Retinal detachment describes an emergency situation that can lead to permanent vision loss. A person with short-sightedness is more likely to suffer from this eye disease as shown by the statistic. The incidence of retinal detachment is about 1 in 300 over a lifetime for those with normal vision, but the risk soars to 1 in 20 among the shorted-sighted. So preserve your gift of sight and understand more about this common eye condition now!
What is Retinal Detachment?
The retina is the innermost and light-sensitive tissue layer of the eye full of photoreceptor cells and nerve fibres. The eye optics create a focused two-dimensional image of the visual world on the retina, which translates that image into electrical neural impulses to the brain to create visual perception. Thus, the retina serves a function analogous to that of the film or image sensor in a camera.
Inside the eyeballs, a clear gel, called the vitreous, fills the space between the lens and the retina. If the vitreous body contracts and pulls away from the retina, it leads to vitreous detachment, creating tears on the retina. Without proper repairing surgeries, it may eventually cause retinal detachment in a few hours.
Symptoms of Retinal Detachment
The vitreous is the gel-like fluid that fills your eye. It is full of tiny fibres that attach to your retina. If the vitreous becomes cloudy or bleed, or the fibres of your vitreous pull away from the retina, you may have the following symptoms before (complete) retinal detachment:
- Flashes of light in one or both eyes (photopsia)
- The sudden appearance of many floaters — tiny specks that seem to drift through your field of vision
- A curtain-like shadow over your visual field
- Blurred vision and gradually reduced side (peripheral) vision
Retinal detachment itself is painless, which makes it hard to notice. If you have the above symptoms, please consult your doctor as soon as possible.
Causes of Retinal Detachment
Most cases of retinal detachment are primary, led by the degenerating and thinning of the retina, as well as vitreous degeneration or liquefaction.
Besides, the causes of secondary retinal detachment include eye injuries, inflammation or eye tumours.
Types of Retinal Detachment
There are three different types of retinal detachment:
- Rhegmatogenous retinal detachment: It happens if you have a small tear or break in your retina. When your retina has a tear or break, the gel-like fluid in the centre of your eye (called vitreous) can get behind your retina. The vitreous then pushes your retina away from the back of your eye, causing it to detach.
- Tractional retinal detachment: This type of detachment can occur when scar tissue grows on the retina's surface, causing the retina to pull away from the back of the eye.
- Exudative retinal detachment: In this type of detachment, fluid accumulates beneath the retina, but there are no holes or tears in the retina. It is relatively rare compared to the other types.
High-Risk Groups of Retinal Detachment
Individuals with the conditions below have a higher risk of retinal detachment:
- Aged 40 to 80 years old
- High myopes (higher than –6.0 Dioptres): In Hong Kong, 20-30% of retinal detachment patients have high myopes
- Previous severe eye injury
- Previously receive eye surgeries (such as cataract removal or glaucoma treatments)
- Hereditary disease(such as Marfan Syndrome)
- Family history of retinal detachment
- Diabetic eye disease (diabetic retinopathy)
- Retinopathy of prematurity
What is Diabetic Retinopathy?
Diabetic retinopathy is a diabetes complication that affects the eyes. Over time, too much sugar in your blood can lead to the blockage of the tiny blood vessels that nourish the retina, cutting off its blood supply. As a result, the eye attempts to grow new blood vessels. However, these new blood vessels do not develop properly and can leak easily.
Diagnosis of Retinal Detachment
Your doctor may use an instrument to examine the back of your eye, including your retina, locate the area(s) of retinal detachment, look for retinal tears/holes and see if the macula degenerates. He/she will also check if degeneration occurs in the other eye.
Treatments of Retinal Detachment
Surgery is almost always used to repair a retinal tear, hole or detachment.Among all cases, over 90% of the patients can reattach the retina successfully through surgeries. Your doctor will adopt one or combined treatments to fix the retina according to your needs and conditions.
- Pneumatic Retinopexy: A bubble of air or gas into the centre part of the eye (the vitreous cavity) to restore the position of the retina and repair the retinal break.
- Scleral Encircling & Buckling Surgery: It involves your surgeon sewing (suturing) a piece of silicone material to the white of your eye (sclera) over the affected area. This procedure indents the wall of the eye and relieves some of the force caused by the vitreous tugging on the retina. If you have several tears or holes or an extensive detachment, your surgeon may create a scleral buckle that encircles your entire eye like a belt. The buckle is placed in a way that doesn't block your vision, and it usually remains in place permanently.
- Pars Plana Vitrectomy (PPV)): It removes the vitreous along with any tissue tugging on the retina. Air, gas or silicone oil is then injected into the vitreous space to help flatten the retina. Eventually, the air, gas or liquid will be absorbed, and the vitreous space will refill with body fluid. If silicone oil was used, it might be surgically removed months later.
When a retinal tear or hole hasn't yet progressed to detachment, your doctor may suggest the following procedures to prevent retinal detachment and preserve vision:
- Photocoagulation: It directs a laser beam into the eye through the pupil. The laser burns around the retinal tear, creating scarring that usually "welds" the retina to underlying tissue.
After your operation, it could take a few months to determine how good your vision will be. You stand the best chance at a good outcome if the repair is done before the centre part of the retina, called the macula, detaches. The longer the time of retinal detachment is, the more irreversible damage is made on the vision.
Estimated Treatment Costs of Retinal Detachment
Depending on the procedures, treatments for retinal detachment are from HK$10,000 to HK$70,000 per eye.
- Retinal Laser Barrier (each eye) at Hong Kong Sanatorium & Hospital: HK$12,500 - HK$16,500
- Retinal detachment surgeries (each eye) at the Private Services of the Hospital Authority: HK$30,450 - HK$72,050
Things to Take Notes About Retinal Detachment Surgery
People with retinal detachment need more bed rest to avoid enlarging the detached area. In the following weeks after the operation, you are advised to rest on the bed and not bend over, bow your head, bump or rub your eyes, and hold heavy objects.
Those who received expandable gas or silicone oil injection need to maintain a specific head posture for a period of time to prevent the retina from detaching again. Air travel is restricted for three months after the gas injection surgery.
The risk of retinal detachment is higher for the short-sighted. Therefore, a suitable and flexible insurance plan that covers regular eye exams and even surgeries is very much needed to protect your precious vision. Cigna DIY Health Plan enables you to freely choose from various protection benefits to customise your plan to your individual needs, including dental coverage, regular oral check-up, treatment cost and emergency. Tailor your health coverage now.
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