The Retina

The retina is a complex layer of tissue that lies at the back of your eye. It contains millions of nerve cells that convert light coming into the eye into nerve signals. These nerve signals are then sent via the optic nerve to the brain, effectively allowing the brain to “see”. Without a constant supply of blood, the nerve signals begin to die, which can lead to a permanent loss of vision.

Retinal detachment occurs when the thin lining at the back of your eye called the retina begins to pull away from the blood vessels that supply it with oxygen and nutrients. Without prompt treatment, it will lead to blindness in the affected eye.

Warning Signs

• The sudden appearance of floaters – dark spots that float in your field of vision
• Sudden short flashes of light in one eye
• Blurred or distorted vision

Causes

Retinal detachment is most often the result of the retina becoming thinner and more brittle with age and pulling away from the underlying blood vessels. It can also be caused by a direct injury to the eye, but this is less common.

Diagnosis

If you suspects a diagnosis of retinal detachment, it is likely you will be referred to an eye specialist (ophthalmologist), usually on the same day. The ophthalmologist will study the back of your eye with an ophthalmoscope (a magnifying glass connected to a light) and a slit lamp (a microscope that magnifies the eye while you rest your head on a chin rest). If there is a poor view of the retina, an ultrasound scan may also be used.

Treatment

The quicker retinal detachment is treated, the less risk there is of permanently losing some or all of your vision in the affected eye.

Most detached retinas can be successfully reattached with surgery. There are a number of different types of surgery available, depending on the individual.

It can take months to fully recover from surgery on your eye. During this period your vision may be reduced, which means you may not be able to do some of your usual activities, such as driving or flying. Unfortunately, some people’s eyesight does not fully return after surgery and they have permanently reduced peripheral (side) or central vision. This can happen even if the retina is reattached successfully. The risk of this is higher the longer the detachment was left untreated.

As retinal detachment is associated with ageing, most cases affect older adults aged between 50 and 75. Retinal detachment caused by an injury can affect people of any age, including children.

Ophthalmic Lasers

Ophthalmic lasers are used as diagnostic as well as therapeutic modalities in patients with retinal diseases. Recent advances in laser technology have allowed more convenient selection of wavelength and a wide variety of delivery systems is available to deliver the laser energy to the retina. In addition, newer lasers that disrupt and cut tissue will become available for use in patients with retinal diseases. The use of imaging lasers and lasers in combination with dyes selectively to enhance their effects have become useful in diagnosis and understanding of pathophysiology of diseases. These lasers will also be therapeutically useful. This manuscript delineates the new types of diagnostic and therapeutic lasers, new imaging dyes and techniques as they apply to retinal diseases as well as the principles of laser-tissue interaction as applied to the retina. This allows the ophthalmologist who treats patients with retinal diseases to make more intelligent decisions regarding the use and acquisition of laser systems.