IS YOUR RETINA AT RISK?
By David Mallory, M.D.

    Retinal detachment occurs spontaneously in the average population in one out of every ten thousand persons every year. However, certain people have a much higher risk. Autopsy studies have shown that more than three percent of people have full thickness tears in their retina , and that 11 percent have a degeneration of the retina called "lattice" which can progress to retinal tears and detachment. If not treated early, retinal detachment can lead to loss of vision and even total blindness.

    The retina is a thin transparent membrane of nervous tissue that lines the inside of the eye much in the same way wallpaper covers the walls of a room. The retina is the actual "seeing" part of the eye. Any tear or hole in the retina can cause the fluid inside the eye to percolate behind the retina causing it to come off the back of the eye and "detach."

    People who are very near-sighted, or myopic, have a longer eye with a stretched retina, and they are more likely to develop retinal detachment. People who have had cataract surgery are at an increased risk for retinal detachment, although the newer methods of surgery have cut this risk almost in half. A blow to the eye can cause a retinal detachment. Boxers like Sugar Ray Leonard are especially prone to retinal detachment.

    Middle-aged or older individuals are more at risk of retinal detachment as even normal aging can cause the retina to thin and develop holes. The jelly-like vitreous that fills the inside of the eye normally shrinks and becomes more liquid with time. If the vitreous shrinks enough, it tugs on the retina and can cause a retinal tear.

    The primary symptoms of a tear in a retina are the sudden onset of a shower of spots or floaters preceded by flashes of light. The retinal tear may then progress to an actual detachment, which is like a curtain covering part of your vision.

    Floaters by themselves are common and just a part of the normal aging process. They are not usually significant unless there is a sudden change, especially if accompanied by light flashes.
If a tear in the retina can be detected before much fluid has seeped under it, the retina can be sealed with either a laser or freezing technique in a simple office procedure resulting in no loss of vision.

    If a detachment has already occurred, and the person's vision is already partially or completely blocked out, an actual in-hospital operation must be done. Ninety percent of retinas can be re-attached with modern surgical techniques. The degree of return of vision, however, depends on how much of retina has detached and for how long.

    Early detection of a retinal detachment can make the difference as to whether good vision returns, and may even make the difference as to whether the retina can be successfully re-attached.

David Mallory, M.D. is a cataract, intraocular lens and laser surgery specialist in practice at the Southwest Eye Clinic.