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.
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