RETINAL DETACHMENT
Retinal detachment is undoubtedly the eye disease which I concern about and want to know about most. As I have mentioned before, this is because I have been a retinal detachment sufferer last year and it brought a lot of unforgettable pain and suffering to me. And so, I really wish to find out what had happened on me, especially its causes, symptoms and possible treatment methods. Below, I will show you what I have found out about this horrible retinal detachment.
What is Retinal Detachment?
Retina is a thin layer of tissue lining the inside of the eyeball which converts light into an electrical message that is sent to our brain through the optic nerve. It is heavily dependent on sufficient blood supply in order to carry out its function properly. But due to certain factors, the retina is separated from its outer layer, leading to disruption of the blood supply. And thus the retina becomes lack of nourishment which can lead to permanent and irreversible damages. The patient soon loses his/her vision gradually or suddenly if the retina is not reattached at once.
How the retina becomes detached? (including its causes)
The vitreous humor is a gel-like substance which fills most of the eye (see Figure 10). It is normally in contact with the retina and in some parts, e.g., around the optic nerve, strongly adherent with it. It has no particular function after our birth. But in some circumstances, mainly aging, shortsightedness or eye injury, the vitreous humor may shrink and contracts. When it does so, it pulls part of the retina with it, causing a tear or hole in the retina. This hole or tear soon allows fluid from the vitreous space to flow between the retina and the back of the eye causing a detachment from the back of the eye.
As time passes, more and more fluid creep behind the retina through the hole or tear causing larger and larger area of retina to be detached. That means more area of the field of sight becomes blurred until the eye completely loses its vision. The detachment process of retina can be resembled by using the sensation of a moving curtain.
Nowadays, the causes leading to retinal detachment is still not clearly known. But it is believed that aging, serious myopia and eye injury are the three main possible causes. In addition, hereditary may be one of the factors leading to retinal detachment too, but it is still under investigation.
Symptoms
1. Flashes and floaters - Black floaters and lightning-like flashes may be noticed.
2. Sudden loss of sight - Bleeding into the eye may occur with a retinal tear and this may cause sudden loss of sight or black streaks before the eye.
3. Gradual loss of sight - Gradual loss of sight may occur with a darkening of part of the field of sight which gradually enlarges until the eye is totally blind.
*FLASHES AND FLOATERS *
As the eye ages or because of other factors, the vitreous humor undergoes change. It gradually becomes more and more watery, thereby losing its gelatinous nature. During this process, it loses its mechanical stability as the hydration of the vitreous humor is uneven, with pools of water occurring in a scattered distribution.
As the vitreous humor moves inside the eye, because of the instability, it can lightly pull on the retina where it is attached, causing the retina to be temporarily stimulated, producing a flash of light. These light flashes are very fleeting, and sometimes of an arc shape. If the pull on the retina is severe, it may actually tear a hole in the retina. It can gradually separate the layers of retina, producing a very serious condition and that is retinal detachment.
On the other hand, the vitreous humor may also deteriorate causing abnormalities within itself which are known as floaters. Occasionally, the vitreous humor pulls so hard on the retina that it can rupture a blood vessel which can create a shower of floaters.
Flashes and floaters are actually the two most important symptoms to the early stage of retinal detachment. So, if you find that there is a sudden onset of flashes and floaters, especially associated with black or gray curtain coming over the field of vision, go to an eye doctor at once.
Detection
An eye specialist can detect a retinal detachment with special optical instruments which allows him to examine the interior of the eyeball as well as the retina.
Treatment
For our retina is very dependent on adequate blood supply, so prolonged separation from nourishment would lower the possibility of complete recovery after treatment for some of the cells of retina may have worn out. As a result, immediate diagnosis is exceptionally important for the recovery of our vision. The following are the few method of treatment today whose main purpose are to seal the retina holes and tears or reattach the retina to prevent the vitreous humor from seeping in and detaching the retina again.
1. Laser or cryopexy - It is used to seal retinal holes or tears. Laser or cryopexy (freezing) is applied around the hole or tear to cause a scar which prevents the leakage of vitreous humor behind the retina. However, this method is only used in the cases when a hole or tear is detected early before retinal detachment has occurred. Once the retina has detached, surgery must be applied instead.
2. Surgery - If detachment has been occurred, surgery must be performed to reattach the retina and seal the hole or tear. There are various methods to reattach the retina which depends on the number, location, nature and severity of the tears or holes and the configuration of the detachment.
3. Indentation - Depressing in of the wall of the eye externally thus pushing it towards the detached retina to reattach it.
4. Pneumoretinopexy - A gas bubble is injected into the eye to seal the retinal hole and the gas pushes the retina against the eye wall thus reattaching the retina.
A PATIENT'S’ EXPERIENCE
------- Leung Pak Keung, Jason (Me)
About two years ago, my Uncle Seven was discovered to get macular degeneration on his right eye and I really cannot believe that I will be a victim of the similar kind of eye disease - retinal detachment. It is because such serious eye disease mainly happen on the old people. Oh, I am only 15 or 16 at that time and the Hong Kong Certificate Examination was ahead of me. Facing such a large surgery in such an early age was really a torture and pain to me. Nervousness flowed through all my body when there were only a few days left before the surgery.........
Clues of detachment and final discovery...................
As a matter fact, I can detect some abnormalities of the vision of my right eye about 6 months before I undergone the unforgettable surgery. These strange signs are actually the symptoms of retinal detachment!
I remember the first time I discovered something wrong with my right eye was the time (Form Five) when I was writing alone at home. I unawares found that the straight lines on the paper all became slightly curved when I looked through my right eye unawares. But I soon forgot about that for it could hardly be detected when using two eyes. Several months later, the lines became more and more distorted and I revealed the condition to my parents. Unfortunately, for the lack of knowledge about optics and eye diseases, they told me that I might get higher myopia and they would take me to prescript a pair of new glasses.
Afterwards, the two most important symptoms of retinal detachment came together one day after coming out from a tunnel, that was, coming out from darkness to brightness. Several arc-shaped flashes suddenly struck at my right eyes which lasted for about 3 seconds each time. And what terrified me most was that my field of vision (right eye) lost half in the upper portion. However, at that time, I wrongly think that it was due to the normal collapse of eye lids because of over-tiredness. But as time passed, this condition have never changed and thus I began to wonder if there might be something wrong with my right eye.
On 20 th August, 1995, my parents decided to take me to an optical shop in order to prescribe a pair of new glasses. When I was having the optician's practice, it was a great surprise to the optician that I could not see even a large central dot with only my right eye. He determined that I must have got a very serious disease with my right eye and advised me to see an eye doctor at once before prescribing new glasses.
Therefore, my parents took me to see one of the most famous eye specialist in Hong Kong, Dr. Ho Chi Ping. With some advanced instruments and the accumulated experience of Dr. Ho, he diagnosed that half of the retina of my right eye has collapsed and many holes have also appeared on the retina of my left eye. He advised seriously that a surgery of reattachment of retina must be undergone immediately, otherwise, the whole retina may collapse. So, I determined to undergo the operation on 4 th September, 1995, but before that my left eye was undergone a laser treatment in order to avoid the vitreous humor from getting into the smal holes and detaching the left retina.
The Operation...............
Since this operation was one of the most complicated in all the eye surgery and the patient must be given general anaesthetic, I had to stop eating about seven hours before the operation. Moreover, all the eyelash of my right eye was cut away to prevent their inconvenience to the doctor during the operation.
The time eventually came and I was lying on a bed inside the quiet operation room. Then the anaesthetist came in and injected something into my body. After a while, I found the face of Dr. Ho was above my head and he said ¢The operation has been very successful¢.I did not know what they had done to me, just as if I have no feeling at all!
Convalescence..............
After the operation, my vision of right eye improved very gradually, but the most important was, the retina has been reattached very tightly and it could hardly be detached again. The doctor told me that my vision can never improved back to normal as the retina had actually detached for a very long time and could not recover back to the normal functioning completely.
Recently, I detected flashes several times again. Does it represent that the early stage of retinal detachment has happened on me again? I do not know and I hope this assumption is false forever.