Retinal Detachment: Time Critical Eye Emergency

A detachment of the retinal can be a very serious and time critical emergency. A detached retina occurs when the retina pulls away from the supporting choroid (middle tissue) in the back of the eye, usually resulting from a hole in the retina that allows fluid to leak between the choroid and the retina.

Since the retina cannot function properly under these conditions, permanent vision loss may occur if a detached retina is not repaired within 24 to 72 hours.

Retinal Detachment is considered a risk for:

Nearsighted adults
People who have had an eye injury or post cataract extraction surgery
People with a family history of retinal detachment
People who have suffered a hard blow or sever trauma to the eye such as a contusion or penetrating wound. There has been a rise in those under teenagers and young adults due to paintball injuries.
Secondary detachments as a result of other diseases, such as tumors, severe inflammations or complications from diabetes.

Statistic for the United States show that nearly 28,000 cases of retinal detachment occurs each year. Most cases are a result of the processing of aging, affects a higher number of people with a Jewish heritage and occurs the least often among blacks.

Symptoms of retinal detachment include:

Flashes of light
Showering effect of floaters in the visual field
Darkening of the peripheral visual field.
Vision loss maybe filmy, cloudy, irregular or curtain-like.
One large floater in the middle of the field of vision or a wavy distortion of objects may also be a sign of a detached retina.

There is no pain associated with retinal detachment, but if you suffer from any of the above symptoms, see your eye doctor immediately. Often floaters will actually decrease as the retina detaches giving a false signal of possible a reversal in the condition when in truth the condition is worsening.

Diagnosis

Retinal detachment is diagnosed through an eye exam by a retinal specialist. The earlier the diagnosis is made, the greater the chance to restore vision. Diagnosis is based on symptoms and a thorough examination of the retina.

Treatment

Surgical treatment for retinal detachment depends on type, severity, and location of the detachment. Risks include infection, bleeding, cataract development, and increased pressure inside the eye. However, without intervention, retinal detachment usually causes permanent partial vision loss or blindness.

There are numerous approaches to treating retinal detachment. These include:
Laser (thermal) or freezing (cryopexy). Both of these approaches can repair a detached retina if it is diagnosed early enough.
Cryopexy – Cryopexy uses nitrous oxide to freeze the tissue behind the retinal tear, stimulating scar tissue formation that will seal the edges of the tear. It is usually done as an outpatient procedure, under local anesthesia.
Pneumatic retinopexy. This procedure can be used to treat retinal detachment if the tear is small and easy to close. A small gas bubble is injected into the vitreous where it then rises and presses against the retina, closing the tear. A laser or cryopexy can then be used to seal the tear. This procedure is 85% successful.
Scleral buckle. This treatment for retinal detachment involves placing a silicone band (buckle)around the eye to hold the retina in place. This band is not visible and remains permanently attached. Thermal treatment may then be necessary to close the tear. This procedure is effective as high as 95% of the time.
Vitrectomy. This procedure for retinal detachment is used for large tears. During a vitrectomy the vitreous is removed from the eye and replaced with a saline solution. It has similar success rates to the scleral buckle.
About 80 percent of all uncomplicated cases can be cured with one operation; an additional 15 percent will need repeated operations and the remainder will never reattach. The prognosis is worse if the macula is detached or if the detachment is of long duration.
Without treatment, retinal detachment often becomes total within six (6) months. Unfortunately, due to continual shrinkage of the vitreous and the development of fibrous growths on the retina, not all retinas can be reattached. If the retina cannot be reattached, then the eye will continue to lose sight and ultimately become blind.

Prevention

Preventing age-related retinal detachment is possible by having regular eye exams and seeing an eye care practitioner immediately when early symptoms (floaters and flashes) are experienced. In most cases, small tears can be repaired easily and vision can be preserved. People at high risk should discuss the frequency of eye exams with their practitioner.
To avoid eye injuries, which may lead to a retinal, detachment use safety glasses or goggles when participating in activities that may have a high risk for eye injuries such as paintball guns, racket ball and many other sports.

By: Christopher Cartre

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 For more click on Retinal Detachment: Time Critical Eye Emergency. At Austin County Eye Associates our focus is on you and the best options for your eye vision care.

A Cataract is the gradual opacification, and yellowing of the natural lens in the eye. The most common type is called Senile, or Nuclear type, and results from the absorption of high energy light over a period of years. The natural lens is made of an Alpha protein which is clear. High energy light causes a chemical reaction that transforms this Alpha protein to a Beta protein which is yellow. Over time, as the lens becomes more and more yellow, it diffracts light as it travels through the lens. Ultimately, it prevents light transmission and vision decreases. It is at this point that people seek out the eye doctor to consider a Cataract operation. Additional types of cataracts are those induced by trauma, drugs and some are even congenital.

Today’s cataract surgery is far superior to that done even 10 years ago. Today a small incision is made in the temporal aspect of the cornea, the natural lens is removed. An implant is introduced into the eye through this opening. Complications to this point may be a poor incision resulting in excess aqueous fluid leaking out and rupture of the natural lens. This will results in lens protein floating around the eye causing an Iritis which is an internal inflammatory response. This is treated with steroid eye drops. While the healing period will be longer, the long term prognosis is unchanged.

The newest intraocular implants, unlike the older ones, are multifocal. That is to say, they let the patient see both distance and near just as they did when they were younger. The Rezoom lens, and the Restore are commonly used implants. They work on the principle of multiple images being projected on to the retina, and allows the patient to see at all distances. They are very similar to old style bifocal contact lenses like the Echelon. The Rezoom has a center zone for near surrounded by distance zones. The Restore has the opposite. The center area is for far while the surrounding zones are for near. Clinical practice has not shown either one better then the other for the average patient.

However, the same problems arise as did with the Echelon bifocal lens. The first is that glare, especially at night, is bothersome. The second is that there is usually some sacrifice for vision at near. The third complication is that the implant must be PERFECTLY placed in the center of the pupil. Many times the implant may shift as the eye heals, and if the ‘sac’ that hold the lens brakes, the implant will also move. Any of these movements will result in decreased vision and on occasion, double vision. Some surgeons have started sewing the implant in place to prevent movement.

In short, the concept is acceptable for these implants, but in practice I have found that most patients with them complain about glare and poor vision requiring eye glasses for either distance, near or both. It is the side effect of double vision, and glare that disturb most people. Keeping in mind that most cataract patients are seniors, and are less tolerant of these visual affects, one must think long and hard if they are willing to take a chance on these multifocal implants. As a side note, the best results with them have been to use a Rezoom in one eye and a Restore in the other.

With cataract surgery so far advanced, the best results seem to still be using a single vision distance implant and using reading glasses after surgery.

Author: Jay Stockman

Jay B Stockman O.D. is a practicing doctor for New York Vision Associates and a prolific write. Visit http://newyorkvisionassociates.com for more information.

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Do you suffer from "cloudy vision"? Are the sights that you see covered with a "murky film" that doesn’t go away when you wipe your eyes? If you are over the age of 55, you may wish to consult your ophthalmologist because you may have Cataracts. Cataracts are a clouding of the natural lens in your eye which is the part of your eye that focuses in and sharpens images. Cataracts form when an accumulation of dead cells clump together over time, clouding over your vision. Although those over the age of 55 are the highest number of cases dealing with Cataracts, it is also possible to get cataracts if you are diabetic, an alcoholic or if you have injured your eye somehow. Luckily, Cataract surgery is available and has become one of the most performed eye surgeries today. Without medical insurance, the costs of eye surgery can be expensive. Cataract surgery can be upwards of $3000. Most insurance companies will fully or partially cover these costs, however. Check with your insurance provider to see what percentage is covered under eye surgery.

Any surgery can be a risky and frightening procedure and cataracts surgery is no exception; that is why alternative cataract  treatments should be explored, however, this surgery is quite common and though risks do occur, they are not frequent. Discussing with your ophthalmologist if you are a prime candidate for this procedure is where you should start. Once they determine if Cataracts surgery will be beneficial to you, it is then time to discuss what will happen during and after the surgery. The surgery is done quickly; usually about an hour and on an outpatient basis. Eye drops are placed into your eye to dilate your pupils and a local anesthetic is then administered to numb the area. Since this is a nerve-wracking experience, a sedative is sometimes given to help the patient relax.

During the surgery, the clouded lens causing your cataract is removed using a laser probe to break up the cloudy party of your lens and then using suction, the fragments are absorbed. Usually, if your cataracts are small, your surgeon will only remove the top part of the lens, keeping the back, undamaged part on your lens in place. If your cataracts are more advanced, your surgeon may need completely remove the lens and implant an artificial lens. Although this sounds tedious, it is done in just about the same amount of time.

The costs of eye surgery for Cataracts, as stated above can be as high as $3000, depending on the severity of your problem and if you need an artificial lens implanted or not. Your ophthalmologist will be able to determine the exact cost (barring any unforeseen costs during the surgery) before the procedure takes place so you are able to plan ahead and discuss with your insurance company how much, if any, they are willing to cover.

Author: Matt Murren

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Cataract is not a disease. Instead, it is a condition whereby the crystalline lens in the eye develops a clouding or opaqueness. This reduces the amount of light that reaches the retina. It ends up causing a person to experience foggy or hazy vision. The condition will get worse as time passes. The causes of cataracts include aging, prescription drugs, eye trauma or an ongoing medical condition.

Cataracts are treated using surgical removal methods. This is a very common treatment and it has a ninety five percent success rate. There are risks however. Some may develop fluctuating eye pressure, bleeding, infection, inflammation, double vision and loss of vision. There are some common temporary risks that may be corrected with time and then more serious risks. The more common and temporary of the cataract surgery complications include:

Cataract Surgery Complications: Itchiness, Stickiness, and Pain

*Itchiness to the white of the eyes with some redness.

*Stickiness to the eyes in general, along with itchiness. The patient may experience blurry vision for awhile after the procedure.

* Some patients feel pain in their eyes for about a week to two weeks

* Some may have eyelids that ache.

Cataract Surgery Complication: Rip of the Lens

A more serious cataract surgery complication is when the lens behind an eye rips during a surgery. This will cause damage to vision. The doctor must perform another surgery to take away the cataract.

Two types of cataract surgery procedures done today. One is the phacoemulsification surgery and the other is known as extracapsular surgery procedure.

Cataract Surgery Complication: Posterior Capsular Opacification

The phacoemulsication surgery requires a lens capsule or casing to be left in the eye for the benefit of placing an intraocular lens into it. After surgery, one of the more common complications may be that the capsule would become cloudy and develop another cataract within a two year time frame. This complication is termed ‘posterior capsular opacification’. The cataract must then be treated with laser surgery. Other familiar cataract surgery complications are discussed below.

Cataract Surgery Complication: Retinal Detachment

This condition occurs when fluid enters through a tear to the retina. The retina ends up becoming detached from the backside of the eye.

Cataract Surgery Complication: Choroidal Hemmorrhage

Choroids are a web of small blood vessels that supply blood to the retina. Choroidal Hemmorrage is when this web of vessels bleed in the surgery. This may happen to older patients or people who suffer from glaucoma.

By: Gavin Sanderson -

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Gavin Sanderson is an established freelance writer. You can find more of his writing at cataractzone.com and lasik-central.com.