The Retina is the part of the eye which receives light stimulus from the environment and converts it into electrical impulses to be sent to the brain for visual interpretation to enable sight or vision to occur. Retinal detachment (RD) refers to separation of the neurosensory retina (NSR) from the retinal pigment epithelium (RPE). This results in the accumulation of Subretinal fluid in the potential space between the neurosensory retina and Retinal Pigment Epithelium. There are basically five typical types of RD: Rhegmatogenous, Tractional, Exudative, combined tractional-rhegmatogenous and the Sub-clinical type of retinal detachment.
RHEGMATOGENOUS RETINAL DETACHMENT
In case of a rhegmatogenous RD, the separation is due to a retinal discontinuity (break, tear). Rhegmatogenous RD requires a full-thickness defect in the sensory retina, which permits fluid derived from synchytic (liquefied) vitreous to gain access to the subretinal space. RRD as opposed to the presence merely of a cuff of SRF surrounding a retinal break,is said to be present when fluid extends further than one optic disc diameter from the edge of the break. . The classic premonitory symptoms reported in about 60% of patients with spontaneous rhegmatogenous RD are flashing lights and floaters associated with acute PVD. After a variable period of time a curtain-like relative peripheral visual field defect may ensue, and can progress to involve central vision.
TRACTIONAL RETINAL DETACHMENT
In the tractional form, RD is caused by progressive contraction of fibrovascular
membranes over large areas of vitreoretinal adhesion, whether present on the retinal surface or, less commonly, underneath it (subretinal strands). No retinal break is present, although it may subsequently develop (combined rhegmatogenous/tractional RD). Similarly, rhegmatogenous RD may develop a secondary tractional element. In the serous form, RD is caused by the subretinal accumulation of fluid, other than that originating in the vitreous cavity, caused by leaking retinal blood vessels or discontinuities in the retinal pigment epithelium. In the hemorrhagic form, RD is caused by the accumulation of subretinal blood, most commonly due to trauma. Retinoschisis is not an RD in the true sense of the word; here layers of the neuroretina split, and the fluid is between layers of the neuroretina. Full thickness retinal detachment can rarely complicate retinoschisis.
EXUDATIVE RETINAL DETACHMENT
Exudative RD is characterized by the accumulation of SRF in the absence of retinal breaks or traction. It may occur in a variety of vascular, inflammatory and neoplastic diseases involving the retina, RPE and choroid in which fluid leaks outside the vessels and accumulates under the retina. As long as the RPE is able to compensate by pumping the leaking fluid into the choroidal circulation, RD does not occur. However, when the mechanism is overwhelmed or functions subnormally, fluid accumulates in the subretinal space. Some of the common causes of exudative RD include choroidal tumors, inflammation, choroidal neovascularization, and the most common latrogenic and idiopathic causes.
RISK FACTORS OF RETINAL DETACHMENT
MANAGEMENT OF RETINAL DETACHMENT
Treatment depends on cause. As technology and repair techniques continue to evolve, a myriad of therapeutic options are now available for its management. Although retinal detachments are common, there is still some controversy on the optimal treatment options for different types and presentations of retinal detachment. Available treatment options include surgical approach; Pneumatic Retinopexy, Scleral Buckle approach, Par Plana Vitrectomy and or other management options such as use of lenses, good illumination, food supplementation and the use of latest technological visual aids.
AIMS AND OBJECTIVES
To reduce or prevent vision loss through diseases such as glaucoma, cataract and refractive errors.
To enlighten the majority of the Ghanaian population about the importance of proper visual care.
To conscientize people on the need for regular eye checks
To get more people to have their wards screened within the Critical periods of a Child’s Vision Development; thus from ages 3 to till about 10 years.
To help the blind and people with low vision live a better life within the society through education of the general public to stop stigmatization.
To help in the fight of extreme poverty that puts the health of people at risk
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