Seeking Care for Retinal Detachments
New floaters and flashes may be a sign of a retinal tear or detachment, especially if they suddenly increase in frequency or are accompanied by a dark curtain or any loss of vision. If you experience these symptoms or are at risk for retinal detachment due to nearsightedness, family history, genetic predisposition, a previous history of retinal detachment, a history of any eye surgery, or a serious eye injury, you need to be seen by an eye specialist immediately. Our subspecialty trained retinal doctors can quickly determine the severity of your condition and recommend the most appropriate treatment.
Our retinal specialists are also experts in treating other common conditions, such as vitreomacular traction, which occurs when the vitreous gel in your eye pulls on your retina, leading to a macular traction or hole. The resulting retinal swelling or break and decreased vision require advanced care from our subspecialists, who have additional training in retinal diseases.
Treatments for Retinal Detachments
Laser
A high-intensity beam of light energy is focused on the retina to weld together a retinal tear. This is a common treatment for small retinal tears.
Cryotherapy
A freezing probe seals the retinal tear then secures the retina to the eye wall. This outpatient procedure is performed on the outside of the eye and can prevent a retinal hole or tear from progressing to a retinal detachment. This is performed when your doctor does not have a clear enough view of the retina to perform a laser treatment.
Pneumatic Retinopexy
During this office-based procedure, a gas bubble is injected into your eye. Your head and body are positioned so that the bubble pushes the retina back into position against the wall of the eye. The procedure is often followed by laser treatment or cryotherapy, which seals off the retinal break. Maintaining the appropriate position in the days following the procedure secures the retina in its place and is important to the success of the procedure. Most small retinal detachments can be managed with these procedures.
Scleral Buckle
A flexible silicone band is sewn around the eye in the operating room to secure the retina in place. Retinal laser treatment or cryotherapy is often performed as well to close the hole causing retinal detachment. The scleral buckle procedure may also be performed in combination with vitrectomy surgery.
Vitrectomy
The vitreous gel -- the clear, jelly-like substance that fills the center of your eye behind the lens -- is surgically removed through tiny incisions. This may be performed in combination with other retinal detachment procedures, as it gives your eye surgeon better access to the back of your eye. The vitreous gel will be replaced with fluid, gas, or an oil bubble according to your eye’s specific needs.
Gas or Silicone Oil Tamponade
Vitrectomy surgery for repairing a retinal detachment often requires injection of gas or a liquid polymer known as silicone oil. These substances help keep the repaired retina in place and reduce risk of retinal detachment happening again. After gas injection, you will likely be required to remain face down for a few weeks after the surgery. There are also restrictions on air travel. Silicone oil may be removed six to 12 months after surgery. This procedure may be combined with cataract extraction and lens placement surgery.
Pioneers and Experts in Retinal Detachment Repair
Latest Advances in Retinal Imaging
We are one of the few centers in the U.S. to use optical coherence tomography (OCT) imaging in the operating room. The technology lets us visualize the layers of the eye with greater detail and identify subtleties and patterns that guide our treatment recommendations. Intraoperative OCT imaging allows for advanced surgical techniques like gene therapy delivery for genetic retinal disease. Our researchers and doctors are pioneers in this intraoperative imaging technology. They are also national leaders in using surgical microscope integrated OCT and interpreting the results.
High-Volume Referral Center
As a premier retina center, our providers have advanced training and skill in handling complex retinal detachments such as recurrent retinal detachments with proliferative vitreoretinopathy. As a result, we receive a high volume of referrals from other doctors. We are frequently called upon to help people who have recurrent retinal detachments or other complex problems following previous surgeries elsewhere.
Retinal Surgery Pioneers
The field of retinal surgery was pioneered at Duke by Robert Machemer, MD, the former chair of our ophthalmology department. Many of our senior surgeons trained under Dr. Machemer, who is widely considered to be the “father of vitreoretinal surgery.” Vitreoretinal refers to treatment of the retina, macula, and vitreous -- the gel and fluid that fill the eye.
Compassionate, Supportive Environment
We offer patient support services, including educational materials and programs, a low vision rehabilitation program, and a dedicated social worker to help you and your loved ones manage your condition and maximize your quality of life.
