By Dr. Anthony Policastro

I was recently at a meeting. Someone there was talking about the issues he had with retinal detachments. The point he made was that we take our vision for granted. However, we sometimes need to pay more attention to it than we do.

The retina is a layer of tissue at the back of the eye that is responsible for vision. Retinal detachment occurs in about 1 in 10,000 people. There are different types.

Sometimes as we age, the retina develops a tear in it. The fluid, that is usually in front of the retina, gets into the tear. It builds up behind the retina and pushes it away. The medical term for this is a rhegmatogenus tear. (Try saying that three times fast). This is the most common type.

The second type is known as tractional. As its name suggest, this one is called by a pulling motion. Scar tissue on the retina can tighten up and pull the retina away from its location.

Diabetes is often the cause of this. High blood sugar levels over a long period of time can damage the blood vessels in the eye. The damaged vessels scar up and pull the retina away from the back of the eye.

The third type is called exudative. In this situation fluid builds up behind the retina (as opposed to collecting there from a tear). This is often due to inflammation behind the retina. It then pushes the retina forward.

Causes of retinal detachment include aging. They include eye injury. They are more frequent after a previous eye surgery. They tend to be more common when there is a family history. They also tend to recur in the same person. They include extreme nearsightedness.

The symptoms of a retinal detachment are important to understand. The best known symptom is seeing what are called floaters. These are flecks, threads or dark squiggly lines that drift across your field of vision. Sometimes these occur under normal conditions but tend to quickly go away. When they persist for more than a few minutes, that should raise a level of concern.

Some people see flashes of light. That is called photopsia. There can be a darkening of vision off to the side. There can be a dark spot covering part of the field of vision.

Getting emergency treatment for the symptoms is important. Untreated retinal detachments can lead to blindness in a matter of a few days.

An eye exam is the most important first step. There are also other confirmatory tests that can be done. There are wide angle images that can be taken of the eye. There are ultrasound tests. There is even what is called an optical coherence tomography machine that can be used.

An emergency room visit is indicated if there is pain. It is indicated for signs of eye infection. It is indicated if there is eye drainage. It is indicated if vision loss starts to occur.

Treatment depends on the type of detachment. If it is due to a tear, the tear can be closed by laser heat. Or it can be closed by freezing. They can close it by blocking it with a drop. The fluid collected behind the tear will ultimately be reabsorbed by the body after the tear is closed.

There are also surgical techniques that can be used. They can place a band or sponge around the eye to hold the retina in place. There is also a surgical procedure to remove some of the fluid before it continues to collect behind the tear.

The ultimate outcome depends on a variety of factors. These include vision before the incident. They include how extensive the detachment was.

Our vision is important. It is one of those things that symptoms should prompt a urgent visit to have checked. Someone at the meeting was wondering how I come up with topics for my articles. Now they know.