Okay, you have reached the Ophthalmologist. What will happen after this?

The Ophthalmologist will put eyedrops to dilate the pupils.

A detailed retinal exam with indirect Ophthalmoscopy will be done. A consultation with a retinal specialist may be advised.

There are no medicines which can cure a retinal detachment. The only treatment is surgery.

It is usually done under local injection anaesthesia. The time taken for surgery may be 1-3 hours.

What does the surgeon do?

The surgeon opens the conjunctiva. The retina is observed  in detail with the Indirect Ophthalmoscope. The sub-retinal fluid is drained. With this, the retina usually returns back to its position. Ice is applied to the retinal tear, called 'Cryo-application'. This causes local scarring and seals the tear. The retinal tear can also be sealed by Laser.  To maintain the retina flat in its normal position, an air or special gas bubble is injected into the eye and the conjunctiva is stitched back.

Sometimes, a surgery called 'vitrectomy' may be required. In this, the jelly of the eye, the vitreous, is removed,  Silicon oil or a substance called PFCL may be injected to keep the retina in place after surgery. 

Instead of all these complicated things why can't the retina be simply stitched back?

The logic is agreeable, but retina is very delicate. Retinal tacks or stitches were used in olden days, but their success was limited. This type of surgery has evolved after ages of trial and error and lots of experimentation.

Are there any special post-operative instructions?

The most important thing to do, is to lie/sit in exactly the position told by the doctor. Only this can maintain the retina in place and help the retina to stick back. The earlier the retina sticks back better will be visual outcome.

Besides this, using the post-operative medicines as advised, general eye cleaning etc. is also important.

Many times Corticosteroids have to be given after Retinal surgery. The body has a natural tendency to heal wounds with scarring. If a lot of scarring occurs inside the eye, a thick scar membrane will form. This white, opaque membrane will hinder vision. Corticosteroids prevent the formation of this membrane.

The Corticosteroids may affect the blood sugar level control in Diabetics. They can cause weight gain, acidity, bone Calcium loss, as side effects if taken for a long time. But they definitely Salvage vision!