When it comes to eye health, Retinal Detachment is one of the most critical conditions requiring emergency medical intervention, where even seconds and minutes are of great importance. For patients facing the risk of vision loss, reaching the right physician and a fully equipped center quickly is vital. Ophthalmology Specialist Ayşe Öner and her professional team of experts aim to restore their patients' vision using the most advanced surgical techniques in this medical emergency.
What is Retinal Detachment?
The retina (nerve layer), which covers the back inner wall of our eye like wallpaper, consists of millions of nerve cells that perceive light from the outside and transmit it to the brain via optic nerves. If we think of the eye as a camera, the retina is the film of this camera. Retinal detachment is the condition where this vital nerve layer peels away or is displaced from the underlying nourishing vascular layer (choroid) toward the eye cavity.
When the retina is separated from the layer beneath it, it is deprived of oxygen and nutrient support. This situation rapidly leads to cell death at the cellular level. If the detached tissue is not reattached to its original place with surgical intervention within a short time, cell deaths become permanent, and the disease results in total and irreversible blindness.
What are the Types of Retinal Detachment?
There are three main types of retinal detachment based on the mechanism of the disease's formation:
1. Rhegmatogenous Retinal Detachment
This is the most common type of detachment. The jelly-like fluid with the consistency of egg white that fills the eye, called vitreous, begins to shrink and liquefy due to factors such as aging or high myopia. During this shrinkage, the vitreous pulls on the retina it is attached to and creates a tear or hole in the retina. The fluid inside the eye leaks through this tear, goes under the retina, and detaches the retina from its place, much like wallpaper bubbling off a wall.
2. Tractional Retinal Detachment
Seen more often in patients with advanced-stage diabetic retinopathy, there is no tear in the retina in this type. Abnormal blood vessels and scar tissues (fibrous bands) formed inside the eye attach to the retina, shrink, and physically pull and detach the retina from the layer beneath it.
3. Exudative (Serous) Retinal Detachment
In this type, there is no tear or traction in the retina. It is the elevation of the retina due to fluid accumulation under it caused by severe intraocular inflammation (uveitis), tumors, or non-ocular systemic diseases such as serious hypertension.
Risk Factors: Who is at Risk?
Although retinal detachment can be seen at any age, it usually occurs in individuals over the age of 40. However, people with the following risk factors need to be much more careful:
- High Myopia: Because the eyeball is longer than normal, the retinal layer thins and becomes much more prone to tearing.
- Eye Trauma: Severe blows to the eye, blunt trauma, or penetrating injuries can lead to sudden retinal tearing.
- History of Cataract Surgery: The risk of detachment increases compared to the general population, especially months or years after complicated cataract surgeries.
- Family History: People with a family history of retinal detachment have a genetic predisposition.
- Other Eye Diseases: Intraocular inflammations, retinal thinning (Lattice degeneration), and uncontrolled diabetes.
What are the Symptoms of Retinal Detachment?
The most important characteristic of retinal detachment is that it is completely painless. However, the eye signals the urgency of the situation with very clear visual signs. If you experience any of the following symptoms, you should apply to our clinic without losing time:
- Light Flashes (Photopsia): Seeing lights in the form of lightning strikes or camera flashes, especially in dark environments, even when your eyes are closed. This is the first sign that the vitreous is pulling on the retina.
- Sudden Increase in Floaters: Specks in the form of spider webs, soot, black dots, or flying flies suddenly appearing in your field of vision (indicates small hemorrhages or cell shedding into the vitreous).
- A Curtain Falling Over Vision: A gray or black curtain descending from one corner of the visual field (usually from below or above) toward the center. This indicates the area where the retina is detached and is proof that the situation is very urgent.
How is it Diagnosed?
When our patients apply with complaints, an urgent and comprehensive evaluation is performed by Specialist Dr. Ayşe Öner. The pupils are dilated with drops, and every millimeter of the retina is examined with a fundus examination using special lenses to determine the location of the tear and the size of the detachment. If the retina cannot be seen directly due to intraocular bleeding, the condition of the retina and the level of detachment are definitively diagnosed using Ocular Ultrasonography (B-Scan USG).
Retinal Detachment Treatment Methods
The only treatment for retinal detachment is surgery; it is not possible to heal it with medication or drops. The method of treatment is meticulously planned by Dr. Ayşe Öner based on the type, size, and duration of the detachment.
1. Protective Treatment: Argon Laser Photocoagulation
If a tear has formed in the retina but fluid has not yet leaked to create a detachment (separation), the condition can be treated with laser as an outpatient procedure in a short time. The area around the tear is surrounded with the laser, effectively "spot welding" it, and the separation of the retina is prevented.
2. Vitrectomy Surgery (Pars Plana Vitrectomy)
Today, it is the most frequently used and most advanced microsurgical method in the treatment of retinal detachment. Entering the back of the eye with millimetric, sutureless incisions, the vitreous gel and tractions causing the retinal separation are completely cleaned. The fluid inside the eye is drained, and the retina is reattached using laser. To ensure the retina stays in place, special gases or silicone oil are placed inside the eye at the end of the surgery.
3. Scleral Buckling
A surgical method applied from the outside of the eye, preferred in some specific detachment cases. A silicone band or sponge is sewn to the white part of the eye (sclera) from the outside, corresponding to the area where the tear is located. In this way, the eye wall is indented toward the tear, and the retina is made to attach.
If you suspect or have been diagnosed with retinal detachment, remember that time is your greatest enemy. To protect your vision in reliable hands with the most advanced technology and to regain your health quickly, you can contact our clinic's patient department immediately.
Frequently asked questions
Sudden flashes of light (photopsia), a sudden increase in floaters or black spots (soot), and the sensation of a black curtain or shadow moving from the periphery toward the center of the visual field are the clearest signs of detachment. Retinal detachment is a true ocular emergency. If not treated within hours or days, it results in permanent blindness. In our clinic, these cases are taken into emergency surgery on the same day without delay.
During Vitrectomy surgery, a special expansive gas is filled into the eye to press the detached retina back into place. The pressure difference in airplane cabins causes this intraocular gas to expand suddenly, leading to intraocular pressure rising to blinding levels. Therefore, flying is strictly prohibited until the gas in your eye is completely absorbed (usually 2 to 6 weeks).
We transform this crisis into VIP comfort. Your surgery is performed with zero waiting time by Dr. Ayşe Öner in our JCI-accredited hospital. If gas has been placed and you cannot fly, our assistants organize your stay in luxury hotels so you can comfortably complete the recovery and prone (face-down) positioning process. If preferred, VIP transfer alternatives via land or sea are planned by us so you can return to your country without being restricted by the flight ban.
