The retina is a very thin layer of cells that lines the inside of the eye. The rod and cone cells absorb the light which is focussed on the retina by the lens. The visual impulse is then transmitted to the brain where the picture of the object is processed and seen.

Sometimes, mostly after a retinal break, the retina can come loose from the inside of the eye. The retina cannot function in this way, and that part of the retina cannot see the light.

What are the symptoms of a retinal detachment?

A retinal detachment may be preceded by the appearance of floaters or flashes. Typically, the patient sees the appearance of a curtain or a bubble from one side of the visual field. This may progress over the visual field until all vision in the eye is lost.

These signs can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches immediately.

About one in seven people with sudden onset of flashes and floaters will have a retinal tear or detachment, according to a study reported in late 2009 in the Journal of the American Medical Association.

Up to 50 per cent of people who experience a retinal tear will have a subsequent detachment. No pain is associated with retinal detachment. If you experience any of the signs, consult your Retinal Eye Specialist right away. Immediate treatment increases your odds of regaining lost vision.

A Macular Hole

A Macular Hole can be caused by Vitreous Shrinkage and / or Separation. The back of your eye is filled with a rather thick, gel-like material called the vitreous humor (also called the vitreous body or the vitreous) that helps your eye keep its shape. The clear vitreous shrinks and becomes more liquid with aging.

Because the vitreous is attached to the retina with tiny strands of cells, it can pull on the retina as it shrinks. Sometimes, this shrinkage can tear off a small piece of the retina, causing a hole.

If this missing piece of retina is in the macula, it’s called a macular hole.

Another direct cause of macular holes due to vitreous shrinkage is when the strands stay attached to the retina and break away from the vitreous. These strands can contract around the macula, causing the macula to develop a hole from the traction.

In either case, fluid develops where the vitreous shrinks to fill the spaces. This fluid can seep into a macular hole, causing blurred and distorted central vision.

Commencing treatment at the earliest possible stage is crucial for achieving an optimal outcome.

A vitrectomy is the most common treatment for a macular hole. During surgery, the Retinal Specialist removes the vitreous gel (the innermost layer of the retina in this area) to stop it from pulling on the retina. A mixture of air and gas is inserted into the space once occupied by the vitreous.

It is of utmost importance that a patient is in a face down position for a few days post operatively. Although closure of the macular hole is often the post operative outcome, a non-closure macular hole and edema may occur, and further treatment will be necessary.