RETINAL DETACHMENT, RETINAL TEARS: WHEN THE DOCTOR BECOMES THE PATIENT

Last Thursday started no different from any other day. With my slightly “frizzy’ hairdo, I commonly removed stray, out-of-control hairs from my face and eyes. In this case, however,  I noted that even with my eyes closed, the hair remained. I called the ophthalmologist for an afternoon examination. As the day progressed, my outlook morphed into that spectrum similar to looking through a lava lamp. I reflected on the knowledge that I had two sisters with spontaneous retinal detachments, both needing surgery in the past 5 years. 

Fortunately, Wake County citizens are blessed with talented medical care. By 4p.m., my ophthalmologist, Dr. Christopher Rusinek, had diagnosed a retinal tear and referred me five minutes down the road to Dr. John Denny at North Carolina Retina. Thirty minutes later, after a minor laser procedure, my condition was treated, and hopefully, I can avoid more major surgery for retinal detachment. I was back at work the next day with limited restrictions on reading, lifting, and bending for a few days. 

This event made me revisit retinal conditions in pets. I consulted with Dr. Jennifer Fontenelle at Animal Eye Care in Cary and Dr. Cynthia Cook at Veterinary Vision in San Francisco. Below are some of the questions and the specialists' responses.

Do you ever see early/ partial detachment in dogs or almost always complete detachments?

Yes, partial detachments occur and can progress. When partial, they are amenable to barrier laser retinopexy (laser assisted tacking) to prevent progression. See web page referenced below.

What is difference between human detachments and those seen in dogs? 

The causes and the duration. The causes in dogs are more related to congenital retinal dysplasia; where humans experience cystoid degeneration and multiple other aging changes). As for  duration, people present earlier for obvious reasons (i.e. early & sudden changes in vision).

In cats with detached retinas, is the cause almost always due to high blood pressure?

Yes, systemic hypertension is the most common cause of retinal detachment in cats.

For retinal detachments in dogs is it normally one eye or both?

It depends on cause.  Once again, the web reference below is an excellent source.

In dogs, if the retina is detached, what are treatment options?

It depends on cause, duration, and prognosis for vision.

Is it most commonly associated with glaucoma or cataract surgery in dogs?

It could be a complication of any intraocular surgery. Glaucoma surgical techniques are both intraocular (ECP) and extra ocular (TSCP). Cataract surgery is a more common intraocular procedure and is thus associated with an overall greater number of post-op detachments.

For more detailed information as to the causes and  treatment, visit the following web page.http://veterinaryvision.com/for-veterinarians/clinical-forum/specific-disease-topics/retinal-detachment/

Dr. Betsy T. Sigmon, DVM, Diplomate American Board of Veterinary Practitioners, Canine & Feline

Hospital Director, Creature Comforts Animal Hospital PLLC

Cary, NC

This is a normal back of the eye ( fundus) with a round optic nerve in a canine

This is a normal fundus with a triangular shaped optic nerve head in a canine

This is a husky with retinal hemorrhages, small

This is a detached retina in a dog.

Here is another patient with a detached retina.

Below  is a  photo of a cat with retinal bleeding due to high blood pressure (hypertensive retinopathy.

This is a laser.

Here is Dr Cook operating on a patients's eye.

Once again, many thanks to Drs. Cynthia Cook and Jennifer Fontenelle for sharing their photos.