dr. Biljana Kostovska talks about retinal detachment

In this time of limited movement, however, there are eye conditions as retinal detachment that are urgent and need immediate medical attention. One of them is ablation (detachment) of the retina. Dr. Biljana Kostovska explains in an interview what the symptoms are, how they are treated and how they should be treated if this condition occurs.

Sudden loss of vision, flashes, and black spots – what does that mean? What do these symptoms mean?

– At the beginning it can only be flashes, sparks, flashes like lightning. Black spots in the field of view or a large dark spot appear if the detachment is accompanied by bleeding into the vitreous space. The condition worsens with the appearance of a curtain in the field of view. When the detachment reaches the center of vision or the macula, which can occur within 1 to 2 days, the vision decreases considerably and the person can no longer read or recognize other people. Retinal ablation or retinal detachment is an emergency that must be operated on within 24 hours. During primary ablation, the retina ruptures and a retinal hole is formed as a result of the penetration of eye water through a small hole in the retina. With the expansion of the hole, the surrounding retina is raised and the retina gradually detaches from the background of the eye. Secondary ablation occurs as a result of inflammation or tumor of the choroid (treatment is more complex and multidisciplinary).

How is retinal detachment/ablation treated?

Retinal detachment/ablation is treated with an operation called vitrectomy. As the retina feeds only while glued to the background of the eye, any retinal detachment can permanently damage the retina. It is therefore important that the operation is performed as soon as possible and any delay results in a worse outcome after the operation. In “Sistina Ophthalmology” we can organize the operation within 24 hours during a working day or holiday. The operation is performed under local anesthesia with sedation. This operation is completely painless. It lasts an average of about an hour, after which the patient can go home the same day.

Vitrectomy is a precise and complex operation. It removes the glass from the inside of the eyeball, through small holes in the sclera (less than 1 mm) after which it is replaced with a special gas (which is resorbed over time) or silicone oil, and the holes in the retina are lined with a laser to attach.

During a vitrectomy, the eye is penetrated through 4 small openings of 1 mm each on the white part of the eye (sclera). During the operation, the vitreous is removed and replaced with fluid. The vitreous is then replaced by the normal aqueous humor that the eye produces itself and the eye functions normally. Once the vitreous has been removed, retinal “holes” are identified, and the retina is attached with laser.

How long does recovery take and what can you do?

– The eye is slightly red after the operation, without pain and the recovery lasts up to 1 month completely. It is necessary to apply drops and ointment therapy for two weeks, and the eye must be closed only for one day. Follow-up examinations are scheduled the day after surgery, 7 days after surgery, and 2 to 3 weeks after the intervention. After 10 days in uncomplicated ablations, the patient can return to daily activities. During those 10 days, the patients need to rest and lie down in a position recommended by a doctor, and they can work on a computer, read or watch TV using the other eye.

Is this type of intervention covered by the Fund?

– More than 10 years of experience, recognition, and tradition in eye surgery, and many years of work with the HIF of RNM to cover vitrectomies and cataracts. More than 10,000 vitrectomies and silicone oil replacements have been performed. We use the Constellation Vision System, the most modern ophthalmic microsurgical system for vitreoretinal surgery and cataract removal, for these interventions. This device is safe to operate, and at the same time allows the duration of the intervention to be brought to an optimal level, which positively affects the patient’s recovery after surgery. At Sistina Ophthalmology, the operation is performed without much waiting and with simple documentation.

The approach of our team is individual for each patient, and the complexity of this type of intervention sometimes requires cooperation with several professionals from several medical fields (cardiology, neurology, etc.). Multidisciplinary approach in order to enable successful resolution, followed by first-class pre-and post-operative medical care.

As part of the Svjetlost Eye Hospital Group from Croatia, which numbers over 60 ophthalmologists and more than 400,000 satisfied patients, our team of vitreoretinal surgeons regularly shares experiences in resolving such eye conditions. Regular attendance at world congresses and education, including training under the guidance of prof. Dr. Ferenc Kuhn (top vitreoretinal surgeon, Professor Lecturer at several universities across Europe), is an added value in terms of their knowledge and experience.