Retinal detachment is a serious condition in which the so-called neuroretina is detached from the underlying epithelium due to a hole or tear. The light receptors can be damaged in just a few hours or days.

Normal eye     Retinal tear     Retinal detachment

Symptoms:

An early sign of a detachment is the perception of lights, black spots or smoke. Later, patients perceive in the periphery a gray or dark shadow; without treatment can occur total blindness within a few days.

Diagnosis:

Diagnosis can only be made by the ophthalmologist. The examination shall be performed following dilatation of the pupil. The patient is forbidden to drive for at least 6 hours!

Therapy:

If the retina is detached, immediate surgery must be performed. The purpose of the operation is to close the hole or tear either externally by suturing a silicone graft into the sclera or internally after removal of the vitreous body (vitrectomy). In the latter case, the space occupied by the vitreous is replaced by gas (SF6 or C3F8) which is absorbed within 10 to 40 days or by silicone oil which is almost always surgically removed three to six months after the initial operation.

Prognosis:

Retinal detachment surgery, although it is a difficult operation, has a very high rate of anatomical success, above 85%. If the centre of the retina, the macula, is detached the prognosis for vision is limited.

Can it be treated with LASER?

No. In many cases, however, detachment can be avoided if the hole or tear is treated in a timely manner with the so-called Argon-Laser.

Preoperative instructions

• Do not eat or drink anything after midnight, the day before surgery.
• Before surgery you will need to undergo blood test and electrocardiogram.
• If you are taking anticoagulant medicines, contact your doctor. You will need to cut them 3-7 days before surgery, after consultation with your doctor.
• Diabetic patients should not take insulin on the morning of surgery. You should take the insulin with you to the clinic (unless otherwise instructed).
• Diabetic patients should not take insulin on the morning of surgery. You should take the insulin with you to the clinic (unless otherwise instructed).

Postoperative instructions:

After the operation, the eye remains closed for less than 24 hours.

After the operation, you don’t have to be hospitalized. It is possible that you have some mild discomforts in the eye (itching ,feeling of foreign body).

A check is necessary the day after the surgery.

Contact your doctor if you experience any of the following symptoms:

increased temperature

severe swelling of the lids with or without pain

severe pain in the eye or head that does not decrease with painkillers.

sudden decrease in vision

The eye is usually irritated for a few days.

Do not rub your eye.

if retinal detachment has been treated by injecting gas into the eye globe, avoid going to high altitude (more than 400 meters above sea level) and flying in any case!

Swimming for at least 3 weeks, intensive exercise and eye makeup are prohibited.

Temporarily poor vision. If the eye contains gas, vision is much impaired – such as when we are in the water.

Depth of field perception (three-dimensional vision) is significantly affected, so a lot of attention is required to walking. There may be problems with activities such as taking your eye drops or picking up objects.

At 2 to 4 weeks after the operation, central vision improves significantly; as this happens, the space occupied by the gas fills with the natural fluid produced by the eye; it takes at least 2 weeks for the gas to be fully absorbed.

Mild pain or discomfort. The eye is slightly irritated after the surgery.

Contact the doctor immediately if:

• There is severe pain
• The vision worsens

At the end of the operation usually the eye is covered only for the same day with a bandage. The next day the bandage is removed in the clinic.

Medication: instillation of antibiotic and steroid eye drops.

Recheck: initially one day, one week and three weeks after surgery.

Avoidance is required in the first few weeks:

• eye rubbing
• swimming
• intensive exercise
• eye makeup

Driving: driving is prohibited until vision is regained

Work: if it is an office job, it is sometimes allowed from the first post-operative day

Possible complications: new retinal detachment, infection, bleeding, cataracts, increased intraocular pressure.

A cataract surgery will almost certainly take place after months if you have not already undergone cataract surgery.

Retinal redetachment occurs in 10 to 15 out of 100 people and requires new surgical treatment.

Bleeding is very rare, as is infection, which occurs in about 1 in 5000 patients.

Success rate of the operation: 85-90%.

Probability of retinal detachment in the other eye: 10% in the decade.