A professional may use the following tests, instruments and procedures to diagnose retinal detachment:
Both eyes will likely be examined even if there are symptoms in just one eye. If a tear is not identified during the visit, the professional may require a follow up within a few weeks to confirm that the eye has not developed a delayed tear as a result of the same vitreous separation. If new symptoms occur, it is important to return to the professional right away.
Surgery is almost always used to repair a retinal tear, hole or detachment. Various techniques are available. Patients are advised to ask the ophthalmologist about the risks and benefits of their treatment options. The proper procedure or combination of procedures will be determined based on patient consultation.
When a retinal tear or hole has not yet progressed to detachment, the eye surgeon may suggest one of the following procedures to prevent retinal detachment and preserve vision.
Both of these procedures are done on an outpatient basis. After the procedure, patients are likely to be advised to avoid activities that might jar the eyes — such as running — for a period of about two weeks.
If the retina has detached, surgery will be needed to repair it, preferably within days of a diagnosis. The type of surgery recommended will depend on several factors, including the severity of the detachment.
Injecting air or gas into the eye. In this procedure, called pneumatic retinopexy (RET-ih-no-pek-see), the surgeon injects a bubble of air or gas into the center part of the eye (the vitreous cavity). If positioned properly, the bubble pushes the area of the retina containing the hole or holes against the wall of the eye, stopping the flow of fluid into the space behind the retina. Cryopexy is also used during the procedure to repair the retinal break.
Fluid that had collected under the retina is absorbed by itself, and the retina can then adhere to the wall of the eye. Patients may need to hold their head in a certain position for up to several days to keep the bubble in the proper position. The bubble eventually will reabsorb on its own.
Indenting the surface of the eye. This procedure, called scleral (SKLAIR-ul) buckling, involves the surgeon sewing (suturing) a piece of silicone material to the white of the eye (sclera) over the affected area. This procedure indents the wall of the eye and relieves some of the force caused by the vitreous tugging on the retina.
If there are multiple tears or holes or an extensive detachment, the surgeon may create a scleral buckle that encircles the entire eye like a belt. The buckle is placed in a way that doesn’t block the patient’s vision, and it usually remains in place permanently.
Draining and replacing the fluid in the eye. In this procedure, called vitrectomy (vih-TREK-tuh-me), the surgeon removes the vitreous along with any tissue that is tugging on the retina. Air, gas or silicone oil is then injected into the vitreous space to help flatten the retina.
Eventually the air, gas or liquid will be absorbed, and the vitreous space will refill with body fluid. If silicone oil was used, it may be surgically removed months later.
Vitrectomy may be combined with a scleral buckling procedure.
After surgery, patients can expect that their vision may take several months to improve. A second surgery may be required for successful treatment. It is possible that some people will never recover all of their lost vision.
