retina surgery

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What is the Retina?

The retina is the lining of the back of the eye, which contains the receptors for vision. It is in fact specialised brain tissue evolved to receive light energy and convert this into electrical signals to communicate to the brain. It is very delicate and therefore a number of things can affect its function.

What is a retinal detachment?

If a hole appears in the retina it will detach rather like wallpaper peeling off a wall. The retina cannot work when it is detached.

Are there symptoms which warn of retinal detachment?

Flashes and Floaters

Many people experience floaters in their vision from small specks of tissue in their vitreous (the gel of the eye). Individuals however who experience recent onset of floaters especially in the over forty age group may be experiencing a separation of the vitreous from the back of the eye (posterior vitreous detachment or PVD). Flashes of light in the periphery of the vision may accompany the floater or floaters. If either flashes or floaters occur there is a chance that the retina has developed a tear during the separation of the vitreous. Such a tear requires immediate attention in case a retinal detachment occurs. For this reason it is important that anyone with sudden onset floaters and flashes has a thorough examination of their retina as soon as possible by a retinal specialist. If a tear is found, before it proceeds to retinal detachment, the retina can be treated by laser or freeze treatment as an outpatient and more extensive surgery avoided.

One patient's drawing of his floaters from vitreous separation.

What can be done?

The only way to repair the retina is by having an operation to find the hole or holes in the retina and seal them for example with cryotherapy as shown below.

cryotherapy cryotherapy2 plombage
Sometimes we can seal a hole by sewing a piece of plombage_on_muscle plastic onto the outside of the eye (left picture) creating a dent in the eye ball which will close the hole inside (right picture).

gas_in_eye Alternatively we can go inside the eye and by removing the jelly in the eye (the vitreous) we can insert a bubble of gas to support the retina. The bubble will float inside the eye and close the hole. If we use gas the patient may need to position their head to make it work.

Following this operation there is a chance that a cataract will develop in the next few years.
The patient must not travel by aeroplane whilst they have a gas bubble in the eye.

Sometimes silicone oil is inserted into the eye instead of gas. Silicone oil can cause glaucoma or cataract and often another operation is required to remove the oil from the eye.
The chance of success depends upon how bad the retinal detachment is. Some patients will require more than one operation to repair the retina. Improvement in the vision occurs over weeks but can take 2-6 months to reach full recovery.

Disclaimer. The information provided in the Retina Surgery web site is not a substitute for professional medical care by a qualified doctor or other health care professional. Always check with your doctor if you have concerns about your condition or treatment. The authors of this web site and St Thomas’ hospital are not responsible or liable, directly or indirectly, for any form of damages whatsoever resulting from the information contained in or implied by the information on the site. (Information for Patients only provides a guide. It is important that you consult your ophthalmologist if you are experiencing problems with your eyes.) The text and images are the copyright of Tom H Williamson.