While a detached retina is extremely distressing, surgeons can reattach the retina. How much vision is retained is dependent on getting prompt care.
What Happens When Your Retina Detaches
The retina is a thin sheet of light-sensitive nerve tissue and blood vessels. It lines the back of the eye. The retina receives images and sends them to the brain. But when this layer is pulled away from its normal position a loss of vision occurs.
Usually there is a hole or tears in the retina prior to the detachment. Then, the retina detaches from the back of the eye like wallpaper peeling. Peripheral retinal detachments occur around the edges of the eye and tend to heal more quickly. If the macula, or central retina, is involved it’s slower to heal. A complete detachment is also possible and takes the longest to heal.
Why Do I Need a Detached Retina Repair?
If your retina has become detached, then a repair is the only way to restore your vision and prevent it from getting worse.
The good news is that if your vision was good prior to this, your odds of having your vision restored are much higher. Your chances of full vision restoration are also better if you act quickly to get it repaired.
Detached Retina Repair: What to Expect
Here’s what to expect from your detached retinal repair.
Prior to Procedure
You will have a comprehensive eye exam, likely including some or all of the following:
- Visual acuity — Your vision will be checked using a chart with letters or numbers.
- Slit lamp examination—A special instrument will be used to look at the front of your eye.
- Tonometry — The pressure inside your eye will be measured.
- Dilated retinal exam — Special drops will dilate (enlarge) your pupils. Your retina will then be examined with special lights and lenses.
- B-scan — A special ultrasound instrument will be used to view the inside of the eye.
- You may also have a general medical exam prior to your surgery.
The Day of Your Procedure
Arrange for a ride to and from the hospital.
Do not eat or drink anything for at least 8 hours before the procedure.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before your repair.
You may have either a local or general anesthetic. Local anesthesia will be injected and numbs the area. General anesthesia will make you sleep. The type of anesthesia used will depend on the type of procedure, your age, and other factors.
Description of Procedures
There are several surgical options to repair retinal detachment. The most common are:
A flexible silicone band will be permanently stitched to the outside surface of the back of the eye. This is done underneath the skin of the eye, so you’ll never see the band.
This band acts like a belt. It buckles the area of the detachment or retinal tear to the wall of the eye. This procedure has a high success rate in reattaching the retina. Local or general anesthesia is used.
A gas bubble will be injected into the cavity of the eye. The pressure will force the retina back into position. You will often need to lie in a special position to keep the gas bubble in place. The retina will usually re-attach within several days. A laser (heat) or cryotherapy (cold) will help seal the retina back into place.
This method generally has a high success rate. It is not suitable for all types of detachment. Local anesthesia is sometimes used. The main benefit of this procedure is that it can be done in the office with anesthetic eye drops.
Vitrectomy (Removal of the Vitreous Humor)
This method may be needed for more complicated retinal detachments. It may also be used if the procedures described above are not successful. The fluid in the eye as well as any scar tissue will be removed. The fluid will then be replaced with a gas bubble or specialized oil known as silicone oil. The bubble or oil will help push the retina back against the eye wall. Retinal breaks will then be sealed with a laser or cryotherapy. A scleral buckle procedure is often done at the same time. Local or general anesthesia is used.
Retina Reattachment Frequently Asked Questions
Here are some of our patients’ most frequently asked questions about what to expect from their surgery.
How Long Will It Take?
Between 1-4 hours.
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
How Long Will I Need to Stay in the Hospital?
You can usually go home the same day as the surgery.
Are There Possible Complications?
Problems from the Detached Retina Repair are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Redetachment of the retina — Sometimes, the retina detaches again following surgery. More surgery would be needed. In severe cases, this complication may be irreversible.
- Endophthalmitis — A serious infection can occur inside the eye.
- Proliferative vitreoretinopathy — This condition causes progressive contraction and scarring of the retina after a repair. This may require surgery. In severe cases, this complication may be irreversible.
Factors that may increase the risk of complications include:
- Poor general health
- Degree of retinal damage
To keep your eye safe while it heals, your doctor will send you home with a bandage and metal shield. There are some other steps you can take to make sure your recovery goes as smoothly as possible.
Your doctor may instruct you to keep your head in a certain position. You should do this as much as possible, even while eating, sleeping, and bathing. Positional pillows can help make this more comfortable.
Until your doctor says it's okay, you'll need to avoid exposing your eye to running water. This may affect your bathing routine as well as limiting activities like swimming. You'll also need to avoid strenuous activity until you've recovered.
It is important to monitor your recovery. If any of the following occur, call your doctor:
- Any change in vision
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, bleeding, or excessive discharge from your eye
- Any new or worsening symptoms
- If you think you have an emergency, call for medical help right away.