Retinal Detachment Surgery
Retinal detachment is a serious eye condition that can lead to total blindness if left untreated. It occurs when the retina tears away from the blood vessels at the back of the eye, starving it of oxygen and nutrients.
Retinal detachment can only be effectively treated through surgery. The type of surgery you will need will depend on how much of your retina has become detached, and for how long.
Prices for retinal detachment surgery start at just over £3,000 per eye at private clinics, but the NHS do offer the treatment free of charge.
What Is Retinal Detachment?
The retina is a thin layer of tissue that lines the back of your eye and allows you to see clearly. Retinal detachment occurs when the retina is lifted or pulled from its normal position, causing it to break away from the tissue at the back of your eye. This tissue contains a layer of blood vessels called the choroid. When the retina detaches from the choroid, it can no longer have blood supplied to it. This deprives your retina of oxygen, causing it to die. This can lead to partial or even total vision loss.
What Causes Retinal Detachment?
There are three types of retinal detachment, each with its own cause. They are: rhegmatogenous retinal detachment, tractional retinal detachment and exudative retinal detachment.
- Rhegmatogenous: rhegmatogenous retinal detachment occurs when there is a hole or tear in the retina, which allows fluid (vitreous) from within your eye to slip through it and reach behind your retina. This causes your retina to separate from the membrane that gives your retina oxygen and nourishment. This is the most common type of retinal detachment.
- Tractional: tractional retinal detachment happens when scar tissue on the surface of the retina contracts, causing your retina to break away from the wall at the back of your eye. This type of detachment tends to affect people with diabetes, where issues with the retinal vascular system can cause the development of scar tissue in the eye.
- Exudative: exudative retinal detachment does not occur due to a break or a tear in your retina. Instead it is caused by a disease of the retina, such as Coats’ disease, cancer behind your retina, or an inflammatory disorder that causes fluid to build-up behind your retina.
There are a number of factors that can put you at a greater risk of developing retinal detachment. They include:
- Being over the age of 50
- A family history of retinal detachment
- Very high myopia (short-sightedness)
- Complications from cataract surgery
- Extreme trauma to your eye
Symptoms Of Retinal Detachment
There are many warning signs that your retina is becoming detached, including:
- Distortion or blurring of your vision
- The onset of short flashes of light in your eye, which last no more than one second
- The sudden appearance of floaters - these are small black dots or streaks that move across your field of vision
If you experience any of the symptoms mentioned above, you should see your GP immediately. If you do not seek urgent medical attention, you will put yourself at risk of completely losing your sight. If your GP believes that you might be suffering from retinal detachment, they will refer you to an ophthalmologist on the same day. Ophthalmologists are specially trained to diagnose and treat eye diseases. They will carry out a series of tests which examine the back of your eye to determine whether you have retinal detachment. If you have a positive diagnosis, your ophthalmologist will discuss with you your treatment options.
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Retinal Detachment Treatment
It is important to treat retinal detachment as soon as possible because the risk of vision loss in your affected eye(s) will significantly increase the longer it is left untreated. Retinal detachment can only be treated through surgery. Approximately 85% of people with the condition will only need to undergo surgery once to successfully reattach their retina.
There are three types of surgery which treat retinal detachment. They are: pneumatic retinopexy, scleral buckling and vitrectomy. All take between one and three hours to complete, and are carried out under general or local anaesthetic. Surgery for retinal detachment is usually an outpatient procedure, meaning that you will be able to return home shortly after the operation is completed (provided that everything went well).
More information about the different types of surgery for retinal detachment can be found below:
Pneumatic retinopexy tends to be used when the detachment is small and straightforward. It involves the injection of a tiny bubble of gas into the middle of the eye. Your head is then positioned in a way that enables the gas bubble to move to the detachment and press against it, pushing the retina back into the correct place. A freezing probe or laser is then used to generate scar tissue in order to hold the retina in place until a seal forms between it and the back of your eye to prevent the retina from detaching again in the future. The gas bubble will remain in your eye for up to 12 weeks, until it is reabsorbed into your body.
Scleral buckling involves stitching fine bands of silicone, rubber or semi-hard plastic onto the sclera (the white of the eye) in the location where your retina has detached. These bands put pressure on the sclera, causing it to press onto the middle of the eye. This enables the torn retina to lie against the wall at the back of your eye. Freezing or laser treatment is then used to create scar tissue around the site where your retina detached to make a seal between the wall of the eye and the retina. This stops the tear from re-appearing in the future, preventing your retina from detaching again.
Vitrectomy is the most popular type of surgery used to treat retinal detachment. It works by removing the fluid (vitreous) from inside the eye through tiny cuts and replacing it with a gas bubble or silicone oil. This acts as a ‘splint’, holding your retina in place against the back of your eye. Your head will be held in a certain position for a short period of time to allow the gas bubble to settle in the correct location. The breaks in your retina are then located and are reattached to the back of your eye using lasers or freezing techniques. Tiny dissolvable stitches are then used to close the cuts made on your eye.
Retinal Detachment Surgery Recovery
It takes approximately two to six weeks for your eye to heal after undergoing retinal detachment surgery. Within this time, your surgeon will arrange a follow-up appointment with you in which they will monitor your recovery and ensure that you are experiencing no complications as a result of the operation.
It can take several months however, for your vision to improve following treatment. You may experience some temporary visual defects including floaters and double vision. The amount of vision that can be restored from surgery will largely depend on how much of your retina had become detached and for how long. For most, retinal detachment surgery will save all of a person’s sight. In a small number of cases however, the procedure is unable to completely rescue an individual’s vision. These people will have small areas of permanent vision loss, but not total blindness.
Immediately after the surgery, your surgeon will place a patch and plastic shield over your eye to protect it. The patch can be removed the following day, but you will need to continue to wear the plastic shield when sleeping for at least three weeks after the procedure. You will also be given anti-inflammatory eye drops to prevent swelling and infection.
If a gas bubble or silicone oil was inserted into your eye during surgery, you will need to “posture” for at least a week following the operation. This involves lying or sitting in a position in which your head is face down, to enable the bubble or oil to float up and press your retina into the correct position while it is healing. Your surgeon will provide you with instructions on how to do this. Be aware that posturing can increase the time it takes for you to return to normal activities, such as going to work.
It is normal to experience some minor side effects during your recovery from retinal detachment surgery, including:
- Pain and discomfort in and around your eye
- Itchy and sticky eyelids
- Fluid leaking from your eye
- Bruising around your eye
You should also avoid doing the following for at least two to four weeks after retinal detachment surgery:
- Rubbing your eye
- Getting soapy water or dirt in your eye
- Rigorous activity or physical contact sports
If you experience a sudden loss of vision, a lot of pain or notice an increasing redness in your eye, you should seek medical advice immediately from your surgeon or GP.
Are There Any Risks?
There are some more serious risks involved with retinal detachment surgery, although they are rare and can be treated easily. Your surgeon will discuss with you the risks involved with the surgery before you undergo the treatment. Risks include:
- The development of cataracts in your eye, due to the insertion of a gas bubble or silicone oil into your eye
- An allergic reaction to the anaesthetic or medication used in the surgery
- The development of an infection in your eye
- The build-up of high pressure within your eye
In 5-10% of cases, patients will need to undergo retinal detachment surgery for a second time. This is often because your eye has naturally tried to heal you detached retina, leading to the development of unwanted scar tissue. This scar tissue can cause your retina to tear away from the tissue at the back of your eye again, putting you at risk of losing your sight. This is known as PVR of proliferative vitreoretinopathy.
How Much Does It Cost?
Retinal detachment surgery is available at some private eye surgery clinics in the UK. Prices can range from just over £3,000 per eye to more than £3,500 per eye depending on the severity of your detachment and the type of surgery you require. Below we have provided a guide price for each type of retinal detachment surgery:
|Surgery Type||Starting Price (Per Eye)|
Leading eye surgery clinics appreciate that the cost of retinal detachment surgery might be too much for you to pay in one lump sum, so many will provide you with the option to pay for the treatment on finance. This breaks up the cost of the surgery into small monthly instalments, payable over a set period of time. These instalments tend to have a fixed interest rate (APR) attached to them, although interest-free options are sometimes available. You will need to pay an upfront deposit to book the day of your surgery, however. This can cost upwards of £500, so make sure you have enough money to cover this.
Is It Available On The NHS?
Retinal detachment surgery is available free of charge on the NHS, meaning you will not need to pay for the procedure yourself. This is because it is considered an essential treatment, as you are at risk of completely losing your vision in the affected eye if it is left untreated for too long.
In order to get retinal detachment surgery on the NHS, you will need to make an appointment to see your GP or optician if you start to experience any symptoms of a detached retina. If they suspect you are suffering from the condition, they will immediately refer you to an NHS ophthalmologist who will carry out a formal diagnosis. If it is discovered that you need treatment for a detached retina, you will be placed on a short waiting list before being notified of the day of your surgery.