Weill Cornell Medical College

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Retinal Detachment and Other Vitreoretinal Disorders

Retinal detachment, a condition in which the retina progressive separates from the inner wall of the eye, produces progressive visual loss which becomes permanent if untreated. Some patients will experience flashes and floaters (which may prove to be harmless without detachment), but some patients will experience more profound symptoms such as loss of side vision or central vision. The accurate diagnosis of retinal detachment requires a careful ophthalmoscopic examination after dilation of the pupil. If holes in the retina are detected at an early stage, treatment in an outpatient setting with laser or cryotherapy (freezing) may be sufficient. Detachment of the retina requires a surgical procedure such as pneumatic retinopexy, scleral buckling, or vitrectomy, and the choice depends on many individual factors. While the surgical procedures are often successful, recurrent detachment may occur and require additional operations. If scar tissue develops on the retina, a condition known as proliferative vitreoretinopathy occurs and greatly increases the difficulty of achieving retinal reattachment. This is particularly troublesome in patients whose detachment is caused by a giant retinal tear.

Macular pucker is a condition in which scar tissue develops on the center of the retina and distorts the visual acuity. It may occur in older individuals without any apparent cause, or following retinal detachment surgery. In symptomatic cases, it can be removed by vitreous surgery with visual improvement in the great majority of cases.

Macular hole is a condition in which certain susceptible eyes develop an opening right in the center of the retina. It produces a blind spot in the visual center, and two decades ago, was thought to be an untreatable condition. An innovative surgery involving vitrectomy with removal of the posterior hyaloids layer, peeling of an inner retinal layer called the internal limiting membrane (ILM), and placement of an intraocular gas bubble for postoperative face-down positioning, has rendered this among the most successfully-treatable of retina conditions.

The retina specialists at Weill Cornell Eye Associates are internationally-noted for their expertise in complicated retinal detachment repair and vitreoretinal disorders including removal of macular pucker, and macular hole repair. In addition, many other conditions such as vitreous hemorrhage due to central retinal vein occlusion or branch retinal vein occlusion are also amenable to modern therapies.