The patient’s vision is recorded and the eye is examined using a slit lamp and then indirect ophthalmoscopy and using special lenses with which the Ophthalmologist can see the retina, assess the degree of detachment and identify the location of the retinal tears. This is caused an ocular fundus examination.
In order to check the retina the Ophthalmologist will put drops in the eyes which will dilate the pupils allowing a wide retinal view but also has a side-effect of blurring the vision for a few hours. Therefore all patients should attend with a companion as their vision will be blurred at the end of the consultation.
Depending on the specific findings the Ophthalmologist will advise whether merely observation is appropriate if there is a posterior vitreous detachment alone or whether laser surgery or other more invasive surgery is required for a retinal tear or detachment.
The specific treatment that the Ophthalmologist decides for the retinal detachment depends on the size and type, but the vast majority of patients who have an actual retinal detachment require surgery in order to flatten the retina.
Before the retinal starts detaching the first step in the development of a retinal detachment is a retinal tear which can cause floaters and flashes but does not cause the shadow. If the Ophthalmologist can only see a retinal tear then it may be suitable to treat that with laser treatment in the clinic. Some very small and special cases of retinal detachment can also be treated with laser in order to surround the edge of the small detached area and stop fluid from leaking further underneath the retina.
However if there is a proper retinal detachment with significant fluid beneath the retina, then an operation usually inside the eye involving Vitrectomy is needed to flatten the retina and in order to do intraocular laser of the retinal tear. This surgery will require a more specialist opinion and treatment from an Ophthalmologist especially trained in retinal detachment surgery known as Vitreoretinal Surgery.
1. There is a family history of retinal detachment, am I likely to get one?
Retinal detachment does run in families particularly associated with myopia and therefore there is a chance that you may get a retinal detachment. Should you have any of the tell-tale symptoms of an early retinal detachment such as floaters, flashes or a shadow developing across the vision then you should seek an urgent opinion and examination from an Ophthalmologist.
2. I have had a retinal detachment in one eye, what is the chance of getting the same in the other eye?
If you have already had a retinal detachment in one eye there is a higher than normal chance of getting a retinal detachment in the other eye.
3. Am I likely to go blind from a retinal detachment?
If the retinal detachment has not involved the macular then it is very unlikely that you will go blind. If the retinal detachment has crossed over the macular which is the most sensitive part of the central vision counting for fine detail and colour, then even if the retinal detachment is successfully surgically flattened then there may be some residual distortion of vision.
A small number of patients have more complicated retinal detachment in which there is proliferative fibrosis preventing successful flattening of the retina despite several operations. In that small number of patients an even smaller number may lose their vision entirely.