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12 December 2008

The vision of Gordon Brown

The new British Prime Minister lost the vision in one eye at a young age. And he only has 30% vision in the other. How did this happen?

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The new British Prime Minister lost the vision in one eye at a young age. And he only has 30% vision in the other. How did this happen?

At the age of 16, while playing in a rugby match, he was kicked against the head and sustained damage to his retina. Doctors fought to save his sight in this eye and for five years he was in and out of hospital, often spending weeks in a darkened room.

He eventually lost sight in one eye and has retained only 30% vision in the other eye.

What is a detached retina, what makes it so dangerous and what are the signs and symptoms?

A medical emergency
A detached retina occurs when the retina peels away from the underlying layer of support.

If immediate treatment is not given, the whole retina could detach and this may cause vision loss and blindness.

Retina detachment does not simply occur overnight: there are early warning signs and if they are heeded, vision can be saved. It often occurs as a result of an inflammation, trauma or advanced diabetes.

However, in most cases it often occurs suddenly as the result of change in the jelly-like substance (also called the vitreous humour).

Flashes of light and floaters
Retinal detachment often happens without any pain, but it usually involves loss of vision, or distortion of vision.

Common warning signs include:

  • The appearance of floaters - small pieces of debris that look like spots, hairs or strings in your field of vision.

  • Flashes of light in both or one of your eyes

  • Blurry vision

  • A shadow or veil over a part of your vision

The risk of developing a detached retina increases over time. As you get older, the vitreous humour changes. However, there are factors that increase your risk:

  • If you have had retinal detachment in one eye

  • Family history of retinal detachment

  • Severe nearsightedness

  • Eye surgery, such as cataract removal

  • Eye injury or trauma

  • Weak areas in the retina

About five in 100 000 people in the general population could be at risk of developing retinal detachment. It is more common in middle-aged and elderly people, who have a risk of about 20 in 100 000. In people with severe nearsightedness, the risk is one in 20.

Laser surgery and freezing
The only effective treatment for retinal tear or detachment is surgery. If a tear or hole gets treated before complete detachment occurs, it is possible that you might maintain most of your vision.

  • Laser surgery (photocoagulation) and freezing (cryopexy). These treatments create a scar around the hole to prevent fluid from entering the hole and being stored behind the retina. Cryopexy is chosen when tears in the retina are too difficult to reach by means of a laser.

  • Pneumatic retinopexy. This treatment is used when the hole is in the upper half of the retina. After laser surgery and freezing have been done, the doctor injects a gas bubble into the eye. Over a couple of days the gas bubble will expand, sealing the hole by pushing against the detached area. Patients may have to keep their heads cocked to ensure that the gas bubble makes contact with the hole.

  • Scleral buckling. One or two silicone bands are sewn to the outside of the eyeball. The bands push against the hole, closes it, and reattaches the retina.

  • Vitrectomy. The vitreous gel is removed and is combined with a scleral buckling (see previous point) procedure, or the eye is filled with a gas bubble.

These procedures could cause complications, such as recurring retinal detachment, retinal tear, a cataract or infection, double vision, scarring on the surface of the eye and glaucoma. This could result in partial or complete loss of vision in the eye. How much vision you maintain depends on how severe the detachment is.

Sources: (Health24, Mayo Clinic, Wikipedia)

Useful resources:

South African Optometric Association
Tel: 011 805 4517

South African National Council for the Blind
Tel: 012 452 3811

Retina South Africa
Tel: 011 622 4904

Ophthalmological Society of South Africa

 
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