Dr Petros Aristodemou FRCOphth, Consultant Eye Surgeon

Retinal Detachment

The commonest type of retinal detachment is related to tears caused by a posterior vitreous detachment. Symptoms of a retinal detachment include a dark shadow, which typically starts at the edge of the vision and expands to eventually cover the central vision, within hours or days. Vision can be preserved if an operation is carried out before the detachment extends to affect the central retina, the macula. If the macula detaches, surgery within a few days can maximise the quality of vision restored. If the retinal detachment is very long standing, any vision gained tends to be limited.

Special subtypes of retinal detachment are:

1) Retinal Detachment arising from retinal breaks secondary to a posterior vitreous detachment (most common subtype, 1:10 000 per year). In one in 10 patients with retinal detachment, the other eye may become affected.

2) Retinal Detachment arising from pre existing holes in the retina and no posterior vitreous detachment (most common in young patients)

3) Retinal detachment arising from a tear at the edge of the retina,aka Dialysis. This may be due to previous eye injury.

4) Retinal detachment due to a Giant Retinal Tear. This condition is rare (1:1 000 000 per year) and can be associated with a family history (e.g Stickler's syndrome) , injury or high shortightedness. Patients are usually younger, in their 30s or 40s.

Any type of retinal detachment may be affected by scarring membranes on the surface and/or scarring bands under the retina (Proliferative Vitreoretinopathy - PVR). This is managed at the time of surgery by peeling significant membranes and / or removing the bands. The presence of PVR reduces the success rate of surgery as these membranes may reform due to the scarring mechanisms of the body. Despite a number of clinical trials so far, no method has been proven to reduce the incidence of PVR recurrence.