Retinal Detachment (cont.)
Andrew A. Dahl, MD, FACS
Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Retinal detachment facts
- What is the retina?
- What is a retinal detachment?
- What are retinal detachment symptoms and signs?
- What are retinal detachment causes and risk factors?
- Which diseases of the eyes predispose to the development of a retinal detachment?
- How does cataract surgery lead to a retinal detachment?
- What other factors are associated with a retinal detachment?
- Why is it mandatory to treat a retinal detachment?
- What types of doctors treat retinal detachment?
- What is the treatment for retinal detachment?
- What are complications of surgery for a retinal detachment, and what is recovery like after retinal detachment surgery?
- What are the results of surgery for a retinal detachment?
- Find a local Eye Doctor in your town
How does cataract surgery lead to a retinal detachment?
Cataract surgery, especially, if the operation has complications involving the vitreous, increases the risk of a retinal detachment. Cataracts create a cloudiness (opacity) within the lens. In cataract surgery today, the goal is to leave much of the capsule of the natural lens in place. Phacoemulsification, the most common procedure, utilizes a very high speed ultrasonic instrument to break up and suck out the clouded lens material inside the capsule. The new intraocular lens (IOL) is then placed within the capsule. The IOL and intact capsule help to support the vitreous gel which fills the back of the eye. Movement of the vitreous gel is a key factor in retinal detachments because the vitreous movement can place traction on the retina and lead to a hole or tear which can be the start of a detachment. Although cataract surgery does increase the chance of retinal detachment, the risk is low, that is less than 2 % over 20 years; and the benefits of cataract surgery ordinarily far outweigh the risk of retinal detachment.
Approximately 30% of patients undergoing modern cataract surgery develop opacification of the posterior capsule within a few years following cataract surgery. This clouding of the portion of the natural lens that is left in the eye during surgery can be treated with a laser to open the capsule and let light pass through without being subject to the cloudiness. Patients who undergo this procedure, known as YAG posterior capsulotomy, have a greater risk of retinal detachment than patients who have not undergone YAG laser posterior capsulotomy.
What other factors are associated with a retinal detachment?
- Blunt trauma, as from a tennis ball or fist, or a penetrating injury by a sharp object to the eye can lead to a retinal detachment.
- A family history of a detached retina that is non-traumatic in nature seems to indicate a genetic (inherited) tendency for developing retinal detachments.
- In a few patients with a non-traumatic retinal detachment of one eye, a detachment subsequently occurs in the other eye. Accordingly, the second eye of a patient with a retinal detachment must be examined thoroughly and followed closely, both by the patient and the ophthalmologist.
- Diabetes that has been complicated by the development of proliferative diabetic retinopathy can lead to a type of retinal detachment that is caused by pulling on the retina (traction) alone, without a tear. Because of abnormal blood vessels and scar tissue on the retinal surface in some people with diabetic proliferative retinopathy, the retina can be lifted off (detached) from the back of the eye. In addition, the blood vessels may bleed into the vitreous gel. This detachment may involve either the periphery or central area of the retina.
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