Mrs. Sangeeta Mittal (Name Changed), 54-year-old lady was puzzled by strange sparking going on in her left eye. She started observing lightening like sensation that was more prominent in dark and would not disappear even after washing or rubbing her eyes. Sensing trouble, she consulted her family physician who advised her immediate retina examination. Detailed retina examination At Retina Clinic, Eye-Q Super specialty Eye Hospitals,  revealed that she was suffering from Posterior Vitreous Detachment (PVD) and a retinal tear.She was explained about the process of PVD and risks associated with retinal tear. She underwent a successful laser photo-coagulation for retinal tear on same day.

The timely Laser Photo-coagulation saved her eye from a potentially blinding problem called retinal detachment. “Not all patients are alert and lucky like Mrs. Sangeeta, many would ignore and present with retinal detachment”- says Dr. Deependra V Singh, Director Retina Services Eye-Q Super-specialty Eye Hospitals.Symptoms of PVD include seeing flashes and Floaters or black spots and up to 15% of these patients with PVD can have “torn retina” (retinal tears) – adds Dr. Singh.

What is PVD?

A clear jelly —the vitreous or‘vitreous jelly’—fills the middle of the eye. The vitreous lies against the retina in the normal eye. It is transparent like glass, so light passes through it to reach the retina. Retina is the film that lines the back wall of the eye.  As you get older, the vitreous collapses and shrinks away from retina. This can happen earlier if you are short sighted or have got your eye injured. Sometimes this shrinking process may happen rather suddenly, and is over in just few days. This process is called a posterior vitreous detachment or PVD. The PVD can occur in 3 ways; 1) The shrinking can occur quietly without you being able to notice it or 2) it may pull or shake the retina resulting in flashes that would subside within couple of weeks with creating serious trouble or the layer of vitreous may separate completely and form a ring or web like floater in your vision that may take months to disappear. 3) Less commonly, PVD will result in formation of retinal tear or hole that can lead to retinal detachment which is a serious eye condition.So, do not ignore flashes, and seek a Retinal examination at the earliest. If the doctor checks your eye and all is well, the floaters and flashes subside. However, you may need a further examination if you suddenly experience another bout of flashes or floaters (this could be a small tear) or a shutter or curtain of blurred vision drifting across your eye, sometimes from below.To check for this, cover one eye at a time for a few seconds every day. If your uncovered eye sees well in all directions, then all is well. 

What is Retinal Detachment?

Known as a medical emergency, Retinal Detachment is separation of the retinal tissue (neural layer) from the layer of blood vessels that provides it nutrients and oxygen. When the cells are deprived of nutrition, they are unable to function and compose a clear picture. While the initial retinal detachment could be restricted, if left untreated for a long time, it can cause blindness in the affected eye. 

What causes retinal detachment?         

  • PVD causes a tear in the retina and allows the fluid or water of the eye to seep under it which detaches the retina from its supporting layer.        
  • Myopia or better known as shortsightedness is a very strong risk factor for RD. Up to 10% of myopic eyes have retinal thinning and holes in the periphery that can lead to RD. The RD in myopia can occur at very young age also.
  • Retinal detachments are also caused by injury to the head or eye. 
  • Diabetes and Hypertension can also damage retinal vessels and lead to Retinal Detachment 

How do we treat retinal detachment?

Most RDs are managed with Suture less high speed Vitrectomy technique, where 3 holes are created in the white portion of the eye to reattach the retina. After Re-attaching retina, Retina Surgeon fixes it with laser and supports it by filling Gas or Silicone Oil in the eye. Fresh Cases require urgent attention.  Early Surgery is known to give better results. Not Ignoring the Symptoms of Retinal Diseases, especially Flashes/Lightening is most effective preventive step against this serious disease.