What is a retinal detachment?
The retina is the light sensitive layer at the back of the eye. It is essential to convert light that comes into the eye into an electrical current. This electrical current then goes to the brain and that’s how vision occurs. If you imagine that the eye is like a camera, then the retina is like a film in the back of a camera.
A retinal detachment occurs when the retina, which is like a layer of wax paper, peels off either partially or completely. Subsequently the retina is not able to work leading to blindness.
What can be done about retinal detachments?
In late 2016, Eye Clinic for Animals (ECA) started to do the first retinal reattachment surgeries in Australia. With the help of Associate Professor Alex Hunyor, a leader in human retinal reattachment surgery, and Dr Joe Wolfer, a world recognised veterinary retinal surgeon, ECA has now completed a number of very successful retinal reattachment surgeries. Surgery itself is technically very difficult, requires very committed owners, and represents the most complicated surgery that we at ECA perform.
Success
Anatomic success and visual success are different – so far we have reattached retinas in over 85% of our patients; however functional success and improvement in vision depends on how long the retinal detachment has been present and how badly damaged the retina is. So far we have an improvement in vision in over 90 % cases. (NOTE: the improvement may only be light perception or motion detection, but for some pets this can lead to a significant improvement in quality of life.) Visual return can take anywhere from 2 – 12 weeks.
Complications
The list of reported complications are numerous, and include but are not limited to the following:
SHORT TERM
- Problems with the Silicon oil (which is deliberately left in the eye post operatively).
- Leakage.
- Incorrect volume in the eye.
- Displacement of oil from the back of the eye.
- Corneal ulcers (a painful defect in the outer clear part of the eye).
- Glaucoma (increased pressure in the eye).
- Intraocular haemorrhage (hyphema).
MEDIUM / LONG TERM
At this stage retinal reattachment surgery is relatively new in Australia, and so we do not have long term (years) of follow up on cases.
- Silicone oil in the front of the eye.
- Dry eye (KCS) or inflammation of the outer clear coat of the eye (keratitis).
- Corneal edema (blueness in the usually clear outer part of the eye).
- Glaucoma – the presence of silicone oil in the eye increases risk.
- Cataract – a whiteness of the lens sometimes necessitating surgery.
- Retinal degeneration – this may be pre-existing or develop subsequent to retinal reattachment surgery.