Retinal Tears & Detachment

Detached and Torn Retina

A retinal detachment is a very serious problem that usually causes blindness unless treated. The appearance of flashing lights, floating objects, or a gray curtain moving across the field of vision are all indications of a retinal detachment. If any of these occur, see Dr. Haas right away.

As one gets older, the vitreous (the clear, gel-like substance that fills the inside of the eye) tends to shrink slightly and take on a more watery consistency. Sometimes as the vitreous shrinks, it exerts enough force on the retina to make it tear.

Retinal tears can lead to a retinal detachment. Fluid vitreous, passing through the tear, lifts the retina off the back of the eye like wallpaper peeling off a wall. Laser surgery or cryotherapy (freezing) are often used to seal retinal tears and prevent detachment.  These are essentially spot-welds of the retina to seal off the tear.

If the retina is detached, it must be reattached before sealing the retinal tear. There are three ways to repair retinal detachments. Pneumatic retinopexy involves injecting a special gas bubble into the eye that pushes on the retina to seal the tear. The scleral buckle procedure requires the fluid to be drained from under the retina before a flexible piece of silicone is sewn on the outer eye wall to give support to the tear while it heals. Vitrectomy surgery removes the vitreous gel from the eye, replacing it with a gas bubble, which is slowly replaced by the body™s fluids.  Sometimes silicone oil is placed in the eye rather than gas for severe detachments in order to keep the retina in place after a vitrectomy.

Retinal Detachment:           

Retinal Detachment Drawings:        

Vitrectomy Surgery

Vitrectomy is a type of eye surgery used to treat disorders of the retina (the light-sensing cells at the back of the eye) and vitreous (the clear gel-like substance inside the eye). It may be used to treat a severe eye injury, diabetic retinopathy, retinal detachments, macular pucker (wrinkling of the retina), and macular holes.

During a vitrectomy operation, the surgeon makes tiny incisions in the sclera (the white part of the eye). Using a microscope to look inside the eye and microsurgical instruments, the surgeon removes the vitreous and repairs the retina through these tiny incisions. Repairs include removing scar tissue or a foreign object if present.

During the procedure, the retina may be treated with a laser to reduce future bleeding or to fix a tear in the retina. An air or gas bubble that slowly disappears on its own may be placed in the eye to help the retina remain in its proper position, or a special fluid that is later removed may be injected into the vitreous cavity.

Recovering from vitrectomy surgery may be uncomfortable, but the procedure often improves or stabilizes vision. Once the blood- or debris-clouded vitreous is removed and replaced with a clear medium (often a saltwater solution), light rays can once again focus on the retina. Vision after surgery depends on how damaged the retina was before surgery.