Dr. Deependra V. Singh ( Medical Director- Retina Services)
Mrs. Sangeeta Mittal (Name Changed), a 54-year-old female was puzzled by strange sparking going on in her left eye. She started observing lightning-like sensation that was more prominent in dark and would not disappear even after washing or rubbing her eyes. Sensing trouble, she consulted her family physician who advised her immediate retina examination. At Retina Clinic, Eye-Q Superspecialty, detailed retina examination revealed that she was suffering from Posterior Vitreous Detachment (PVD) and a retinal tear. She was explained the process of PVD and risks associated with a retinal tear. The timely Laser Photocoagulation saved her eye from a potentially blinding problem called retinal detachment.
“Not all patients are alert and lucky like Mrs. Sangeeta, many would ignore and present with retinal detachment”- says Dr. Deependra V Singh, Director Retina Services Eye-Q India Super Specialty Eye Hospitals. Symptoms of PVD include seeing flashes and Floaters or black spots and up to 15% of these patients with PVD can have “torn retina” (retinal tears) – adds Dr. Singh.
What is PVD?
A clear jelly —the vitreous or ‘vitreous jelly’—fills the middle of the eye. The vitreous lies against the retina in the normal eye. It is transparent like glass, so light passes through it to reach the retina. The retina is the film that lines the back wall of the eye.
As you get older the vitreous collapses and may shrink away from the retina. This may happen earlier if you are short-sighted or have injured your eye. Sometimes this shrinking process may happen rather suddenly and is over in just a few days. This process is called a posterior vitreous detachment.
The shrinkage or PVD essentially occurs due to liquefying of vitreous, a natural process, and is usually harmless. The PVD can occur in 3 ways;
The shrinking may occur quietly without you being able to notice it or it may pull or shake the retina resulting in flashes that subside within a couple of weeks or the layer of vitreous may separate completely and form a ring or web-like a floater in your vision that may take months to disappear.
Less commonly, PVD will result in the formation of retinal tear or hole that can lead to retinal detachment.
So, do not ignore flashes, and seek for Retinal examination. If the doctor checks your eye and all is well, the floaters and flashes subside. However, you usually need a further examination if you suddenly develop a lot more flashes or floaters (this could be a small tear) or a shutter or curtain of blurred vision drifting across your eye, sometimes from below. To check for this, cover one eye at a time for a few seconds every day. If the eye you have not covered sees well in all directions, all is well.
What is Retinal Detachment?
Known as a medical emergency, Retinal Detachment is the separation of the retinal tissue (neural layer) from the layer of blood vessels (that provide it nutrients and oxygen). When the cells are deprived of oxygen, they are unable to compose a clear picture. While the initial detachment could be restricted, if left untreated for a long time, it can cause blindness in the affected eye.
What causes retinal detachment?
- PVD causes a tear in the retina and allows the fluid or water of the eye to seep under it which detaches the retina from its supporting layer.
- Myopia or better known as short-sightedness is a very strong risk factor for RD. Up to 10% of myopic eyes have retinal thinning and holes in the periphery that can lead to RD. The RD in myopia can occur at very young age also.
- Retinal detachments are also caused by injury to the head or eye.
- Diabetes and Hypertension can also lead to Retinal Detachment
How do we treat retinal detachment?
- Most RDs are managed with a Sutureless high-speed Vitrectomy technique, where 3 holes are created in the white portion of the eye to reattach the retina. After Re-attaching retina, Surgeon fixes it with laser and supports it by filling Gas or Silicone Oil in the eye.
- Fresh Cases require urgent attention. Early Surgery is known to give better results
Not Ignoring the Symptoms of Retinal Diseases, especially Flashes/Lightening is the most effective preventive step against this serious disease.