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Retinal detachment

Retinal detachment

Retinal detachment is a condition where the retina separates from the back of the eye. This condition is classified as an emergency, so it must be treated immediately. Otherwise, retinal detachment can cause permanent blindness. 

The retina is a thin layer at the back of the eye. This layer functions to process the light captured by the eye. The light that has been captured will be converted into an electrical signal and passed on to the brain, which will interpret the signal as an image. 

A retina that is detached from its position can cause impaired vision. This disorder can occur partially or completely, depending on how much of the retina is detached. 

Retinal detachment can happen to anyone, but it's more common in people over 50 years of age. 

Types and Causes of Retinal Detachment
Retinal detachment occurs when the eye's retina detaches from the blood vessels that carry oxygen and nutrients. Based on the mechanism that causes detachment of the retina of the eye, retinal detachment is divided into three types, namely:

Rhegmatogenous retinal detachment

Rhegmatogenous retinal detachment is the most common type of retinal detachment. This type of retinal detachment occurs when a tear in the retina allows the fluid in the center of the eyeball (vitreous) to seep in and accumulate behind the retina. This condition causes the retinal layer to detach from its base. 

Generally, tears in rhegmatogenous retinal detachment occur due to changes in the texture of the vitreous as you age. Tears can also occur due to several conditions, namely nearsightedness, eye injuries, and eye surgery. 

Exudative retinal detachment

Exudative retinal detachment occurs when fluid or blood accumulates behind the retina so that the retina detaches. However, in this type, the accumulating fluid does not cause a tear in the retina. 

Fluid buildup generally occurs due to leaking blood vessels or swelling at the back of the eye. Causes can be:

Injury or trauma to the eye
Macular degeneration
Eye tumors
Inflammation of the eye
Coats disease, a rare disease that causes abnormal development of the retina of the eye,
Tractional retinal detachment
This type occurs when there is scar tissue that pulls on and off the retina. This scar tissue is generally formed due to diabetic retinopathy, which is an eye disorder that occurs in people with diabetes. Diabetic retinopathy can cause damage to the blood vessels of the eye. 

In other words, tractional retinal detachment is more common in diabetics whose blood sugar levels are not controlled. 

Retinal detachment risk factors
There are a number of factors that can increase a person's risk of developing retinal detachment, namely:
  1. Over 50 years old
  2. Have you had a retinal detachment before?
  3. Have a family history of retinal detachment
  4. Have a serious eye injuryu
  5. Suffering from severe nearsightedness (myopia).
  6. Have had surgery on the eye, for example cataract surgery?

Suffering from diseases of the eye, such as inflammation of the middle lining of the eye (uveitis),

Retinal Detachment Symptoms

Retinal detachment, or retinal detachment, is painless. Vision loss can occur suddenly or be preceded by any of the following symptoms:

There are lots of black spots floating in sight (floaters).
Vision is blurred or obscured by shadows.
The field of view narrows.
Flashes of light in vision (photopsia)
When to see a doctor
As previously mentioned, retinal detachment is classified as an emergency. Therefore, immediately go to the doctor if you experience the symptoms mentioned above, so that treatment can be started immediately. This can prevent permanent blindness. 

Diagnosis of retinal detachment

To diagnose retinal detachment, the doctor will ask about the patient's complaints. After that, the doctor will give eye drops to dilate the patient's pupils. Please note that these eye drops may cause temporary eye discomfort. 

Next, the ophthalmologist will perform an ophthalmoscope examination with a special instrument to see the inside of the eye. If the ophthalmoscope cannot clearly observe the condition of the retina, for example, due to bleeding in the eye, the doctor will perform an ultrasound of the eye. 

Retinal Ablation Treatment

Retinal detachment treatment varies, depending on the patient's condition. If the retina is torn or perforated but has not yet detached, the ophthalmologist can take the following steps to improve vision and prevent the retina from detaching:

Cryopexy: to freeze the retinal tear so that the retina remains attached to the wall of the eye.
Laser therapy (photocoagulation) is used to burn the tissue around the retinal tear and help the retina stick.
If the retina has detached, the doctor will treat it with a surgical procedure. The type of surgery performed depends on the severity of the patient's condition, namely:

Pneumatic retinopexy
This procedure involves injecting a gas bubble into the eye, which presses the retina back into its normal position. This procedure is chosen if only a small part of the retina is detached. 
In a vitrectomy, the doctor will remove the vitreous and the tissue that is pulling on the retina. After that, a gas or silicone bubble will be injected into the eye to hold the retina in position. Over time, gas bubbles will be naturally replaced by body fluids. 
Scleral buckling
The doctor will place the silicone from the outside of the white part of the eye (sclera). This silicon will bring the wall of the eyeball closer to the retina so that the retina returns to its position. In severe conditions, silicone will be permanently placed around the eye but not obstruct vision. 

Retinal detachment complications

Retinal detachment that is not treated immediately can cause complications in the form of permanent blindness or only being able to distinguish between dark and light. 

Sufferers can also experience complications due to retinal detachment treatment, such as:

  • Infection or bleeding in the eye
  • Glaucoma
  • Cataract
  • Relapse of retinal detachment
  • Retinal detachment prevention
Retinal detachment is difficult to prevent. However, the risk of this condition occurring can be reduced through the following efforts:

Carry out routine eye examinations at least once every year, especially for diabetics.
Control blood sugar levels and blood pressure so that the condition of the blood vessels in the retina remains healthy.
Use eye protection when doing activities that risk eye injury.
See a doctor if floaters, flashes of light, or any changes in the field of vision appear. 

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