Threat to Vision

Eyes are the windows to the world. Guard yourself against damage to retina
Dr. Rajeev Jain

Eyes are one of the most important vital organs of our body. They enable us to see and enjoy the beauty that surrounds us in the world. Inside our eyes, lies a thin layer of tissues called retina on which light rays are focused to form the image. Retina converts light into signals and then send them to the brain so that we can see the image through our eyes.
Retina plays a very important role in our vision. Be it major or minor, damage to the retina can seriously affect us our eyesight and calls for immediate medical attention. Failure to do so, might lead to loss of vision or permanent blindness.
Retinal detachment is a condition in which the retina gets detached or peels away from the back wall of the eye. This leads to reduction of blood supply along with source of nutrition to the retina, resulting in degeneration. Retina, if remains detached, can cause permanent loss of vision.
If someone observes flashes of light in their vision accompanied by floaters (thread like moving strands in the vision) and darkened side vision, don’t delay visiting a retina specialist as these are the primary symptoms of retinal detachment.
There are three main types retinal detachment. First and the most common type is retinal break or tear. In this, liquid present in the centre of the eye called vitreous, passes through the retinal tear making the retina lift off from its position. In medical terms, it is called Rhegmatogenous retinal detachment.
The second most common type is exudative retinal detachment. This happens due to leakage of fluid (exudates) from the retina. Tumours and inflammatory disorders of the eye cause exudative retinal detachment.
Traction retinal detachment is the third kind of retinal detachment. Proliferative Diabetic Retinopathy (PDR) causes traction retinal detachment. In this, the retina gets pulled from the vascular tissue in the vitreous cavity.
People who are short-sighted are at the risk of developing retinal detachment. Anyone who had an eye injury in the past, or had undergone a complicated cataract surgery is more prone to retinal detachment. Besides, those with a family history of retinal detachment are at increased risk of developing this disorder.
A surgery for reattaching the retina is the most successful way to treat retinal detachment. Depending upon the characteristic and age of the patient, appropriate technique is adopted for the treatment. There are basically 3 ways to treat retinal detachment.
The oldest and most common technique to treat retinal detachment is scleral buckle. It is used for patients suffering from rhegmatogenous retinal detachments in which there are no major complications. In this the buckle (a silicone sponge or solid silicone) is sewn onto the outer wall of the eyeball to close the retinal break or tear. A person can get back to home on the same day of the surgery, and resume their daily chores in a few days’ time.
Vitrectomy is another technique used generally for those patients suffering from traction retinal detachments caused by diabetes. But this treatment can also be used for patients with rhegmatogenous detachments, especially if they are associated with vitreous traction or vitreous hemorrhage.
For those having a single tear rhegmatogenous detachment,a Pneumatic retinopexy can be a good option. In this treatment, a gas bubble is injected in the vitreous cavity (middle part of the eye) and is positioned in a way that it covers the retinal break.
Depending upon the cause behind retinal detachment,a retina specialist can advise you on the type of procedure to be used for the treatment.
Post the surgery, a patient might feel tired for the first 2-3 weeks. Also, it is advised that person should not drive or fly while the gas bubble is still there in the eye. Many a times, a person may feel uncomfortable or scratchy in the eye during the first few days. Strenuous activities should be avoided until your eye is completely healed. Post healing, one can get back to their normal course of work and lead a normal life.
There is a possibility that if you have retinal detachment in one eye then you might develop it in the other eye as well. After careful examination, if any weak area vulnerable to develop break is discovered a laser treatment can be performed by the doctor to strengthen the retina.
A retinal detachment in most cases can be prevented with regular eye examination. If you notice any changes in your vision, don’t ignore and get yourself checked. If you have diabetes, it becomes even more important to have eye examination once a year. Also those having near vision problem should ideally get their eyes checked at regular basis.
If you suffer from diabetes or hypertension, it is advised to keep your levels under control so that no added pressure falls on the retinal blood vessels. While performing outdoor activities like swimming, scuba diving, snowboarding etc., make sure you wear protective glasses. Eye protection is also required for those whose work involves usage of chemicals or artificial UV lights.

(The author is Eye Surgeon and Director, Save Sight Centre, Delhi)