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this is Goyang Shinsegae Eye Clinic.
Eye diseases can often develop without causing noticeable pain.
The retina, in particular, does not have pain receptors, which means that retinal problems may occur without any pain or discomfort.
For this reason, some patients may not seek medical attention until they begin to notice changes in their vision, by which time the condition may already have progressed to a stage requiring treatment.
Retinal detachment is one of the eye conditions for which timely diagnosis and treatment are especially important.
If the detached area expands and reaches the macula, which is responsible for central vision, significant vision loss may occur.
Therefore, if you suddenly notice an increase in floaters, repeated flashes of light known as photopsia, or a dark shadow or curtain-like obstruction in part of your visual field, it is important to have your eyes examined promptly at an ophthalmology clinic in Paju.
1. What Is the Role of the Retina?
The retina is a very thin layer of nerve tissue located at the innermost part of the eye.
It contains photoreceptor cells that detect light and convert incoming visual information into electrical signals, which are then transmitted to the brain through the optic nerve.
In simple terms, the retina functions in a way similar to the film or image sensor in a camera.
For the retina to function normally, it must remain closely attached to the underlying retinal pigment epithelium.
However, when a retinal tear develops and liquefied vitreous fluid enters beneath the retina, the neurosensory retina may separate from the retinal pigment epithelium.
This condition is known as retinal detachment.
2. Early Symptoms
① Sudden Increase in Floaters
Floaters are visual disturbances that appear as black dots, threads, cobwebs, or other small objects drifting across the field of vision.
Floaters can also commonly occur due to age-related changes in the vitreous.
However, a sudden increase in floaters may require further evaluation.
② Flashes of Light, or Photopsia
Photopsia refers to seeing flashes, sparks, or lightning-like lights, often in the peripheral vision, even when no actual light source is present.
This can occur when the vitreous pulls on or stimulates the retina.
③ A Curtain-Like Shadow in the Visual Field
Part of the visual field may appear to be covered by a dark shadow or curtain.
As the retinal detachment progresses, the area of visual field loss may also increase.
If the detachment reaches the macula, central vision may also become impaired.
④ Sudden Loss of Vision
If the retinal detachment progresses to involve the macula, central vision may become blurred or visual acuity may decrease significantly.
Rather than assuming that these changes are simply caused by eye fatigue, it is important to have the condition of the eye properly evaluated.
3. How Is Retinal Detachment Diagnosed?
Not all retinal detachments appear in the same form.
In some cases, a retinal tear may be present without an actual detachment.
In other cases, the detachment may be limited to the peripheral retina or may have already extended to involve the macula.
Therefore, during an ophthalmic examination, several factors must be evaluated comprehensively, including:
✔ the location and number of retinal tears,
✔ the extent of the retinal detachment,
✔ whether the macula is involved,
✔ and whether vitreous hemorrhage is present.
A dilated fundus examination is typically performed as part of the basic evaluation.
Depending on the patient’s condition, additional tests may include ultra-widefield fundus photography, optical coherence tomography (OCT), and ocular ultrasonography.
OCT is particularly useful for obtaining cross-sectional images of the retina and assessing fine retinal structures, including the macula.
If the retina cannot be clearly visualized because of vitreous hemorrhage or other media opacities, ocular ultrasonography may be helpful.
4. What If Emergency Surgery Is Required for Retinal Detachment?
Emergency surgery for retinal detachment is a highly delicate microsurgical procedure involving extremely thin and sensitive retinal tissue.
Therefore, it is important to choose an ophthalmology clinic equipped with both an appropriate diagnostic system and microsurgical equipment capable of accurately evaluating the condition.
At our clinic, the condition and extent of the retinal lesion are assessed before surgery using ultra-widefield fundus photography and OCT.
Based on these findings, an individualized treatment plan is established.
When emergency surgery is required, the procedure is performed using a high-resolution surgical microscope and specialized microsurgical equipment.
5. Treatment Options
✓ Vitrectomy
Vitrectomy is a surgical procedure in which the vitreous that is pulling on the retina is removed so that the retina can be repositioned and reattached.
If necessary, fluid beneath the retina may be drained, and laser treatment may be applied around the retinal tear.
A gas bubble or silicone oil may then be placed inside the eye to help keep the retina securely attached during the healing process.
✓ Scleral Buckling
Scleral buckling is a surgical procedure in which a silicone band or sponge is attached to the outer wall of the eye, known as the sclera.
This gently indents the wall of the eye inward, reducing traction around the retinal tear and helping the tear to close.