Definition

Retinal detachment is a disease that affects the retina. This is a thin tissue, composed of different cell layers, which covers the inner surface of the eye and, thanks to photoreceptors, allows the light signal to be translated into a nervous signal and transmitted to the brain, which transforms it into an image. Without retinal cells you can't see. Retinal detachment occurs because of trauma or sudden/excessive dehydration. The lack of water in the body can lead to a lower elasticity of the vitreous collagen fibers that make up the vitreous body, i.e. the gelatinous substance that adheres to the retina. Following a traction, therefore, the retina breaks or detaches.  

Symptomatology

Very often the detachment of the retina begins in the peripheral part of the visual field, without pain and special effects on vision. As the disease progresses, there is a partially blurred vision, often referred to by patients as “how to see through water”, which progressively worsens depending on the extent of the detachment. The feeling is that of a dark curtain that drops partially veiling the view. If the detachment is total and includes the central portion of the retina (macula), you stop seeing completely and only the perception of brightness remains. The visual symptoms that can precede the detachment of the retina are, instead, sudden flashes of light (phosphenes) and the onset or increase of the moving bodies of the vitreous, the so-called "eye floaters". These moving bodies are due to the movements of collagen fibers that float inside the eye when the vitreous begins to lose compactness. 

Diagnostics

Essential for an effective diagnosis is to undergo vision control at the first onset of symptoms. The eye examination, however, is also an excellent prevention tool that, those who have undergone cataract surgery, the over 40 and even more the over 60, and even the myopic at a young age, must perform periodically. Only the fundoscopy can detect if a dangerous situation is developing.  

Therapy

Retinal detachment is always a surgical emergency and should be operated as soon as possible. The episcleral cerclage is the surgery chosen. It consists of placing a silicone rubber bandage (of thickness and height varying generally from 2 to 7-10 mm) around the sclera, i.e. the outer layer of the eyeball. The bandage exerts pressure on the sclera allowing the detached retina to be reattached and, therefore, the vision restoration. In the most severe cases, a vitrectomy should be used, which is the removal of the vitreous body (which is replaced by other means such as water, silicone oil, air or gas).