28 Mar Regular Examination for Retinal Detachments
Routine eye examinations looking for retinal detachments are not necessary. Unlike diabetic retinopathy where the probability is quite high that every patient with diabetes develops the disease, a detachment does not happen often in the general population and usually is associated with symptoms.
Patients are often worried about developing a retinal detachment. Sometimes they’ve had a previous retinal detachment, they are worried about having an asymptomatic problem or there is a family history of retinal detachment.
Previous Retinal Detachment
I often examine patients who have had previous retinal detachments. I have never found an asymptomatic (patient is unaware of any symptoms) condition in the same eye once they have had and have healed from previous surgery.
For example, a patient who is fixed with a scleral buckle is highly unlikely to detach again once the retina has been attached for a month or two following surgery.
In the case of scleral buckles, it has been my experience that the other eye is actually at higher risk for developing a retinal detachment than the original eye (once healed). By actually changing the shape of the eye, the scleral buckle does offer some “protective” effect.
Asymptomatic Retinal Detachments Do Exist
Occasionally, patients are diagnosed with asymptomatic detachments. These are pretty uncommon.
Once a patient has had one retinal detachment; however, it is unlikely, and very rare, that a second detachment is missed as patients have a heightened awareness and there are almost always symptoms of vision loss, flashes or floaters.
Except for a few rare genetic disorders, while myopia is a hereditary, retinal detachments in the general population are not hereditary.
What Does this Mean?
Once diagnosed and treated, a detachment is unlikely to recur. Despite a family history or a personal history of retinal detachment, once successfully treated, I usually do not see patients again after 6 months to a year. This may not be a global practice pattern.
Regular examination in patients without symptoms also is unlikely to discover a retinal detachment.
The best advice, however, is to make sure that any new flashes and floaters (the two most common symptoms of a retinal tear) get checked out with a dilated eye exam, especially if you have a personal history of retinal detachment or a family history.