Retinal Detachment: Risks and Surgical Options for Seniors

Retinal detachment

Hello Doctor: My mother is nearly 70 years old, with over 1000 diopters in her right eye and over 600 diopters in her left eye.
About two months ago, she noticed a dark shadow in her right eye, and recently she feels that the shadow has spread.
After examination at a major hospital, it was determined that she has a macular hole leading to retinal detachment, which requires surgery.
However, our family is concerned about her physical strength.
If she does not undergo surgery, will her condition worsen to the point of needing removal, or could it affect her other healthy eye?

linn, 30~39 year old female. Ask Date: 2015/08/24

Dr. Wang Zhangji reply Ophthalmology

The likelihood of needing enucleation due to a macular hole or affecting the other eye is low.

Reply Date: 2015/08/24

More Info

Understanding retinal detachment, especially in seniors, is crucial for both patients and their families. Retinal detachment occurs when the retina, a thin layer of tissue at the back of the eye, separates from its underlying supportive tissue. This condition can lead to permanent vision loss if not treated promptly. In your mother's case, the presence of a dark shadow in her vision and the diagnosis of a macular hole leading to retinal detachment are significant concerns that warrant immediate attention.

1. Risks of Not Undergoing Surgery: If your mother does not undergo surgery for her retinal detachment, there is a high risk that her condition will worsen. Retinal detachment can lead to more severe complications, including complete vision loss in the affected eye. In some cases, if the detachment is not addressed, it may lead to the need for more invasive procedures, including enucleation (removal of the eye) if the eye becomes irreparably damaged. Additionally, untreated retinal detachment can increase the risk of complications in the other eye, especially in individuals with high myopia (nearsightedness), as they are more prone to similar issues.

2. Surgical Options and Considerations: Surgical intervention is typically the recommended course of action for retinal detachment. The most common procedures include pneumatic retinopexy, scleral buckle surgery, and vitrectomy. The choice of surgery depends on several factors, including the type and extent of the detachment, the presence of any associated complications, and the overall health of the patient. While surgery carries risks, including infection, bleeding, and potential vision loss, the benefits of restoring or preserving vision often outweigh these risks, especially in cases of significant detachment.

3. Age and Health Considerations: At nearly 70 years old, your mother's overall health and physical condition will be important factors in determining her surgical candidacy. Surgeons will assess her general health, any comorbid conditions, and her ability to tolerate anesthesia and the surgical procedure itself. It is essential to have a thorough discussion with her ophthalmologist about her specific risks and benefits related to surgery. Many seniors successfully undergo retinal detachment surgery and experience positive outcomes.

4. Post-Surgery Recovery: Recovery from retinal detachment surgery can vary. Patients may need to maintain a specific head position for a period following the procedure, and follow-up appointments will be crucial to monitor healing and vision restoration. It is essential to have a support system in place to assist your mother during her recovery, as she may need help with daily activities.

5. Consultation with Specialists: If there are concerns about your mother's physical condition or the surgical procedure, consider seeking a second opinion from a retinal specialist. They can provide additional insights into the risks and benefits of surgery, tailored to her specific situation. It is also beneficial to discuss any concerns about her overall health and how it may impact her surgical options.

In conclusion, while the decision to proceed with surgery can be daunting, especially for elderly patients, the risks of not addressing retinal detachment can lead to severe consequences. Engaging in open discussions with her healthcare team, understanding the surgical options, and considering her overall health will help in making an informed decision. It is crucial to act promptly to preserve her vision and quality of life.

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