Retinal detachment

Asif Mahmood Khokhar — Thu, 23 Sep 2021 15:50:47 +0000

Retina is like a lamination on the inner surface of the eye. Small nerve fibers arise from throughout thr retina nad converge in the center at the point which is called optic disc. When we examine with different instruments, retina looks like the pictures below

The innermost layer seen in the picture is retina

Holes develop in the retina or sometimes some part of retina torns out. The holes and breaks appear as seen in following picture

When a part of retina tears out or a hole develops in some part, then fluid perculates and accumulates under the retina. That part of the retina bulges inwards as seen in the pictures

Detached retina and fluid appears as seen in this picture

When retina is detached, one method of reataching it is buckling. A silicon band is tied around the eye which presses from outside and compells the two layers of retina remain attached. The silicon band is seen as following after operation

The latest method for treatment of retinal detachment is vitrectomy operation. The fluid is drained out and the hole or break is welded by layer. This method is really a miracle. We should be thankfull to the reasearchers and Allah for this blessing to humanity. In the past This operation used to be very lenthy. Sometimes even 14 hours took one operation! bu now due to newer invenstions sometimes can be completed even less than a hour!

You can see how instruments work during vitrectomy operation

Laser is being applied during vitrectomy operation

I am performing vitrectomy operation by The Storz Company's Millinuim Vectrectomy Machine, Zeiss Company's Lumera Model Operation Microscope, and BIOM. This modern method requires neither general anesthesia nor stitching

I am performing vitrectomy operation by Oertli Company's Feros microsurgical system machine, Zeiss Company's Lumera Model Operation Microscope, BIOM. This modern method requires neither general anesthesia nor stitching.

How diabetes damages the retina?

Asif Mahmood Khokhar — Tue, 07 Jan 2020 05:52:18 +0000

?What is the effect of diabetes on retina

The visual system cannot function properly due to impaired retina.

Many blood vessels are blocked due to diabetic damage, which leads to ischemia of many parts of the retina. This results into lack of oxygen supply which leads into formation of membranes on the retina and into the vitreous. These membranes that form on the retina reduce vision. The blood vessels in these membranes are very fragile, which repeatedly rupture and bleed, which clots on the retina or cloudifies the vitreous and causes reduction of vision.
These membranes contract and cause detachment of retina; they may make breaks in the retina leading to detachment of retina. These consequences may lead to permanent loss of vision especially if not managed timely.

FFA Images: The images below show signs of leakage and inflammation caused by impaired blood vessels, as seen in the FFA test. In the areas that are black blood vessels have been blocked. This blockage results into elimination of blood supply to those parts. Those areas that are looking too white, are those areas in which blood vessels are leaking into the retina.

These blood vessels are abnormal. These have grown in attempt of compensation of the blocked blood supply. But these are can't compensate rather these are very slender and fragile and bleed easily. And also give rise to membranes.

In the images the retina has entered the final stages of the damage. Due to these membranes, the retina has been pulled from its place. The middle photo shows a thick layer of membranes. In the image at left side the entire retina has been affected and has been detached and lifted-up. In this way the ability of retina to feel the light is severely affected. And the retina becomes completely non-functional.

Does the operation of retina is successful? People are warning us. We are also afraid that the operation of the retina will not be benficial and the vision will be completely lost. It is heard all over that the retinal disease is incurable?

The problem of retinal impairments is very important in Pakistan. The main reason for this is that there are very few places for its treatment, and there are very few doctors trained to treat it. As a result, people develop a frustrated and careless attitude towards treatment of retinal disorders, so the disease goes on progressing far beyond. When the treatment is approached the disease is really incurable. In fact, the delay in initiating treatment makes the cure uncertain. However, even at that stage it is possible to at least reduce the amount of disability.

With the emergence of innovative methods of treatment, 90% of patients can now be treated successfully, but many of them have to undergo a second or third operation. It is extremely difficult to predict about the prognosis.

I am performig laser procedure for diabtic retinopathy

Retina looks like these after laser application

My dad has had diabetes for a long time. A few days ago, his vision suddenly deteriorated. When the doctor examined him, the doctor told that a blood vessels had ruptured. He has been prescribed medicines. How does the vessel ruptures? Can the problem be treated with laser or surgery?

With the help of laser application, the hole can be sealed-off, which stops the leakage and resoles the swelling. The laser is also applied to prevent the detachment of the retina. However, it is important not to delay the treatment by laser. Since most people start treatment too late, so the benefit is minimal.

Most of such patients do not benefit from laser treatment. Intravitreal injections are mostly dangerous and there is risk of development of tear in the retina due to these injection.

Most of these patients need vitrectomy operation.

retina – Dr Asif Khokhar