What is a Retinal Detachment?

The retina is the light sensing nerve tissue lining the inside of the eye. The retina can separate from the underlying tissue, called the retinal pigment epithelium, causing blindness. This most commonly occurs due to age associated degeneration of the vitreous gel within the eye causing the gel to flick around with eye movement, creating whiplash-like movements that can pull a tear in the retina. It is essential that this is repaired as soon as possible.

The symptoms of a retinal tear that precede to retinal detachment are flashing lights and a shower of dark spots or a spider’s cobweb. It is essential that people with these symptoms seek urgent medical care, because if there is no early separation of the retina from the pigment tissue, laser treatment alone in the clinic can prevent the progression to retinal detachment. Once the retina starts to detach, people become aware of an absence of detail in their peripheral vision, as well as blurring and distortion.

Retinal detachments can sometimes be treated in the clinic, with a gas bubble and laser treatment with local anaesthetic. However, the majority of detachments require surgery in the operating theatre.

There are 2 ways to manage retinal detachments: external reinforcement called scleral buckling or microsurgery within the cavity of the eye called “vitrectomy”. The basic principles of retinal detachment repair are to identify the tear, reattach the retina to the underlying tissue and use spot welding techniques to create a waterproof seal around the tear margin to ensure the retina remains attached. In general, a gas bubble is also left inside the eye for a variable period of time, to hold the retina in place while it is healing.

A/Prof Wilson Heriot has been recognised for his excellence in retinal detachment surgery and was awarded a US$1.5 million grant from the US Department of Defence, to fund a research project developing a new method for retinal detachment repair. The method is call Retinal Thermofusion and currently in translation to a clinical trial at the Royal Victorian Eye and Ear Hospital.