Retina shift: Don’t linger, treat now

This condition caused by trauma or disease such as diabetes is preventable but could lead to blindness if neglected, warns Consultant Ophthalmologist Dr. Charith Fonseka.
Kumudini Hettiarachchi reports

They are described as the “windows” through which men, women and children “view” the world. But how many of us give them due thought......for in the blink of an eye there could be darkness. Responsible for channelling much of the information our brain receives, the eyes are considered “very sensitive” and “delicate”, MediScene understands.

Retinal detachment is one of the most significant of sight-threatening conditions, explains Consultant Ophthalmologist Dr. Charith Fonseka who is attached to the National Eye Hospital in Colombo, stressing that some cases of retinal detachment could be prevented.

Pointing out that the retina is the light sensitive layer of tissue at the back of the inner eye, he says that a detached retina is a very serious condition which could bring in its wake blindness, if not treated immediately. The detachment occurs when the retina separates from its supportive tissue.

The non-medical explanation, according to this Ophthalmologist, is that the retina comes off from where it should be. Although some people such as those who are short-sighted may be at a slightly higher risk than others, he underscores that it is only “slightly”.

Retinal detachment could come about due to a tear in the retina caused by an injury or as a result of complicated eye surgery, MediScene learns. Diseases such as diabetes can also cause traction of the retina leading to retinal detachment.

Advising people, particularly parents and teachers, to prevent trauma to the eyes of children by discouraging them from playing with sharp objects such as knives, scissors and pointed sticks, Dr. Fonseka points out that retinal detachment could follow accidents both at home and school as well as road accidents.

Another group who should take extra care not only to control their disease but also undergo regular screening should be those with diabetes, he urges, adding that diabetic retinopathy is caused when the tiny blood vessels of the retina get damaged. This can result in the formation of new, fragile blood vessels and in some cases these could bleed into the eye leading to sudden blurring of vision.
Diabetes needs to be controlled, he reiterates, urging people to “keep a tight control of blood sugar” to pre-empt retinopathy.

One in five people in the urban areas of the country has diabetes or is in the pre-diabetic stage, it is learnt. Retinal detachment caused by both trauma and diabetes is preventable to a large extent and would ease the load of Retinal Surgeons who have to deal with 400 people who are currently on the National Eye Hospital’s waiting list for surgery. Prevention as much as possible in these two categories will make patient numbers manageable, he stresses.

People should be alert to the warning signs of floaters (like a moving fly, cobwebs or a ring) and flashes of light in their vision. The early stage of retinal detachment could appear as a curtain covering part of the visual field, while in the latter stage there could be loss of vision with only a perception of light or movement, says Dr. Fonseka.

In retinal detachment, the only option is surgery and urgent surgery, MediScene learns, for if the retina is not fixed soon the amount of vision is reduced.

“The chances of recovery are highest if the operation to fix the retina is done as soon as possible,” says Dr. Fonseka, detailing the two procedures carried out as ‘Scleral buckling surgery’ and ‘Vitrectomy’.
While Scleral buckling surgery is performed from the outside of the eye mainly on young people with retinal tears, Vitrectomy is from the inside of the eye.

Pointing out that if a person with a detached retina waits too long, it could sometimes become inoperable, Dr. Fonseka says that the National Eye Hospital and other government hospitals such as Kandy as well as several private hospitals are well-equipped to deal with it.

So far, however, the problem has been the dearth of Ophthalmic Surgeons specialised in handling Vitrectomies, he says, assuring though that now there are a few at the Eye Hospital.

Dr. Fonseka’s message to the people is simple – if there is trauma to the eye or a person is having diabetes and there are symptoms of retinal detachment, “Don’t linger, seek medical treatment right now.” This will be the only way doctors can prevent loss of sight in retinal detachment.

Celebrities with detached retinas

Journalist, publisher and politician Joseph Pulitzer of Pulitzer-Prize fame had been a victim of detached retinas, going blind in his 40s, an internet search finds. Among other celebrities who had the condition is soccer star Pele, it is learnt.

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