Can retinal detachment be prevented?
Hi, I am 33 years old and developed a retinal detachment in my right eye. This has been successfully treated with a scleral buckle and gas bubble. The doctor advised that I laser the retina wall in my left eye because he was worried that it might detach too. Is it possible to prevent retinal detachment, and what are my treatment options? Kindly advise. Thanks!
This answer discusses the issue in general, and is not intended as specific advice for any particular patient.
But yes, in short, retinal detachment can be prevented.
Here's the long answer:
There are several kinds of retinal detachment, but the ones that most people refer to are 'rhegmatogenous retinal detachments'. These happen when a tear or hole develops in the retina, and liquefied vitreous gel enters the retinal break causing it to separate and detach from the wall of the eye. The actual detachment can happen any time after the retinal break occurs, but usually not at the exact same time.
If a retinal tear or hole is identified before the retina detaches, prophylactic laser treatment can be applied around the retinal break. This causes the retina to stick to the wall of the eye around the break, thereby preventing fluid from entering it.
However, any one session of laser treatment does not guarantee 100% prevention of future detachments. This is because future retinal breaks can occur in unlasered parts of the retina, and it is not possible to laser the entire retina as excessive lasering can affect vision. Therefore, even after laser treatment to prevent retinal detachments, patients should remain watchful of sudden increases in floaters, bright flashes of light, or shadows blocking vision. If any of these are experienced, they need to get the eyes checked again in case of further retinal breaks.
Lasering an eye that has no retinal breaks can be controversial depending on the patient's individual circumstances. This is where a frank discussion with your doctor regarding the perceived risk vs benefit ratio would be helpful in deciding whether to proceed, or on the other hand, whether to monitor the situation for the time being.