Retinal Detachment is the separation of the eye's nerve membrane, responsible for receiving images, from its outer layers, on which it depends to feed and oxygenate the cells that make it up. It is a very important pathology in ophthalmology, as the prognosis is gloomy as it can end in blindness if not properly treated. The success of the surgery is directly related to the location and above all with the time until the doctor intervenes.
It is very important to consult an ophthalmologist as soon as possible or, failing this, to go to a hospital emergency unit. The longer the delay before treatment is carried out, the greater the risk of definitive visual loss.
The retina is a thin membrane that constitutes the innermost part of the eye and is extremely important, as its function is to receive the light stimuli captured by our eyes and to transform light information into nervous information, to be subsequently processed by our brain. The separation of this layer from the wall of the eye leads to the inhibition of the nutritive processes in the affected area, giving rise to cell death. Hence the urgency of treatment in these situations.
Types of Retinal detachment:
There are three types:
- Regmatogen,
- Serous or exudative;
- Traditional
In a rhegmatogenous retinal detachment, the most frequent one, the separation of the affected layers occurs due to the entry of vitreous (the jelly-like part of the eye) due to a tear or a hole in the retina. In this case the result also depends on whether the macula (the central area of the retina where the image that we fix is formed) is involved or not. If it is, it becomes urgent and replacement, as it is an area which is very sensitive to the lack of oxygenation of the main vision cells, the cones. As the retina is fed by the layer underlying it, the choroid, the separation puts the cells in a situation of anoxia (lack of oxygen) and after some time they begin to die. These cells, being nerve cells, do not have the capacity to regenerate. Thus cell loss leads to a significant decrease in their number and consequently the definitive loss of visual acuity.
Once again we reiterate the need for an urgent visit to the ophthalmologist, for the reasons given:
- A serous or exudative retinal detachment, appears by exudation of fluid behind the retina (from the choroid), without any tear separating the layers;
- A traditional retinal detachment occurs due to the traction exerted on the retina by the vitreous, which may originate in a posterior vitreous detachment or in disease situations that cause vitreo-retinal adhesions such as diabetic retinopathy, which is the most frequent case.
In posterior vitreous detachment, the traction on the retina causes a tear or hole, the liquefied vitreous, can pass through the opening and cause the detachment.
In the case of diabetic retinopathy the case is different. Here the traction is due to very strong adhesions created by membranes that form at the vitreoretinal interface (diabetic retinopathy proliferative). The detachment is tent-like and there is no tearing. The surgery in these cases is done by vitrectomy, with peeling of the aforementioned membranes, so that the retina returns to its place.
