The goal of most treatments is 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 to preserve vision. Your doctor will work with you to determine the best treatment for you, which may include:
- Laser therapy (focal laser photocoagulation). To repair a retinal tear or hole, your surgeon may use a high-energy laser to heat small pinpoints on the retina that then create scar tissue which binds (or "welds") the retina to the underlying wall of the eye.
- Scatter laser treatment (panretinal photocoagulation). This laser treatment often can shrink abnormal new blood vessels that are bleeding into the vitreous in diseases such as diabetic retinopathy. Multiple laser burns cause the new blood vessels to shrink and scar. Although this may result in some loss of side (peripheral) vision, it may be necessary to sacrifice some side vision to preserve central vision.
- Freezing (cryopexy). Cryopexy (KRI-oh-pek-see) is often used to treat retinal tears along the retinal periphery that are hard to reach with a laser. Intense cold freezes the area around a retinal tear or hole, producing a tissue reaction that results in a delicate scar. The scarring secures the retina to the eye wall, sealing the holes and preventing retinal detachment.
- Pneumatic retinopexy. Pneumatic retinopexy (noo-MAT-ik RET-ih-no-pek-see) is used to treat certain types of retinal detachment such as a tear in the upper half of the retina. After cryopexy, a bubble of air or gas is injected into the inside of the eye (vitreous cavity). The bubble floats in the eye, pushing the retina against the wall of the eye so that a scar develops on the eye wall. This seals the retinal tear so that the retina reattaches itself. The bubble will gradually be absorbed.
- Scleral buckling. In this surgery to repair retinal detachment, your surgeon sews a small piece of silicone material to the outside eye surface (sclera). This creates a buckle that flattens or indents the sclera, relieving the tugging of the vitreous on the retina. Sometimes the surgeon drains fluid under the retina through a tiny hole in the eye wall. A scleral buckle can be used for a segment of your eye (segmental buckle) or to encircle the entire circumference of your eye (encircling buckle).
- Vitrectomy. When bleeding or inflammation clouds the vitreous fluid in the eye and obstructs the surgeon's view of the retina, the blood-filled vitreous can be removed (vitrectomy) and replaced with a salt solution to maintain the shape of the eye and improve vision. The cause of the blood can be identified and treated with delicate instruments that often include the use of a microlaser probe inside the eye. Vitrectomy may be performed for diabetic retinopathy, macular hole, epiretinal membrane, infection within the eye, eye trauma or to manage retinal detachment.
- Eye injections. Injection of medication into the vitreous fluid in the eye may be effective in treating wet macular degeneration, diabetic retinopathy and 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.
Learn more about treatment of retinal detachment, diabetic retinopathy, dry macular degeneration and wet macular degeneration.
Nov. 19, 2012