In order to best understand what a detached retina actually is, and to be aware that it’s a medical emergency, we’ll start today’s lesson with an explanation of how our eyes work. If you find yourself blinking a lot, don’t be surprised. Also, if you are a visual learner, there’s an animated graphic that you can see if you keyword “retina” at the American Academy of Ophthalmology’s website: aao.org. The following is the text:
“Light rays enter the eye through the cornea, pupil and lens. These light rays pass through the vitreous, a clear gel-like substance that fills the middle of the eye. The light rays are focused on the retina, a light-sensitive tissue lining the back of the eye. The macula is a very small area at the center of the retina that gives us our fine pinpoint central vision. The area of the retina surrounding the macula gives us our peripheral or side vision. The retina converts the light rays into signals that are sent through the optic nerve to the brain.”
There is no pain if your retina detaches; instead, you may experience all or some of the following symptoms: “Seeing flashing lights all of a sudden. Some people say this is like seeing stars after being hit in the eye,” AAO says. “Noticing many new floaters all at once. These can look like specks, lines or cobwebs in your field of vision. A shadow appearing in your peripheral vision. And a gray curtain covering part of your field of vision.”
Any of these signs is a medical emergency. Call your ophthalmologist or go to the emergency room as quickly as possible. A detached retina can cause you to lose your vision. It’s not something you play the “wait and see” game with. The “see” might become past tense.
Detached retina comes in third behind glaucoma and macular degeneration for threats to your vision. According to Medscape.com, “the annual incidence is approximately one in 10,000 or about 1 in 300 over a lifetime. Other sources suggest that the age-adjusted incidence of idiopathic retinal detachments is approximately 12.5 cases per 100,000 per year, or about 28,000 cases per year in the U.S. Certain groups have higher prevalence than others.”
Who’s at risk? According to Mayo Clinic, anyone can develop a detached retina, but aging tops the list followed by anyone who’s had a retinal detachment in the other eye. People with a family history of a retinal detachment are also at a higher risk.
Also at risk are people who have extreme nearsightedness (myopia); have had eye surgery, such as a cataract removed; previous severe eye injury; previous eye diseases or disorders, including retinoschisis, uveitis or thinning of the peripheral retina (lattice degeneration).
Mayo tells us that rhegmatogenous (reg-ma-TODGE-uh-nus, in case you want to pronounce it) detachments are the most common. “They are caused by a hole or tear in the retina that allows fluid to pass through and collect underneath the retina. This fluid builds up and causes the retina to pull away from underlying tissues. The areas where the retina detaches lose their blood supply and stop working, causing you to lose vision,”
What happens is the vitreous changes consistency and either shrinks or becomes more liquid. “As the vitreous separates or peels off the retina, it may tug on the retina with enough force to create a retinal tear. Left untreated, the liquid vitreous can pass through the tear into the space behind the retina, causing the retina to become detached,” Mayo says.
People with poorly controlled diabetes may experience a tractional detachment. This happens when scar tissue grows on the retina’s surface resulting in the retina pulling away from the back of the eye.
Those who have age-related macular degeneration or had an injury to their eye, tumors or inflammatory disorders may develop exudative detachment. This is different in that fluid accumulates beneath the retina, but there aren’t any holes or tears.
Treatment almost always involves surgery. Your ophthalmologist will explain the various options that will work best for you and your eyesight. Bonner General Health Ophthalmology Clinic can be reached at 208-265-1011.
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at [email protected]