Favoring factors:
History of surgery on cataract,
Eye trauma,
Sometimes without any particular cause or contributing factors.
Mechanism
Most retinal detachments begin with a tear in the retina allowing vitreous fluid to penetrate under the retina, detaching the retina. These tears are often the result of normal aging of the eye, with the vitreous detaching from the retina, and are, most of the time, unimportant. These vitreous detachments are particularly common in elderly myopic people.
Symptoms :
They are variable, sometimes very discreet, sometimes very alarming.
They include phosphenes, flashes, floating flies, reduction of the visual field, sudden drop in acuity.
Diagnostic :
Faced with these symptoms, it is advisable to consult an Ophthalmologist quickly because only a thorough examination of the back of the eye and the retinal periphery will allow us to distinguish a posterior vitreous detachment (perfectly benign) from a retinal tear or detachment which requires urgent treatment.
Treatment :
In the event of a tear, laser photocoagulation around the tear can create a barrier and thus prevent future detachment.
If the detachment is established, the treatment is more complex, of the surgical type, the final result being inconsistent, especially if the macula has been affected and the repair has been late.
There are three types of surgery:
Directed eye banding allows the reattachment of the retina by external compression of the eyeball. This technique does not require opening the eye. It is an effective technique in more than three-quarters of cases. The most common complication remains recurrence of the detachment.
Vitrectomy consists, after opening the eye, of removing a part of the vitreous which tends, by its retraction, to pull on the edges of the tear. The extracted vitreous is replaced by a resorbable gas. Healing is directed by positioning the head during the few hours following the intervention.
The outcome of the intervention is generally satisfactory.
Pneumatic retinopexy involves injecting a gas or gel into the eye to allow the retina to be reattached, which must be guided by correct head orientation.
It is a simple technique with few side effects. However, it is not suitable for large detachments.
It can be followed or combined with the other two techniques in the event of insufficient results.
It is also important in the case of myopia to have the ophthalmologist perform preventative examinations of the back of the eye and the retinal periphery in order to detect early lesions (holes, retinal tears) which can be easily treated by retinal photocoagulation, thus avoiding a later detachment with a more severe prognosis.
