The retina of the eye is one of the most important contributors to the process of vision. It works by transmitting light signals to the human brain, which are then transformed into clear images. Retinal detachment is one of the most common diseases affecting the retina and negatively impacting vision. If left untreated, it can eventually lead to vision loss.

However, the treatment methods for retinal detachment vary depending on the stage of the condition. Typically, early-stage treatment involves the use of laser therapy, while late-stage treatment involves vitreous body excision. Therefore, it is crucial to accurately diagnose the patient’s condition before performing retinal detachment surgery.

What is retinal detachment surgery?

The goal of retinal detachment surgery is to repair the damage caused by the vitreous body, which often shrinks and pulls away from the retina, separating it from the eye wall. This can result in either partial or complete retinal detachment.

However, the treatment methods for retinal detachment vary depending on the stage of the condition. Typically, early-stage treatment involves the use of laser therapy, while late-stage treatment involves vitreous body excision.

Therefore, it is crucial to accurately diagnose the patient’s condition before performing retinal detachment surgery.

Diagnosis

There are several methods that aid in diagnosing retinal detachment, including:

  1. Fundus examination, which is conducted by applying dilating eye drops to allow the doctor to clearly visualize the patient’s retina and identify any holes, tears, or detachments.

  2. Ultrasonography, which involves applying a gel or certain liquid to the eyelid while the patient closes both eyes. An ultrasound device, called ultrasonography, is then directed at the eye to examine and detect symptoms related to retinal detachment.

Treatment of Retinal Detachment

The treatment approach in the early stage differs significantly from the later stages. By early stage, we mean the condition where tears and holes begin to appear on the surface of the retina, followed by a partial detachment resulting from the initial leakage of fluids behind the retina.

Retinal detachment surgery can be performed in these two stages using laser therapy. However, in the later stage of retinal detachment, treatment often involves vitreous body excision.

Laser Treatment for Retinal Detachment

Laser therapy is not considered a definitive solution for this problem except in very early cases. It works by sealing small tears and ruptures in the retina. This technique can also be used to secure the retina to the eye wall by creating scars that connect the retinal tissues to the wall.

Vitreous Body Excision Surgery

Vitreous body excision from the eye is the most well-known and effective procedure for treating retinal detachment. This method involves injecting a certain liquid substance such as silicone oil or a specific type of gas into the eye after removing the vitreous body.

The injected substance, whether it is gas or liquid, pushes the retinal tissues towards the eye wall. Over time, the retina reattaches to its natural position, resulting in a significant improvement in vision for the patient.

When Does Vision Improve After Retinal Detachment Surgery?

The duration of vision improvement varies depending on the type of procedure performed during retinal detachment surgery. In cases treated with laser therapy, patients typically start to experience improved vision after several weeks.

For patients who undergo vitreous body excision and gas injection, improvement is usually noticed after approximately 6 weeks following the procedure.

In cases where the vitreous body is removed and silicone oil is injected, patients typically experience improvement within the first three months after the operation.

However, during this period, the vision may not be sufficiently clear or sharp.

Patients may need to undergo another surgical procedure to remove the injected substance after approximately three months from the initial operation.

Dr. Ammar Nassar, a specialist in retinal surgery, advises undergoing retinal detachment surgery as soon as symptoms of the condition appear or when diagnosed during regular eye examinations.

Intravitreal Injections for the Treatment of Retinal Detachment

When discussing retinal detachment or retinal tears, we are referring to one of the most dangerous retinal diseases. It is among the most severe eye conditions and becomes even more critical in individuals with diabetes.

Intravitreal injections are used to treat retinal detachment at certain stages of the disease. This is explained in more detail by Dr. Ammar Nassar.

What is Retinal Detachment?

Before delving into the process of intravitreal injections for the treatment of retinal detachment, it is necessary to understand what retinal detachment or retinal tears are and the nature of this condition.

Retinal detachment occurs when fluid accumulates in a specific location. It is similar to noticing a wall with leaks or seepage, where you can observe its effects on the wall, such as bulging or peeling paint due to fluid accumulation.

Similarly, retinal detachment involves a disease that affects the retina and causes it to detach or leads to the detachment of the macula, resulting from the accumulation of fluids behind or between its layers. This typically occurs due to weakened blood vessels that nourish the retina, allowing the leakage or proliferation of fluid in abnormal areas (known as proliferative retinopathy).

Therefore, retinal detachment, in simple terms, refers to an increase in the thickness or swelling of certain retinal tissues, which weakens these tissues. In this condition, the sensory receptors of the retina, responsible for receiving and transmitting visual signals to the retinal nerve cells, the optic nerve, and the visual cortex in the brain, are affected. This directly impacts the patient’s vision. In some cases, the doctor may resort to intravitreal injections to treat retinal detachment before the condition progresses and leads to retinal fibrosis or detachment, which complicates the treatment methods.

What are the common eye conditions treated with intraocular injections?

  • Age-related macular degeneration
  • Diabetic retinopathy
  • Macular edema (swelling of the macula)
  • Uveitis (inflammation of the uvea)
  • Central retinal vein occlusion

What are the symptoms of retinal detachment?

What makes retinal detachment a serious disease is that it may not present any symptoms in the early stages. Patients may remain unaware and neglect to control their blood sugar levels or undergo regular eye examinations. Many people are unaware that blood vessels in diabetic patients are weak, making the retina vulnerable to this disease. It is crucial for patients with diabetes, especially those who have had the disease for more than five years, to undergo regular eye check-ups to ensure that their retinas are not affected. Dr. Ammar Nassar strongly emphasizes this.

In advanced cases or when treatment is neglected (whether it’s retinal injections or other treatments used for different degrees of detachment), symptoms may include:

  • Difficulty and blurriness of vision, where patients struggle to see details of objects and faces clearly.
  • Appearance of dark spots or floaters in the visual field.
  • Unstable vision.
  • These symptoms can progress to partial loss of visual field.

How are intraocular injections for retinal treatment performed, and what are their advantages?

Intraocular injections for retinal treatment ensure that the medication reaches the retina with a higher concentration within the eye. They provide direct treatment for retinal diseases, especially those affecting the retina. They improve or slow down the deterioration of vision more effectively. Additionally, when antibiotics are injected near the source of infection, they are more efficient.

How are intraocular injections for retinal treatment performed?

Many individuals seek information about the procedure for intraocular injections for retinal treatment. It is a simple procedure performed in an eye clinic that takes approximately 15 to 30 minutes. The steps include:

  • Administering eye drops to dilate the pupil.
  • Disinfecting the eye and eyelids to minimize bacteria.
  • Numbing the eye using anesthetic eye drops to ensure a painless experience.
  • Placing an eyelid speculum to stabilize the eye during the procedure.
  • Injecting the medication using a specialized needle into the eye through the conjunctiva (the white part of the eye).
  • Patients may feel some pressure during and after the injection, but without any pain.

Does the patient need to undergo repeat injections for retinal treatment?

Some individuals wonder about the need for repeat injections in the eye and whether it is necessary or not.

Dr. Ammar Nassar explains that in most cases, patients may require repeat injections. According to certain protocols, patients may need to undergo injections once a month for a period of three months.

The frequency of injections beyond this duration depends on the improvement achieved in the condition, which is determined and monitored through optical coherence tomography (OCT) imaging.

If the condition improves, the swelling disappears, and the blood vessels stop leaking fluid after three injections, for example, there is no need for further injections unless the swelling recurs.

However, it is crucial for the patient to maintain regular follow-up with the doctor to determine the progress of the condition.

Intraocular injections are considered a safe treatment, and there is no problem if they are administered for several years. Some cases may require repeat injections to slow down disease progression, improve vision, or prevent vision loss in chronic conditions such as central retinal vein occlusion.

Certain cases may require weekly injections, several months of treatment, or longer intervals based on the eye’s condition and its level of improvement. Therefore, it is always advisable for patients to adhere to the prescribed treatment to prevent the deterioration of the eye’s condition. This is how intraocular injections are performed for retinal treatment.