Dziram Eye Center

Retina Surgery
Facts about the retina

- The retina occupies the internal layer of the eye. It is the layer of the eye which contains photoreceptors which transform light into visual perception to be transported by the nerves into the brain for a person to see.

- Comparing the eye to an analogue camera as shown in Fig. above , the retina is the film of the camera on which the pictures are formed.

- The retina contains blood vessels which can be affected by any disease of the body which affects the blood or blood vessels, the commonest being diabetes, sickle cell and hypertension. When the blood vessels are affected, they can bleed into the eye, causing retinal and vitreous hemorrhage which if not prevented or treated can lead to blindness.

- Diseases of the retina are called retinopathies. If it is due to diabetes, it is called diabetic retinopathy. If it is due to sickle cell, it is called sickle cell retinopathy etc.

  
Normal Retina                                        Diabetic retinopathy                  Sickle Cell Retinopathy

-The retina is loosely attached to the inside of the eye. With age however, holes can sometimes develop in the retina and the vitreous, which is a jelly like substance occupying most of the space at the back of the eye (Fig.1), can become fluid and this fluid can sip through the hole, peeling off or detaching the retina. This is what we call retinal detachment. Retinal detachment could however be caused by injuries to the head or eye which create tears, holes or breaks in the retina to subsequently cause a detachment.

 
Normal eye                                                                  Detached retina
- Retinal detachment is an EMERGENCY condition of the eye which if not treated promptly, leads to blindness.

- Changes also occur on the retina due to age. These changes cause irreversible reduction of vision and are called Age-related Macula Degeneration ( AMD or ARMD) and this is the leading cause of blindness in advanced countries where the life expectancy is high.
As the adage goes, ' Prevention is better than cure'. That is the best way to describe treatment of retinal diseases, especially those which have to do with blood diseases such as diabetes, sickle cell or hypertension. Early diseases of the retina from the above-mentioned diseases can be treated with laser, which burns out the areas of vascular proliferation which otherwise if left untreated can lead to bleeding and blindness.


A retina after laser photocoagulation

In moderate diseases, some group of drugs, called Anti-VEGF ( Vascular Endothelial Growth Factor), namely Avastin and Lucentis, could be injected into the eye to stop new blood vessels (which could lead to bleeding) from growing or proliferating in the retina. In advanced diseases however, surgery must be done if blindness is to be prevented. 


Normal Visison                                    View of a patient with diabetic retinopathy

An eye becoming blind is not the end of the matter. If an eye is left to become blind from retinal diseases, that eye could then begin to cause pain after some years. The pain could be so intense and cause so many sleepless nights that the ultimate would be to remove the eye.
Retinal detachment however cannot be treated medically. It needs URGENT surgery to prevent blindness which could ensue in just a matter of days! This is because once the retina is detached, the photoreceptors die out. If surgery is done later and the retina is re-attached, the cells are already dead and cannot be revived and thus the vision will still remain poor.

All the above procedures, i.e. Argon Laser Photocoagulation, injection of Avastin or Lucentis, Retinal surgery for diabetic, sickle cell retinopathy etc, and Retinal detachment surgery, are all performed at Dziram Eye Clinic.
Dziram Eye Clinic and it’s partner clinic, Sight For Africa, are the only Eye Clinic in Ghana which will offer surgery for retinal diseases from September 2012, when Dr. Cofie returns from training in Germany and Kenya!
To conclude, if you or any relative or friend of yours is diagnosed to have diabetes, sickle cell or hypertension, that person should come for an urgent eye check up to know the status of his retina so as to prevent future disease and blindness. Of course this must be done in line with a good control of the medical condition, i.e. diabetes, sickle cell or hypertension. For retinal detachment, immediate surgery is needed!


Dziram Eye Center Introduces vitreo-retinal surgery from September 2012...