Retinal detachment happens when an injury causes the retina to peel away from the wall of the eye. It can happen quickly, or a small tear can continue to progress over time until the retina detaches.
“My face looked … It was so used to being abused. Pow, pow, slap, kick, scratch. Anything that you think of that someone can do physically was done to this,” Regina Overton said.
Regina is an actress in the urban web series "RapStar." But until recently, she could barely read her lines. She is a domestic abuse survivor, and years of trauma took a toll.
Regina developed retinal detachment in both eyes. The retina is the tissue at the back of the eye that reflects light. A tear can cause blurred vision and needs to be treated right away.
“If only a retinal hole or retinal tear develop, we are able to fix it by doing laser and usually majority of patients don’t develop retinal detachment,” said Dr. Gennady Landa of New York Eye and Ear Infirmary of Mt. Sinai.
With a retinal detachment, fluid passes through the tear and lifts the retina off the back of the eye. People who are very nearsighted or those with advanced diabetes may have a higher risk.
Warning signs include loss of vision, seeing flashing lights or “floaters.”
Years ago, Regina’s abuser convinced her to delay treatment. She is now blind in the right eye. Two years ago, she noticed changes in the left eye and scheduled surgery quickly.
“In her case, we were amazed by her recovery,” Landa said.
“It gave me back my life,” Regina said.
Landa says retinal detachment can occur weeks or months after the initial injury, so it’s important for people who have had facial injuries to recognize the warning signs and seek treatment.
Surgeons were able to restore 95 percent of the vision in Regina’s left eye.
RETINAL DETACHMENT: EARLY WARNING SIGNS CAN SAVE SIGHT
BACKGROUND: The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. When the retina detaches, it is lifted or pulled from its normal position. If not promptly treated, retinal detachment can cause permanent vision loss. In some cases there may be small areas of the retina that are torn. These areas, called retinal tears or retinal breaks, can lead to retinal detachment. Retinal detachments affect between 0.6 and 1.8 people per 10,000 per year. It is most common in people who are in their 60s or 70s. The long-term outcomes depend on the duration of the detachment and whether the macula was detached. If treated before the macula detaches outcomes are generally good. Regina Overton’s left eye had luckily not extended the detachment to the center of the retina and the urgent intervention prevented further deterioration of her vision.
(Source: https://nei.nih.gov/health/retinaldetach/retinaldetach and https://en.wikipedia.org/wiki/Retinal_detachment)
DIAGNOSIS AND TREATMENT: Your doctor will perform a retinal examination by using an instrument with a bright light and special lens to examine the back of your eye, including the retina. This type of device provides a highly detailed view of your whole eye, allowing the doctor to see any retinal holes, tears or detachments. They may also perform an ultrasound imaging test if bleeding has occurred in the eye, making it difficult to see your retina. The most common retinal detachment is caused by a break in the retina. The second type of detachment is caused by scar tissue that grows on top of the retina and pulls the retina up. The third type is when fluid collects under the retina, but there is no tear. For all of these types, loss of peripheral vision, seeing flashes and floaters are common warning signs. If your retina has detached, you'll need surgery to repair it, preferably within days of a diagnosis. A procedure, called pneumatic retinopexy, injects a bubble of air or gas into the center part of the eye. If positioned properly, the bubble pushes the area of the retina containing the hole or holes against the wall of the eye, stopping the flow of fluid into the space behind the retina. Another procedure, called scleral buckling, involves the surgeon sewing a piece of silicone material to the white of your eye over the affected area. A final procedure, called vitrectomy, removes the vitreous along with any tissue that is tugging on the retina. Air, gas or silicone oil is then injected into the vitreous space to help flatten the retina.
BREAKTHROUGH IN RETINAL SURGERY: Hypersonic vitrectomy, which uses hypersonic reciprocating hydraulics to liquefy the vitreous, may be the next major breakthrough in vitreoretinal surgery. While pneumatic cutters use a double-port probe, wherein the vitreous is first aspirated and then sheared, the new system liquefies and aspirates the vitreous with a 23-gauge single-port probe. “Rather than being cut, the vitreous is reduced to the viscosity of water and aspirated, using much lower energy with greater efficiency, causing less traction and turbulence,” Amar Agarwal, MS, FRCS, FRCOphth, director of Dr. Agarwal’s Group of Eye Hospitals, said. In addition, Agarwal expects the same probe can be used for both cataract surgery and vitrectomy in specific cases to remove nuclear fragments and vitreous in posterior capsular rupture. “This is a huge advantage,” Agarwal said. The results of the study have not yet been disclosed, but Dhivya Ashok Kumar, MD, FICO, research officer of the project, said that surgery was mostly uneventful and patients are doing well.