Retinal Detachment

"The sudden appearance of flying flies or luminous flashes should be a reason for urgent consultation with an ophthalmologist".

DR. MANUEL SÁENZ DE VITERI VÁZQUEZ
SPECIALIST. OPHTHALMOLOGY DEPARTMENT

The retina is the layer at the back of the eye that captures light stimuli and perceives the images that will be sent to our brain.

In retinal detachment, the spontaneous separation of the neurosensorial retina (inner layer of the retina) from the pigment epithelium (outer layer) occurs.

In the majority of cases this occurs because a tear has been produced in the retina through which fluid has been passing that has detached the retina.

The treatment of retinal detachment is surgical and the main objective of the surgery is to seal all the retinal tears or holes and to reapply the retina. This is done basically with 3 methods: vitrectomy, scleral surgery or pneumatic retinopexy.

The Department of Ophthalmology has a team of retinal surgeons with extensive experience in the management of retinal detachment complications.

What are the symptoms of retinal detachment?

Many times retinal detachment is preceded by the sudden appearance of flying flies or a sudden increase in those already existing, as well as the appearance of luminous flashes (symptomatic vitreous detachment).

Any of these symptoms should be a reason for urgent consultation with an ophthalmologist, since at this time the detachment may not yet be established.

If we find one or more retinal tears in the fundus examination, it would be advisable to perform a preventive laser treatment even if it has not yet caused a detachment.

If the detachment is already present in addition to the symptoms mentioned above, we may notice a "shadow" or "curtain" that prevents us from seeing through part of the eye.

It is very important to make an early diagnosis, since the possibilities of improvement are greater if the central area of the retina called the macula is not detached.

Do you have any of these symptoms?

You may have a retinal detachment

How is retinal detachment diagnosed?

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The diagnosis of retinal detachment is established with the symptomatology referred by the patient and is complemented with the exploration of the fundus of the eye.

In the event of compatible symptoms, this will be done:

  • An examination of the fundus of the eye under pupil dilation to check the state of the retina. 

How is retinal detachment treated?

The main benefit of the surgery is to avoid blindness of the eye affected by the detachment. You may have already lost some vision from the detachment at the time of surgery, so even if the surgery is successful, your vision may not return to normal.

There are different surgical techniques, depending on the degree and stage of retinal detachment:

  • Vitrectomy: This is a type of microsurgery that is performed under a microscope, making 3 small incisions in the white part of the eye, through which very fine instruments are inserted
    First the vitreous gel is removed (vitrectomy), then the neurosensorial retina is reapplied over the pigment epithelium.
    Then the broken retinas are treated with laser or cryotherapy, and finally the eye is filled with gas or silicone oil that will plug the broken retinas while the laser or cryotherapy heals. As long as we have gas in the eye we will not see well but this will gradually disappear over the next few weeks (2-8 weeks). After surgery, we position the patient with the head in a certain position for 7-14 days so that the gas or silicone bubble will plug the retinal breaks.
  • Scleral Surgery: A solid silicone band or band segment is sewn onto the outermost layer of the eye wall (the sclera).
    This band will push the wall of the eye inwards causing an indentation, which closes the break, thus allowing the retina to be reapplied.
  • Pneumatic Retinopexy: A gas bubble is injected into the eye, without doing vitrectomy, and the patient is positioned in a certain way so that this gas plugs the tear and thus the retina can be reapplied. At the moment of the gas injection we can treat the tear with cryotherapy or later when we have already reapplied the retina we can treat it with laser or cryotherapy.

The anatomical success rate of retinal detachment is approximately 90% with a single surgery. In the cases that are not achieved at the first time, they can be re-operated, thus increasing the success rate to approximately 98%. In any case, anatomical success is not always linked to functional success.

If the detachment caused a loss of vision, even if we manage to reapply the retina, we may not be able to recover the vision already lost.

Where do we treat it?

IN NAVARRE AND MADRID

The Department of Ophthalmology
of the Clínica Universidad de Navarra

Equipped with the latest technology, the Department of Ophthalmology has the necessary equipment, both technical and human, to offer comprehensive and specific assistance to each patient.

We are one of the few centers that have a microsurgery laboratory for the improvement of clinical practice.

Organized in specialized units

  • Cornea and eye surface
  • Retina
  • General Ophthalmology
  • Refraction defects
  • Oculoplastic
  • Pediatric ophthalmology
Imagen de la fachada de consultas de la sede en Pamplona de la Clínica Universidad de Navarra

Why at the Clinica?

  • More than 30 years of experience.
  • Experts in the diagnosis and treatment of ocular pathologies.
  • With the security and guarantee of a prestigious hospital.

Our team of professionals