Understanding RETINAL DETACHMENT OPHTHALMIC EDUCATION (11) [Archives:2000/38/Health]

What is the retina?
Imagine that your eye is like a camera, and the retina is the film. The retina is a fine sheet of nerve tissue lining the inside of the eye. Rays of light enter the eye and are focused on the retina by the lens. The retina produces a picture which is sent along the optic nerve for the brain to interpret. Its rather like the film in the camera being developed so that pictures can be produced.

What is retinal detachment?
Usually the retina is attached to the inner surface of the eye. If there is a tear or hole in the retina then fluid can get underneath it. This weakens the attachment so that the retina becomes detached rather like wallpaper peeling off a damp wall. When this happens the retina cannot compose a clear picture from the incoming rays and the vision becomes blurred and dim.

Who is more likely to get it?
Detachment of the retina happens more to middle aged, short sighted people. It is quite uncommon however and only about one person in ten thousand is affected. Very rarely, younger people can have a weakness of the retina.

What are the symptoms?
1.The most common symptom is a shadow spreading across the vision of one eye.
2.Patients may also experience bright flashes of light
3.And/or showers of dark spots called floaters.

These symptoms are never painful. Many people experience flashes or floaters and these are not necessarily a cause for alarm. However if they are severe and seen to be getting worse, and/or you are losing vision then you should see a doctor urgently.
Prompt treatment can often minimize the damage to your eye.

What is the treatment?
If you get help early, it may only be necessary to have a laser or freezing treatment. This is usually performed under a local anaesthetic. Often however, an operation to repair the hole in the retina will be needed. This is usually done under a general anaesthetic and can be repaired with a single operation in 90 percent of cases. This does not usually cause much pain but your eye will be sore and swollen for a few days afterwards.

How much vision can we expect after a successful operation?
This depends on how much the retina has detached and for how long. The shadow caused by the detachment will disappear in all cases when the retina has been put back in place. However, if the detachment involves the part of the retina which is responsible for your central vision, this may not recover. The longer this part of the retina has been detached, the smaller the chance that your central vision will recover to its former level. But, if this is the case, you will still have some useful vision left.

What happens if the retina is not put back in place?
Most people will lose all useful vision if no operation is carried out, or if the treatment is unsuccessful.

Can retinal detachment be prevented?
If your family has a history of retinal detachment, or your doctor finds a weakness in your retina then preventive laser or freezing may be needed. In most cases however it is not possible to take preventive action. Retinal detachment does not happen as a result of straining your eyes, bending or heavy lifting.

Can retinal detachment happen in the other eye?
If you have had a retinal detachment in one eye, you are at increased risk of developing one in the other eye. But there is only about a one in ten chance of this happening.

Are there any facilities in Yemen to help this group of patients?
Operations to restore the retina need expensive surgical equipments and well trained eye doctors. Unfortunately till now there is no place in Yemen that can provide good service to help these patients. We hope that eye centers in Yemen with the help of overseas eye centers will be able to provide some help to these patients in the near future.

Routine eye exam by an eye specialist is very important.
It is your sight and your eyes need every care they deserve.

Reference: Royal College of Ophthalmologists educational leaflets, London.

Mahfouth A Bamashmus FRCSEd, FRCOphth
Consultant Ophthalmic Surgeon
Ibn Al-Haitham Clinic
University of Science & Technology, Sanaa

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