The main goals of treatment are to stop disease progression and preserve or improve vision. In many cases, damage that has already occurred can't be reversed, making early detection important. Your doctor will work with you to determine the best treatment. Options may include:
April 22, 2015
Using a laser. A certain type of laser surgery (focal laser photocoagulation) can repair a retinal tear or hole. Your surgeon uses a laser to heat small pinpoints on the retina. This creates scarring that usually binds, or welds, the retina to the underlying tissue. Immediate treatment of a new retinal tear with a laser can decrease the risk of the tear leading to a retinal detachment.
- Shrinking abnormal blood vessels. Your doctor may use a technique called scatter laser photocoagulation to shrink abnormal new blood vessels that are bleeding or threatening to bleed into the vitreous. This treatment may help people with conditions such as diabetic retinopathy. With extensive scatter laser photocoagulation, you may experience loss of some side (peripheral) vision or night vision.
- Freezing. In this process, called cryopexy (KRY-o-pek-see), your surgeon applies a freezing probe to the external wall of the eye to treat a retinal tear. Intense cold reaches the inside of the eye and freezes the retina. The treated area will later scar and secure the retina to the eye wall.
- Injecting air or gas into your eye. This technique, called pneumatic retinopexy (RET-ih-no-pek-see), is used to help repair certain types of retinal detachment. It's used with cryopexy or laser photocoagulation.
Indenting the surface of your eye. This surgery, called scleral (SKLEER-ul) buckling, is used in the repair of a retinal detachment caused by one or more retinal tears. Your surgeon sews a small piece of silicone material to the outside eye surface (sclera). This indents the sclera and relieves some of the force caused by the vitreous tugging on the retina. This technique may be used with cryopexy, laser photocoagulation or vitrectomy.
A scleral buckle can involve a segment of your eye (segmental buckle), or it can encircle the entire circumference of your eye (encircling buckle).
Evacuating and replacing the fluid in the eye. In this procedure, called vitrectomy (vih-TREK-tuh-me), your surgeon removes the gel-like fluid that fills the inside of your eye (vitreous). He or she then injects air, gas or liquid into the vitreous space.
Vitrectomy may be used if bleeding or inflammation clouds the vitreous fluid and obstructs the surgeon's view of the retina. This technique may be part of the treatment for people with conditions such as retinal tear, diabetic retinopathy, macular hole, infection, eye trauma or retinal detachment.
Injecting drugs into the eye. Your doctor may suggest injecting medication into the vitreous fluid in the eye. This technique may be effective in treating people with wet macular degeneration, diabetic retinopathy or broken blood vessels within the eye.
For example, to treat wet macular degeneration, periodic injections of medications directly into your eye may help stop disease progression. In some cases, this treatment may help to partially recover vision.
- Implanting a retinal prosthesis. People who have severe vision loss or blindness owing to retinal disease may be a candidate for surgery. Mayo Clinic offers a new surgical option called retinal prosthesis.
- Epiretinal membrane. Dorland's Illustrated Medical Dictionary. 32nd ed. Philadelphia, Pa.: W.B. Saunders; 2011. http://dorlands.com/index.jsp. Accessed Oct. 30, 2014.
- Yanoff M, ed., et al. Ophthalmology. 4th ed. Edinburgh, U.K.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed Oct. 30, 2014.
- Facts about age-related macular degeneration. National Eye Institute. http://www.nei.nih.gov/health/maculardegen/armd_facts.asp. Accessed Oct. 30, 2014.
- AskMayoExpert. Age-related macular degeneration. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- AskMayoExpert. Diabetic retinopathy. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- AskMayoExpert. Posterior vitreous detachment. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Gilca M, et al. Factors associated with outcomes of pneumatic retinopexy for rhegmatogenous retinal detachments: A retrospective review of 422 cases. Retina. 2014;34:693.
- Al Shamsi HN, et al. Diabetic macular edema: New promising therapies. World Journal of Diabetes. 2013;4:324.
- Facts about diabetic retinopathy. National Eye Institute. http://www.nei.nih.gov/health/diabetic/retinopathy.asp. Accessed Oct. 31, 2014.
- Preferred practice pattern: Diabetic retinopathy summary benchmarks. American Academy of Ophthalmology. http://one.aao.org/guidelines-browse?filter=preferredpracticepatterns. Accessed Oct. 31, 2014.
- Riggin EA. Decision Support System. Mayo Clinic, Rochester, Minn. Jan. 7, 2015.
- Patel SV (expert opinion). Mayo Clinic, Rochester, Minn. March 23, 2015.
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