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Most retinal detachments do not require emergency surgery. I operated this Saturday morning, however, to repair a retinal detachment for a patient who should not wait through the weekend for the operation. In this case it was an “emergency.”
Often, as with my patient (RR), there is a history of flashes and/or floaters preceding eventual loss of vision. RR had some vague symptoms over the past two weeks, but did not become too concerned until he started to lose some of his peripheral vision.
His central vision was unaffected. He could see well at distance, read and watch TV, but objects located down and to the right in his peripheral vision were missing…and it was getting worse.
There are really only two emergencies faced by a retinal surgeon. Endophthalmitis, or infection inside the eye is the most devastating and is the biggest eye emergency.
A retinal detachment not including the macula, but is in danger of detaching the macula is a relative emergency. Fluid located “above” or “superior to” could shift downward, thus detaching this crucial area and decreasing central vision.
In the diagram, the macula (small brown spot in the center of the picture) is still attached. If the area of retinal detachment were to enlarge, the macula might become affected. Central vision would be lost and permanent visual loss is possible.
Fluid underneath the retina often obeys the laws of physics…and moves with gravity.
The timing of retinal detachment surgery is basically determined by the state of the macula. There are three possibilities;
A detached retina is potentially blinding. The retina is the light sensitive tissue that lines the inside of the eye. A retinal tear or hole usually leads to a retinal detachment. Floaters can sometimes be the earliest, and only, symptom. Many times there is little warning and a retinal detachment usually occurs without trauma.
Capital Eye Consultants
Randall V. Wong, M.D.
Contact: Brigitte O’Brien
|A: 3025 Hamaker Court, Suite 101 • Fair fax, Virginia 22031|
Dressler Ophthalmology Associates, PLC
Randall V. Wong, M.D.
Contact: Andrea Armstrong (Surgery/Web)
Chrissy Megargee (Web)
|A: 3930 Pender Drive, Suite 10 • Fairfax, Virginia 22030|