Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
How does cataract surgery lead to a
retinal detachment?
Cataract surgery, especially if the operation has complications, increases the risk of a retinal detachment. Cataracts are areas of cloudiness (opacities) that form in the lens. Following the introduction of extracapsular surgery, a modern method used almost exclusively today for the removal of cataracts, the risk of retinal detachment became far less. In extracapsular cataract surgery, part of the capsule of the lens is left in place so that the vitreous gel is undisturbed. Phacoemulsification is a type of extracapsular cataract surgery that utilizes a very high speed ultrasonic instrument to break up and suck out the clouded lens of the eye. The capsule that is left in the eye may at a later time become cloudy, necessitating opening the capsule by using a laser. Opening the capsule increases the risk of retinal detachment.
In intracapsular cataract surgery, the predominant surgical method used from 1965 to 1990, the entire lens was removed. The capsule at the back of the lens, therefore, was no longer present to hold the vitreous gel in place. Consequently, the vitreous gel moved forward, and the retina was subjected to increased pulling or traction on the retina from the vitreous, which led to tears of the retina. Today, if the capsule is broken, which can be a complication during extracapsular cataract surgery, the vitreous gel similarly can move forward and pull on the retina. This sequence can lead to a retinal tear and a detachment, especially during the first year after surgery.
What other factors are associated with a
retinal detachment?
Blunt trauma, as from a tennis ball or fist, or a penetrating
injury by a sharp object to the eye can lead to a retinal
detachment.
A family history of a detached retina that is non-traumatic in
nature seems to indicate a genetic (inherited) tendency for
developing retinal detachments.
In as many as 5% of patients with a non-traumatic retinal detachment of one
eye, a detachment subsequently occurs in
the other eye. Accordingly, the second eye of a patient with a
retinal detachment must be examined thoroughly and followed closely,
both by the patient and the ophthalmologist.
Diabetes can lead to a type of retinal detachment that is caused
by pulling on the retina (traction) alone, without a tear. Because of abnormal blood vessels and scar tissue on the retinal surface in some people with diabetes, the retina can be lifted off (detached) from the back of the eye. In addition, the blood vessels may bleed into the vitreous gel. This detachment may involve either the periphery or central area of the retina.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Glaucoma is a common eye condition in which the fluid pressure inside the eye rises because of slowed fluid drainage from the eye. If untreated, glaucoma may damage the optic nerve and other parts of the eye, causing the loss of vision or even blindness.
Marfan syndrome is hereditary condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics: dislocation of one or both lenses of the eye; a protruding or indented breastbone; scoliosis; flat feet; aortic dilatation; dural ectasia; stretch marks; hernia; and lung collapse. Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Eye floaters are deposits or condensation that forms in the eye's vitreous humor. These deposits cast shadows on the retina, and as the eye moves, the deposits shift position, making it appear as though the shadows are moving or floating.
A cataract is an eye disease that causes the eye's lens to become cloudy and opaque with decreased vision. Causes of cataracts include diabetes, hypothyroidism, certain genetic illnesses, hyperparathyroidism, atopic dermatitis, and certain medications. Symptoms and signs include a decrease in vision and a whitish color to the affected eye. Treatment depends upon the patient's specific visual needs and may involve cataract surgery.
Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include: abdominal pressure, pelvic pain, and pain during intercourse. Diagnosis and treatment of benign uterine growths depends upon the type of growth.
Many common eye disorders resolve without treatment and some may be managed with over-the-counter (OTC) products. It's important to visit a physician or ophthalmologist is the problem involves the eyeball itself or the condition hasn't improved after 72 hours of use of an eye-care OTC product.
The most common cause of a black eye is due to an injury to the face or head. Most black eye injuries are minor and heal on their own, however, some may lead to significant injury. In addition to trauma to the face, cosmetic surgery can cause a black eye(s) as a side effect. People should be aware of the situations in which medical care should be sought immediately for a black eye.
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems in a person with diabetes include glaucoma, cataracts, and retinopathy. Examples of symptoms include blurred vision, headaches, eye aches, pain, halos around lights, loss of vision, watering eyes. Treatment for eye problems in people with diabetes depend on the type of eye problem. Prevention of eye problems include reducing blood pressure, cholesterol levels, quitting smoking, and maintaining proper blood glucose levels.
eye. Read about symptoms, signs, diagnosis, treatment, and prognosis.
Coats' disease is a rare eye condition that typically progresses to vision loss or blindness in one eye. Gradual vision loss is usually the first symptom, followed by a cloudy white or yellow pupil due to the presence of a cataract. Treatment focuses on limiting the blood vessel progression and may involve cryotherapy or laser photocoagulation.
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