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88 Yearsof Eye Care in Gujarat India.

Care With Compassion

Pioneer of Phako Emulsification Surgery in India (Since 1987).

Diva eye institute is gujarat's No 1 eye hospital which has been awarded with NABH (National accreditation Board of Hospitals)

Retina

The Diva Eye institute has behind it a robust history of eighty years of eye care in the state of Gujarat.

Retina

Excellence in the focal area of retinal treatments and surgeries in Ahmedabad

Retina is the rear area of the eye where images are captured and sent to the brain, just like a photographic film. Retinal diseases occur when the retina, macula or fovea are affected. Diagnosing retinal diseases is complex process and should be conducted by ophthalmologists with specialization in retinal treatments.

DIVA Eye Institute's expertise in treating retinal eye diseases

DIVA Eye Institute's consultants command a combined experience of 35 years in successfully managing varieties of retinal conditions. The hospital offers a range of present-day evaluation and treatment options, with the support of top-end resources. In retinal treatments, surgeon's expertise is very important and we employ two retinal specialists. Every year over 5,000 patients suffering from retinal diseases are treated at the Diva Eye Institute.

Common retinal diseases treated at DIVA Eye Institute
  • Diabetic retinopathy: poor vision or loss of eye sight could be caused by diabetes. Blood vessels that nourish the retina get damaged due to pressure. Early detection of this disease can help the patients suffering from diabetes. Know more about diabetic retinopathy.
  • Hypertensive retinopathy: usually found in people suffering from hypertension. The cause of hypertension has to be treated along with the eye. Know more about floaters and flashes.
  • Retinal detachment: this happens when the retina detaches itself from the layer of blood vessels behind it. This condition has to be treated immediately as permanent vision loss can happen. Know more about retinal detachment.
  • Macular degeneration: usually related to ageing process. This condition happens when the tissue in the macula degenerates, affecting the central vision. The damage caused cannot be reversed but can be treated effectively if identified early. Know more about age-related macular degeneration.
  • Vitreous hemorrhage: it is a condition of intraocular bleeding from retinal vessels leading to sudden vision loss. It should be treated as soon as it is diagnosed.
  • Know more about UVEITIS.
  • Know more about CENTRAL RETINAL VEIN OCCLUSION

Treatment options for retinal diseases at DIVA Eye Institute

Each disease has different treatment options; these include vitrectomy, scleral buckling, pneumatic retinopexy, cryopexy, photocoagulation, and laser surgery, among others.

Technological advancements at DIVA Eye Institute that aid in retinal treatments:
  • Comprehensive diabetic eye care
  • Digital fundus photography, with FFA (Fundus Fluorescein Angiography) and ICG (IndoCyanine Green Angiography) options
  • Millennium Vitrectomy System
  • Stellaris vitrectomy system
  • Zeiss miscroscope
  • B-scan ultrasonic biometry
  • OCT- optical coherence tomography
  • Advanced vitreo-retinal surgery
  • Retinal detachment surgery
  • ROP screening
  • Intra-vitreal anti-VEGF therapy
  • Posterior Sub-Tenon (PST) injection therapy
What is Diabetic Retinopathy?
Patients with diabetes are more likely to develop eye problems such as cataracts and glaucoma, but the disease's affect on the retina is the main threat to vision. Most patients develop diabetic changes in the retina after approximately 5-20 years. The effect of diabetes on the eye is called diabetic retinopathy. The longer the duration of diabetes, the higher are the chances of developing diabetic retinopathy. After 25 years, nearly all diabetics have some signs of retinopathy. Some of these will have significant decrease in vision and fewer may even become blind. It is estimated that a diabetic is 25 times more prone to blindness than a non-diabetic. Diabetic retinopathy is one of the leading causes of blindness in the developed world. Diabetic retinopathy is the leading cause of blindness in young and middle-aged adults today. The longer a person has diabetes, the greater their chance of developing diabetic retinopathy. There are two types of diabetic retinopathy:

  • Non-proliferative diabetic retinopathy (NPDR)
  • Proliferative diabetic retinopathy (PDR)
  • Maculopathy

NPDR, also known as background retinopathy, is an early stage of diabetic retinopathy and occurs when the tiny blood vessels of the retina are damaged and begin to bleed or leak fluid into the retina resulting in swelling (diabetic macular edema) and the formation of deposits known as exudates. Many people with diabetes develop mild NPDR often without any visual symptoms.

Maculopathy:
Maculopathy occurs when the central area of the retina, where most of the light sensitive cells which give us our central vision (especially important for close activities such as reading), is affected.

Maculopathy can be exudative. Here laser treatment may be of some help. Maculopathy can also be ischaemic. This form is untreatable: prevention by good control of diabetes and hypertension is the best management

PDR carries the greatest risk of loss of vision and typically develops in eyes with advanced NPDR. PDR occurs when blood vessels on the retina or optic nerve become blocked consequently starving the retina of necessary nutrients. . New, fragile, vessels develop as the circulatory system attempts to maintain adequate oxygen levels within the retina. This is called neovascularization. Unfortunately, these delicate vessels hemorrhage easily. Blood may leak into the retina and vitreous, causing spots or floaters, along with decreased vision.

PDR may lead to any one of the following:
  • Vitreous hemorrhage - proliferating retinal blood vessels grow into the vitreous cavity and break down. Both the hemorrhaging and resultant scar tissue may interfere with vision.
  • Traditional retinal detachment - scar tissue in the vitreous and on the retina cause the retina to detach.
  • Tractional and rhegmatogenous retinal detachment - scar tissue creates a hole or tear in the retina causing it to detach.
  • Neovascular glaucoma - abnormal blood vessel growth on the iris blocks the flow of fluid out of the eye causing the pressure to increase and damaging the optic nerve.

Symptoms of Diabetic Retinopathy
Generally, people with mild NPDR do not have any visual loss. A dilated eye exam is the only way to detect changes inside the eye before loss of vision begins. People with diabetes should have an eye examination at least once a year. More frequent exams may be necessary after diabetic retinopathy is diagnosed.

People with PDR experience a broader range of symptoms. They may:
  • See dark floaters
  • Experience loss of central or peripheral vision
  • Experience visual distortions or blurriness
  • Experience temporary or permanent vision loss
Diagnosis of Diabetic Retinopathy | Detection of Diabetic Retinopathy
Diabetic Retinopathy is diagnosed by:
  • Dilated Retinal examination: dilating the pupil and looking inside the eye with an ophthalmoscope. If an ophthalmologist discovers diabetic retinopathy, he or she may wish to order color photographs of the retina through a test called fluorescein angiography.
  • FUNDUS FLUORESCEIN ANGIOGRAPHY: During this test, a dye is injected into the arm and quickly travels throughout the blood system. Once the dye reaches the blood vessels of the retina, a photograph is taken of the eye. The dye allows the ophthalmologist to detect damaged blood vessels that are leaking dye.
  • Retinal photography
  • Optical coherence tomography
Prevention of Diabetic Retinopathy
The most effective overall strategy for diabetic retinopathy is to prevent it as much as possible. Researchers have found that diabetic patients who are able to maintain appropriate blood sugar levels have fewer eye problems than those with poor control. Diet and exercise play important roles in the overall health of those with diabetes.

Diabetics can also greatly reduce the possibilities of eye complications by scheduling routine examinations with an Ophthalmologist. Many problems can be treated with much greater success when caught early.

Can I prevent the development of retinopathy?
Tight control of diabetes can reduce the risk of retinopathy. It will also reduce the occurrence of other diabetic complications.

Regular eye check-ups are necessary for early diagnosis as there may be no symptoms in the early stages. If diagnosed early, it is treatable and further damage can be prevented.

When should I have my eyes examined?
You must see your eye specialist as soon as diabetes is examined, and yearly thereafter.

How will I be examined for Diabetic Retinopathy?
At our center, our optometrist will take a detailed history and check your vision and intra-ocular pressure. You will then be examined by one of our senior eye surgeons. Drops will be instilled in your eye to dilate the pupil. This will allow the specialist to examine the lens, vitreous, retina and optic nerve (The dilating drops will cause blurring of vision for 5-6 hours and activities such as driving should be avoided during that time).

For more detailed information, your doctor may take photographs of the retina. These enable him to keep an accurate record of the retinopathic changes and to compare with future findings.

Flourescein angiography may be required. In this procedure, a dye is injected intravenously. Photographs of the retina are taken as the dye passes through the blood vessels of the eye. Areas of leakage or poor blood flow can thus be detected and one can determine the areas which need laser treatment.

OCT (Optical Coherence Tomography ): This is a non-contact , non-invasive procedure which can give Qualitative Description by location, form, structure and identify anomalous structures. It can give quantitative measurements specifically of retinal thickness, volume, and nerve fiber layer thickness. This is most helpful in assessing the macular edema in diabetic retinopathy

Treatment for Diabetic Retinopathy At Diva Eye Institute
Diabetic retinopathy is treated in many ways depending on the stage of the disease and the specific problem that requires attention. The retinal surgeon relies on several tests to monitor the progression of the disease and to make decisions for the appropriate treatment. These include: fluorescein angiography, retinal photography, and ultrasound imaging of the eye.

  • Pan retinal Photocoagulation (PRP) : The abnormal growth of tiny blood vessels and the associated complication of bleeding is one of the most common problems treated by vitreo-retinal surgeons. Laser surgery called pan retinal photocoagulation (PRP) is usually the treatment of choice for this problem. With PRP, the surgeon uses laser to destroy oxygen-deprived retinal tissue outside of the patient's central vision. While this creates blind spots in the peripheral vision, PRP prevents the continued growth of the fragile vessels and seals the leaking ones. The goal of the treatment is to arrest the progression of the disease.
  • Anti-VEGF Injections are given intravitreal. Also injection Triamcinolone and Ozurdex are given .
  • Vitrectomy is another surgery commonly needed for diabetic patients who suffer a vitreous hemorrhage (bleeding in the gel-like substance that fills the center of the eye).

During a Vitrectomy, the retina surgeon carefully removes blood and vitreous from the eye, and replaces it with clear salt solution (saline). At the same time, the surgeon may also gently cut strands of vitreous attached to the retina that create traction and could lead to retinal detachment or tears.

Patients with diabetes are at greater risk of developing retinal tears and detachment. Tears are often sealed with laser surgery. Retinal detachment requires surgical treatment to reattach the retina to the back of the eye. The prognosis for visual recovery is dependent on the severity of the detachment.

Facilities at DIVA Eye Institute for Treatment of Diabetic Retinopathy
  • Retinal photography by Topcon image net software
  • Digital Fundus fluorescein angiography
  • Zeiss green laser for PRP
  • B scan for three dimensional ultrasound imaging and analysis
  • OCT (Optical Coherance Tomography)

Digital Fundus Fluoroscien Angiography (FFA) and Fundus Photography. This is connected to image net software for easy Archiving and retrieval of Photographs and instant reporting. this machine dose the angiography of retinal blood vessels and shoes areas of leek of fluids, infaction (no flow of blood), blockages and other pathologies



Red Diode Laser - It is used for treatment of disease like Diabetics Retinopathy, Vascular Occlusions and peripheral retinal degenerations. It fully equipped with three delivery systems:

  • Slit Lamp delivery system
  • Laser indirect Ophthalmoscope
  • Endolaser delivery System

OCT (Optical Coherence Tomography ): This is a non-contact , non-invasive procedure which can give Qualitative Description by location, form, structure and identify anomalous structures. It can give quantitative measurements specifically of retinal thickness, volume, and nerve fiber layer thickness. This is most helpful in assessing the macular edema in diabetic retinopathy
Macula:
  • A sensitive area in the centre of the retina which provides us with sight in the centre of our field of vision.
  • Allows us to see the fine details when we look directly at something.
  • Damage to it may cause loss of central vision and makes difficult for person to read and do fine work.
Age Related Macular Degeneration (ARMD): In Brief
  • Painless disorder that affects the macula, in one or usually both eyes, causing progressive loss of central and detailed vision.
  • It is the leading cause of significant vision loss among patients over the age of 50.
  • Does not lead to total blindness but patient may find it difficult to do read, drive and recognize people.
Causes of Age Related Macular Degeneration (ARMD)
  • Not yet fully understood
  • Aging
  • Decline in the body's antioxidant systems
  • Smoking
  • Hereditary
  • Environment Factors like exposure to UV rays
  • Obesity

Symptoms of Age Related Macular Degeneration (AMRD)
  • Blurry vision
  • Distortion of vision so that straight lines appear wavy or curved and objects appear smaller or larger than normal.
  • A dark or empty area appears in the centre of vision
  • Difficulty in reading, watching television, and recognizing faces.
Normal Vision
Vision with ARMD
Types Of ARMD
Macular degeneration can be either dry (non-neovascular) or wet (neovascular). Neovascular refers to growth of new blood vessels in an area, such as the macula, where they are not supposed to be.

The dry form is more common than the wet form, with about 85 to 90 percent of AMD patients diagnosed with dry AMD. The wet form of the disease usually leads to more serious vision loss.

Dry Macular Degeneration (non-neovascular): Dry AMD is an early stage of the disease and may result from the aging and thinning of macular tissues, depositing of pigment in the macula or a combination of the two processes.

Dry macular degeneration is diagnosed when yellowish spots known as drusen begin to accumulate in and around the macula. It is believed these spots are deposits or debris from deteriorating tissue. Gradual central vision loss may occur with dry macular degeneration but usually is not nearly as severe as wet AMD symptoms. However, dry AMD through a period of years slowly can progress to late-stage geographic atrophy (GA) - gradual degradation of retinal cells that also can cause severe vision loss.

Yellowish spots (drusen) that form in the back of the eye or retina are an early sign of "dry" macular degeneration

Wet Macular Degeneration (neovascular). In about 10 percent of cases, dry AMD progresses to the more advanced and damaging form of the eye disease. With wet macular degeneration, new blood vessels grow beneath the retina and leak blood and fluid. This leakage causes permanent damage to light-sensitive retinal cells, which die off and create blind spots in central vision.

Choroidal neovascularization (CNV), the underlying process causing wet AMD and abnormal blood vessel growth, is the body's misguided way of attempting to create a new network of blood vessels to supply more nutrients and oxygen to the eye's retina. Instead, the process creates scarring, leading to sometimes severe central vision loss.

Wet macular degeneration falls into two categories:
  • Occult. New blood vessel growth beneath the retina is not as pronounced, and leakage is less evident in the occult CNV form of wet macular degeneration, which typically produces less severe vision loss.
  • Classic. When blood vessel growth and scarring have very clear, delineated outlines observed beneath the retina, this type of wet AMD is known as classic CNV, usually producing more severe vision loss.

"Wet" macular degeneration occurs with formation of abnormal blood vessels and leakage in the back of the eye (retina), affecting the macula where fine focusing occurs.

Diagnosis of ARMD | Detection of ARMD Age Related Macular Degeneration;
DIVA EYE INSTITUTE OFFERS all diagnostic and treatment modalities for ARMD
Dilated retinal evaluation : After dilating the pupils, a retina specialist examines the macula for any degenerative changes.

Fundus Photos : If signs of macular degeneration are found, our retina specialist may take detailed pictures of the retina for future comparison.

Fluorescein angiography (FA): A special, extremely safe dye called fluorescein is injected into the arm. Then, photographs are clicked as the dye passes through the retina. This test determines the location of blood vessel or vascular damage and whether or not laser treatment could be potentially beneficial. Fluorescein angiography is essential to pinpoint the exact location of any planned laser treatment. Most importantly, this test determines whether or not there are leaking blood vessels (wet macular degeneration) which, if found, can be treated with lasers or injections.

Optical coherence tomography (OCT): This is a noninvasive examination technique that produces a cross-sectional image of the posterior retina in vivo. OCT is particularly useful in determining the specific layers of retinal involvement as well as the presence of macular inflammation or swelling.

Amsler Grid Test
An extremely useful standardized test that may indicate macular problems or worsening of age-related macular degeneration is the Amsler grid. The Amsler grid consists of a square grid with a dark dot in the middle. Broken or distorted lines or a blurred or missing area of vision could be one of the first signs of age-related macular degeneration. The grid also helps to monitor changes in vision once changes have been detected or treatment initiated.

Treatment for ARMD in DIVA Eye Institute
There is as yet no outright cure for age-related macular degeneration, but some treatments may delay its progression or even improve vision.

Treatments for macular degeneration depend on whether the disease is in its early-stage, dry form or in the more advanced, wet form that can lead to serious vision loss. No FDA-approved treatments exist yet for dry macular degeneration.

The goal of all macular degeneration treatments are to stabilize the condition Antioxidants:

Deficiencies in antioxidants (specifically zinc and vitamins A, C, and E, selenium, copper, lutein, and zeaxanthine) have been noted in some people with age-related macular degeneration. Antioxidants may protect against age-related macular degeneration by preventing free radicals or unstable oxygen from damaging the retina. Different treatments of the wet form are available and may help decrease the amount of vision that is lost.

Laser treatment:
Laser treatment may stop or lessen vision loss in early stages of the disease. It is performed with a specific wavelength designed to cauterize the abnormal blood vessels. A laser beam destroys existing blood vessels and may stop the growth of new ones.

A scar forms after the laser treatment. This produces a permanent loss of vision in that area of the retina, sacrificed in order to preserve the rest of the eye layer. Vision usually does not improve after laser treatment. It works in about half the cases, and only a small number of people meet the criteria for laser treatment. Its limitations have prompted a search for other forms of therapy..

Anti-VEGF therapy:
Vascular endothelial growth factor (VEGF) causes new blood vessels to develop and increases leakage and inflammation of blood vessels. Most of these drugs are insoluble and therefore cannot be given as eyedrops. Thus, the ideal form of administration is directly into the eye with a very fine needle. These injection procedures are a form of surgical intervention and should be performed only by an ophthalmologist familiar with the technique, indications, contraindications, possible complications, and alternative therapies. Strict sterile protocols are necessary as with any surgical procedure.

The anti - VEGF injections available today include the following :

Pegaptanib (Macugen) is a drug approved by the FDA in December 2004 that blocks VEGF and helps stabilize vision. Pegaptanib was found to be beneficial in treating both classic and occult subfoveal choroidal neovascular membranes (the areas of abnormal growth of new blood vessels). The drug is administered by an ophthalmologist as an injection into the eye.

Bevacizumab (Avastin) is another anti-VEGF drug that is currently approved for cancer of the colon or rectum. There is now an NIH-sponsored trial underway to scientifically compare Avastin to Lucentis. Both drugs carry a small risk to the patients of stroke.

Ranibizumab (Lucentis) is a newly approved anti-VEGF antibody for the treatment of wet age-related macular degeneration. It is also approved for cancer when given in systemic (delivered to the entire body) form. It is administered inside the eye via the pars plana. Preliminary studies have shown improved vision in patients with many forms of wet age-related macular degeneration. Lucentis is very costly, and multiple treatments for each eye are often necessary.

Facilities Available For Diagnosis And Treatment Of ARMD:
DIVA Eye Institute is fully equipped with world class equipments and experienced and well trained retina specialists for diagnosis and treatment of macular degeneration.
Floaters are small specks, strands or clumps or aggregates of cells that move through a person's field of vision. Flashes, as the name suggests, are sudden flashes of light or "lightning streaks." Both are caused by changes related to aging that take place in the vitreous. Flashing lights may be associated with high nearsightedness and could indicate a serious retinal problem.

What causes floaters and flashes?
The vitreous is the gel-like fluid that fills the eyeball. Around middle age, this gel may begin to thicken, and as it do, small clumps or strands of cells may form. These clumps get in the way of the light entering your eye and cause you to see floaters. Some will fade after a time, but other floaters remain for years.

Flashes are caused when the shrinking vitreous pulls at areas of the retina where it is tightly adhered. This pulling or tugging pressure on the retina produces a sensation of light, similar to when you press the side of your eye with your finger. This could indicate a retinal tear or detachment, which is a sight threatening condition.

What are the symptoms and signs of floaters and flashes?
If a spot or shadowy shape passes in front of your field of vision or to the side, you are seeing a floater. Because they are inside your eye, they move with your eyes when you try to see them. Floaters may appear as different shapes, such as specks, clouds, dots, circles, lines, or cobwebs. You can often see them when looking at a plain background, like a blank wall or blue sky.

You may also see flashes of light. These flashes occur more often in older people, and usually are caused by mechanical stimulation of photoreceptors when the gel-like vitreous occasionally tugs on the light-sensitive retina. They may be a warning sign of a detached retina. Flashes also occur after a blow to the head, often called "seeing stars."

Some people experience flashes of light that appear as jagged lines or "heat waves" in both eyes at once, lasting 10 to 20 minutes. These types of flashes are usually caused by a spasm of blood vessels in the brain, which is called migraine.

What is the treatment that is available for floaters and flashes?
In general, floaters do not require any treatment. However, all people with new onset of floaters or flashes, or a sudden increase in existing flashes or floaters, should be checked for torn retina by an ophthalmologist. This requires an examination with dilated pupils using an instrument called an indirect ophthalmoscope. This examination requires a bright light and gentle pressure on the eyelid, but is not painful. The reason this is important is that if caught early, torn retina can be easily repaired in the office with a laser. If retinal detachment is allowed to develop, surgery becomes necessary.

Since most floaters will diminish with time, treatment for the floaters themselves is not needed. For severe cases where a large floater obstructs vision, a form of laser surgery has recently become available at DIVA Eye Institute. Vitrectomy surgery, where the vitreous is removed and replaced with a clear fluid, is available for extensive and dense floaters which obstruct vision, but is a major eye operation and is not appropriate for floaters which are simply annoying, but do not obstruct vision
The retina is a thin membrane lining the inner surface of the back of the eye. It is made up of light sensitive nerve tissue and behaves like the film in a camera. When light enters the eye it passes through the transparent cornea, then pass through the pupil in the centre of the iris and falls on the lens. It then passes through the lens and vitreous (a jelly-like substance) before being focused the retina. From here the optic nerve relays the image to the brain.

What is retinal detachment?
Retinal detachment means that the retina separates (detaches) from the back of the eye. 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. This detached part will not work properly causing blurring or blind spots in vision. It requires urgent treatment before vision is permanently affected. If not promptly treated, retinal detachment can cause permanent vision loss.

What causes the retina to detach?
Most retinal detachments are preceded by a hole or tear in the retina. This may occur when the retina becomes 'thin', due to ageing or more often if the vitreous (the jelly-like substance that fills the eye) shrinks from the retina. Fluid then collects behind the retina, separating it from the back of the eye

Which people are more at risk for retinal detachment?
A retinal detachment can occur at any age, but it is more common in people over age 40. It affects men more than women. A retinal detachment is also more likely to occur in people who:
  • Are extremely nearsighted
  • Have had a retinal detachment in the other eye
  • Have a family history of retinal detachment
  • Have had cataract surgery
  • Have other eye diseases or disorders, such as retinoschisis, uveitis, degenerative myopia, or lattice degeneration
  • Have had an eye injury

What are the symptoms of retinal detachment?
Retinal detachment usually causes partial or total loss of vision in that eye.

Symptoms include a sudden appearance or gradual increase in either the number of floaters, which are little "cobwebs" or specks that float about in your field of vision, and/or light flashes in the eye. The sudden appearance of floaters or flashes of light is a warning that the eye must be immediately and thoroughly examined to rule out retinal problems such as tears. The earlier these are diagnosed, the more easily can they be treated.

Sometimes the patient may not notice floaters or light flashes, but a "wavy" vision, or a dark spot in some part of their vision.

Another symptom is the appearance of a curtain over the field of vision.

Sometimes there is sudden total loss of vision in one eye.

A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.

What are the different types of retinal detachment?
There are three different types of retinal detachment:

Rhegmatogenous: A tear or break in the retina allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. These types of retinal detachments are the most common.

Tractional: In this type of detachment, scar tissue on the retina's surface contracts and causes the retina to separate from the RPE. This type of detachment is less common. It occurs secondary to problems like diabetic retinopathy and vein occlusions.

Exudative: Frequently caused by retinal diseases, including inflammatory disorders and injury/trauma to the eye. In this type, fluid leaks into the area underneath the retina, but there are no tears or breaks in the retina.

How is retinal detachment treated?
Surgery of some sort needs to be performed as early as possible if better results are to be achieved. Your eye surgeon will be able to decide which treatment is best for you depending n the severity of the detachment. The retinal tear must be sealed and the retina must be reattached and prevented from further detachment.

If there is a hole or a tear, the aim is to seal the retina around the tear so as to prevent fluid collecting behind the tear and producing a detachment. This is usually done by laser photocoagulation or a freeze treatment called cryotherapy. The laser is used to produce tiny burns around the tear, resulting in scars that will seal the edges of the tear and prevent fluid collecting behind it - the retina is "welded" back into place. Cryopexy is the term used to freeze the wall of the eye behind the tear - again the scar so formed will seal the edges of the tear. Both these techniques can be done as out-patient procedures, and do not involve any incision, suturing etc .i.e. they are applied from outside the eye.

If there is a detachment, you may require admission and general anaesthesia as the surgery is more complex. The surgery aims to press and hold the back of the eye against the retinal holes until scar formation seals up the tears. Fluid may need to be drained from behind the retina before it can settle back onto the wall. One often needs to place a scleral buckle, a silicone band or pad on the outside of the eyeball to push the wall of the eye against the retinal hole. At the same time laser or cryo is also used to seal the tear. If necessary, a vitrectomy may also be performed.

In more complicated detachments, vitrectomy may be necessary. Here the shrunken vitreous body is removed and replaced with air, gas or silicon oil. This will push the retina back onto the wall from inside the eye. During a vitrectomy, the doctor makes a tiny incision in the sclera (white of the eye). Next, a small instrument is placed into the eye to remove the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain a round shape. Gas is often injected to into the eye to replace the vitreous and reattach the retina; the gas pushes the retina back against the wall of the eye. During the healing process, the eye makes fluid that gradually replaces the gas and fills the eye. With all of these procedures, either laser or cryopexy is used to "weld" the retina back in place. Often the surgeon might prefer to inject silicone oil into the eye so that long term support to the retina is obtained. This silicone oil, of course, needs to be removed later.

After surgery, normal activities can be resumed. If necessary, you will be advised by your doctor to maintain certain positions - posturing- after the surgery.

How successful is the treatment?
With modern therapy, over 90 percent of those with a retinal detachment can be successfully treated, although sometimes a second treatment is needed. However, the visual outcome is not always predictable. The final visual result may not be known for up to several months following surgery. Even under the best of circumstances, and even after multiple attempts at repair, treatment sometimes fails and vision may eventually be lost. Visual results are best if the retinal detachment is repaired before the macula (the center region of the retina responsible for fine, detailed vision) detaches. That is why it is important to contact an eye care professional immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over the field of vision.

About 40% of cases will regain good vision while in the others some amount of useful vision will be achieved.

DIVA Eye Institute has successfully treated thousands of patient suffering from retinal detachment in Ahmedabad and other cities in India.

Fequently Asked Questions ?