Retinal Detachment – Seeing the signs and where medical negligence occurs
‘Red Flag’ Blog Series
What is Retinal Detachment?
The retina is a thin layer of nerve tissue that lines the wall at the back of the eye, often described as being like the film in a camera. As rays of light pass through the eye onto the retina, it in turn sends electric impulses to the optic nerve in the brain, allowing it to interpret the images around us.
Retinal detachment is a relatively rare but serious condition that occurs when a layer of the retina begins to pull away from the blood supply which supplies it with oxygen and nutrients – the epithelium. This pulling away or detachment can result in permanent loss of vision in the affected eye if left untreated.
How is it caused?
There are three ways in which the retina can become detached:-
- Rhegmatogenous retinal detachment
The most common form of retinal detachment occurs when a tear appears in the retina allowing a build-up of fluid in the eye. This fluid build-up in turn causes a retinal detachment. - Exudative retinal detachment
This occurs when blood vessels underneath the retina begin to leak fluid and begin to push the retina forward. This may be caused by such conditions as inflammation in the eye. - Tractional retinal detachment
This occurs when the retina and vitreous (jelly-like fluid inside the eye) become tightly stuck together. The vitreous can then pull at the retina and cause a detachment. This can happen as a result of an injury, inflammation, or the abnormal growth of blood vessels (common in people with diabetes) in the eye.
Who is at risk?
Retinal detachment is generally associated with the ageing process, and mostly affects people aged between 45 and 75. However, it can also be caused by injury to the eye at any age.
Furthermore, it is more common in those who are very short-sighted, have a family history of the condition and those who suffer from various eye conditions such as diabetic retinopathy.
What are the symptoms?
There are a number of warning signs which indicate retinal detachment. Immediate action is required in order to reduce the risk of permanent sight loss.
These warning signs include:
- The sudden onset of “floaters”, or dark spots floating (i.e. moving around) in the field of vision.
- Sudden short flashes of light in one eye
- Blurred or distorted vision
It should be noted that the “floaters” can take different forms such as small dots, a cobweb effect or a larger dark spot the size of a house fly. Any indication of dark spots or sudden changes in the field of vision should be taken very seriously.
If I suspect it – what should I do?
A quick reaction to the symptoms of retinal detachment is essential to help prevent sight loss. Without treatment, you can continue to lose vision, described as a “black curtain” creeping across the eye.
You should attend with an ophthalmologist or optometrist as soon as possible. If you cannot attend a specific eye doctor, you should contact your GP for advice or contact your nearest out-of-hours service.
How is it treated?
Prompt diagnosis and treatment of retinal detachment is essential.
If you go to your GP or optometrist with the symptoms of retinal detachment or a dramatic change in vision, you should be referred to a specialist ophthalmologist urgently.
Depending on the extent of the retinal detachment that has already occurred, any delay in referral may result in substantial vision loss.
Usually, retinal detachment is treated by emergency surgery. The retinal condition will be examined by an ophthalmologist and the best course of surgery decided upon. Surgery usually involves the insertion of gas or silicone into the eye to repair the tear or fill the detachment.
Again, in many cases, the sooner this surgical treatment takes place, the less damage occurs to the field of vision.
Where can negligence happen?
Negligence by a medical professional can occur in a number of ways in relation to the treatment of retinal detachment:
- Failure to recognise the presenting symptoms of retinal detachment.
- Failure to refer the patient in sufficient time to a specialist ophthalmologist.
- Failure to adequately diagnose the condition.
- Failure to find the retinal break.
- Failure to perform repair surgery in sufficient time.
- Failure to perform repair surgery to the adequate standard.
It should be noted that negligence mostly occurs in failure to recognise the symptoms and refer quickly. The longer the delay in advance of surgery, the more difficult it is to successfully repair the detachment.
If I have been affected by sight loss – who can I talk to?
As medical negligence solicitors, we are aware of how important it is that the symptoms of retinal detachment are noticed quickly, diagnosed correctly and treated as soon as possible.
We understand that sight loss can be a traumatic and life changing experience. We can provide both legal advice and access to practical support services to help you cope physically and emotionally with the condition.
It is important that anyone who wants to pursue a compensation claim relating to retinal detachment instructs a specialist clinical negligence solicitor with knowledge of this condition and experience of cases involving it.
Katie Mulroy is a Solicitor at Bolt Burdon Kemp specialising in clinical negligence claims. If you or a loved one are concerned about the treatment you have received, contact her free of charge and in confidence on 020 7288 4853 or at katiemulroy@boltburdonkemp.co.uk for specialist legal advice. Alternatively, you can complete this form and one of the solicitors in the Medical Negligence team will contact you. You can find out more about the team here.
