What is retinal detachment?

The retina is a thin layer of nerve cells that lines the inside of the eye. It is sensitive to light (like the film in a camera) and you need it to be able to see properly. Your retina is detached because it has one or more holes in it and so is allowing fluid to pass underneath it. This fluid causes the retina to become separated from the supporting and nourishing tissues underneath it. Small blood vessels may also be bleeding into the vitreous (the jelly substance in the centre of the eye), which may cause further clouding of your vision.

Retinal detachments can be caused by a variety of reasons. They can develop at any time, sometimes without any warning or explanation. Patients who suffer a direct blow to the eye, are short sighted or have previously had cataract surgery are at higher risk. Some types of retinal detachments can run in families, but these are rare.

Video: Mr. Mokashi explains the function of the retina

The Treatment

There are many types of surgery. We can seal retinal holes by applying 'splints' on the wall of the eye. These splints are made of sponge or solid silicone material. We put them under the skin of the eye and they usually stay there permanently. Other people will not usually notice them.

In some cases, the jelly-like substance called the vitreous is responsible for the retina becoming detached. As part of your surgery, we remove this jelly during an operation called vitrectomy. During this operation, we make tiny cuts in the eye and remove the vitreous. We then put a gas or silicone oil bubble in the eye. This acts as a 'splint' to hold the retina in position to help it to heal. If we used a gas bubble, your normal body fluids will replace it naturally over time. If we use silicone oil, we may need to remove this during another small operation several months after your first operation.

We usually put small stitches in the eye. At the end of the operation, we may put a pad or shield over your eye to protect it.

After the Operation

If you have discomfort, we suggest that you take a pain reliever such as Paracetamol every four to six hours (but not aspirin as this can cause bleeding). It is normal to feel itching, sticky eyelids and mild discomfort for a while after retinal detachment surgery. It is common for some fluid to leak from your eye. Occasionally, the area surrounding the eyes can become slightly bruised. Any discomfort should ease after one or two days. In most cases, your eye will take about two to six weeks to heal.

Try to rest while your eye is healing. We will give you eye drops to reduce any inflammation, to rest the eye and to prevent infection. We will explain how and when you should use them. Please don't rub your eye.

If you experience a loss of vision, substantial pain or sudden increased redness of the eye post surgery, then please get in contact with us urgently as you may require examination and possible emergency treatment.

Posturing

If we put a gas or silicone bubble in the eye, we will usually ask you to keep your head and body in a particular position. This is called 'posturing' and aims to provide support to seal the holes in your retina. The bubble floats inside the eye cavity and we will usually ask you to hold your head in a position, so that the bubble lies against the holes. This is an important part of the treatment and the position in which you hold your head will depend on where the holes are in your retina. We will usually ask you to keep your head perfectly still for long periods of time. We may also advise you to sleep in a particular position at night. By following our instructions, you will give your retina the best chance to be successfully treated.

Caution

If you have a gas bubble in your eye, you must not travel by air as rapid assent to high altitudes might cause dangerous rise in pressure inside your eye. Similarly, should you need general anaesthesia for any other surgical treatment, you should inform the doctors that you have a gas bubble inside your eye. This is because the gas used by the anaesthetists to put you to sleep could also cause a rise in pressure.

The Benefits of Retinal Detachment Surgery

The most obvious benefits are preventing you from going blind and helping you to see more clearly. You have already lost some sight because of the detached retina. If the surgery is successful, it will usually bring back some, but not all of your sight.

The Risks of Retinal Detachment Surgery

There is a small risk of complications, either during or after the operation. Complications are not common and in most cases, we can treat them effectively. Very rarely some complications can result in blindness. Possible complications during the and after the operation:

  • Bleeding inside the eye
  • The surgery could produce more holes in the retina
  • Bruising of the eye or eyelids
  • Inflammation inside the eye
  • Double vision
  • Infection in the eye- endophthalmitis. This is very rare but can lead to serious loss of sight.
  • High pressure inside the eye
  • Cataract
  • Allergy to the medication used

Further Surgery

Retinal detachment surgery is not always successful. Every patient is different detached and some retinas are more complicated to treat than others. Some patients may need more than one operation. Your surgeon will talk to you about the chances of success with the operation you are about to have.

Expectations After Surgery

After surgery, it usually takes some weeks for your vision to recover. If we use a bubble, your vision will be very blurred immediately after surgery. This is normal and you should not be alarmed by it. Once the retina is attached, your sight will continue to improve slowly over several months. You may be given sight tests to see if glasses would help you see.

Your final vision will depend on the nature of your original detached retina. If we diagnose and treat it quickly and successfully, most of your vision will be restored. If when we diagnose a detached retina, the eye already has poor vision, we may not be able to restore some of your sight. You may not recognise faces or be able to read number plates, for example. Your peripheral vision will usually be preserved. This allows you to see people and objects approaching you from the sides. This peripheral vision is very important for day-to-day activities such as going out and climbing stairs.

What are the costs?

 Initial no obligation consultation, including full diagnostics from £200

Retinal Detachment Surgery is £5,500 per eye

2 Free post-operative check-up appointments

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Interest free finance over 12 months available - subject to status