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Retinal Tears and Detachment:
The retina is an essential layer of tissue which lines the back of the eye that converts light into an electrical signal which is sent to the brain via the optic nerve. It is often referred to the “film of the eye” and detachment of the retina can lead to permanent blindness if not treated urgently. Retinal tears are the most frequent cause of retinal detachment.
Retinal tears cause sudden flashes of light and a new onset of floaters. If the retinal tear is not treated in short order, the retina detaches a dark curtain starts to block your vison until you no longer can see.
Risk factors for retinal detachment include extreme myopia (nearsightedness), family history of retinal detachment, history of retinal detachment in the fellow eye, eye or head trauma, eye inflammation and lattice degeneration (thinning of the peripheral retina present in 8-10% of people). Retinal detachments may occur at any age but are most common after the age of 40.
This is made by careful dilated in office examination. We use Optos to assist in localizing rears that cause detachments.
If the retinal tear has not yet caused a retinal detachment, they can be treated in the office by using a laser. This is called laser photocoagulation. This procedure creates a seal around the tear preventing fluid from accumulating under the retina and subsequent detachment.
If the tear progress to a retina detachment, then depending on the size and location of the retinal detachment either scleral buckling and/or pars plana vitrectomy are performed. These surgeries are offered by the retina service at InVision.
Scleral buckling involves placing a solid silicone band around the eye wall (sclera) and indenting the wall to close causative retinal breaks. Pars plana vitrectomy is a surgery done through 3 small incisions in the sclera (the white of the eye), whereby the vitreous humor (the gel-like substance that fills the eye between the lens and retina) is accessed and the vitreoretinal traction is released. The retina is reattached, retinal tears are surrounded with laser to induce a scar-like seal, and a vitreous substitute, usually gas, is placed into the vitreous cavity. This gas keeps the retina attached by limiting the flow of fluid under the retinal breaks while the laser scarring forms. The patent will be required to position in a manner that best achieves this in the early postoperative period.
Dr. Gloth is a gifted retinal surgeon who has performed many lasers for tears as well as many types of retinal detachment repairs. We are fortunate to have in our multispecialty practice.