What is it?

Retinal detachment is the separation of the neurosensory retina from the underlying tissue (retinal pigment epithelium), caused by the accumulation of fluid between the two. There are three mechanisms that can cause retinal detachment. The rhegmatogenous type, which is the most common type, is caused by a retinal tear that can occur after a vitreous detachment. The tensile type, which is typical in proliferative diabetic retinopathy and the exudative type, when there are problems or vascular permeability secondary to tumors.

Symptoms

The most common initial symptom of the rhegmatogenous type, although not always present, is the sight of flashing lights, sometimes repetitive and perceived on a single sector of the visual field. This may indicate the presence of a retinal break, condition that may lead to retinal detachment. However, the light flashes do not always appear as a symptom. The appearance of a shadow, like a curtain which blocks the partial or even full vision in one eye, is a possible symptom of detachment.

In the presence of any of these symptoms, you should go urgently to an ophthalmologist to examine the retina by pupil dilation and through ultrasound, if necessary, to facilitate the diagnosis.

Treatment

The treatment, always surgical, requires the relocation and adaptation of the retina and can be done internally (through vitrectomy) and externally (through indentation). Sometimes a combination of both techniques is necessary. Adhesion is achieved by inducing a thermal lesion with a laser, or generating a scar stimulus through freezing (cryotherapy). Sometimes, depending on the case, the use of intraocular gases or intraocular silicone oil may be necessary.

In some cases, preventive laser treatment for retinal breaks with uncomplicated detachment is advised.

The speed and degree of visual recovery will depend on each individual case. Overall prognosis of retinal detachment depends mainly on its size, if it does not affect or the point of maximum vision (the macula), and on its time of evolution.

Prevention

An annual ophthalmologic examination with pupil dilation is recommended, in order to check the retinal periphery. Laser over degenerative lesions likely to cause a landslide will be applied. In any case, the earliness in the diagnosis and proper treatment are essential for a good outcome of the process.