing the macula with an ophthalmoscope;
- A simple vision test in which you look at a grid resembling graph paper;
- Sometimes special photographs, called angiograms, are taken to find abnormal blood vessels under the retina. Fluorescent dye is injected into your arm and your eye is photographed as the dye passes through the blood vessels in the back of your eye.
How is Macular Degeneration Treated?
Despite ongoing medical research, there is no cure yet for “dry” macular degeneration. Some doctors believe that nutritional supplements may slow macular degeneration, although this has not yet been proven. Treatment of this condition focuses on helping a person find ways to cope with visual impairment.
In its early stages “wet” macular degeneration can be treated with laser surgery, a brief and usually painless outpatient procedure. Laser surgery uses a highly focused beam of light to seal the leaking blood vessels that damage the macula. Although a small, permanently dark “blind spot” is left at the point of laser contact, the procedure can preserve more sight overall.
Despite advanced medical treatment, people with macular degeneration still experience some vision loss. Your ophthalmologist can prescribe optical devices or refer you to a low-vision specialist or center. A wide range of support services and rehabilitation programs are also available to help people with macular degeneration maintain a satisfying lifestyle.