Symptoms Indicating Scleral Buckling Surgery

Scleral buckling surgery is a time-tested procedure used to treat retinal detachment, a serious eye condition that can lead to permanent vision loss if left untreated. This surgical technique involves placing a flexible silicone band (called a scleral buckle) around the eye to gently push the wall of the eye against the detached retina, helping it reattach and heal.

One of the most established and effective surgical procedures to repair a detached retina is scleral buckling surgery. While newer techniques like vitrectomy and pneumatic retinopexy are available, scleral buckling remains a preferred choice in certain cases, especially in younger patients or those with specific types of retinal tears. This technique has been used for decades and boasts a high success rate when performed in a timely manner.

What Is Retinal Detachment?

The retina is the light-sensitive layer of tissue at the back of the eye that sends visual signals to the brain. Retinal detachment occurs when the retina separates from the underlying tissue, disrupting its function. This condition is considered an ocular emergency and requires prompt treatment.

There are different types of retinal detachment :-

1. Rhegmatogenous retinal detachment (RRD) :- The most common type, caused by a retinal tear or break.

2. Tractional retinal detachment :- Occurs when scar tissue on the retina pulls it away from the eye wall, often seen in diabetic retinopathy.

3. Exudative retinal detachment :- Caused by fluid buildup without a retinal tear, often due to inflammation, tumors, or vascular disorders.

Scleral buckling surgery is most commonly used to treat rhegmatogenous retinal detachment.

Key Symptoms Indicating the Need for Scleral Buckling Surgery

Recognizing the early signs of retinal detachment is critical. If you experience any of the following symptoms, seek immediate consultation with an ophthalmologist. Delayed treatment can result in permanent vision loss.

Sudden Appearance of Floaters

Floaters are tiny shapes or specks that drift across your field of vision. While occasional floaters are common with aging, a sudden increase in floaters may be a sign of a retinal tear or detachment.

Why it matters :- Floaters may indicate that the vitreous gel in the eye is pulling away from the retina, potentially causing tears that can lead to detachment.

Flashes of Light (Photopsia)

Seeing flashes of light, especially in the peripheral vision, can be another warning sign. These flashes may resemble lightning streaks or camera flashes.

Why it matters :- Flashes occur when the retina is irritated or tugged on by the vitreous gel, a precursor to retinal tears or detachment.

Shadow or Curtain Over Vision

One of the most serious symptoms is the sensation of a shadow or curtain moving across your vision, either from the top, side, or bottom.

Why it matters :- This symptom usually indicates that the retina is detaching. Immediate surgical intervention, like scleral buckling, may be needed to restore vision.

Blurred or Distorted Vision

A sudden onset of blurred or distorted vision, especially in one eye, can signal retinal issues. Straight lines may appear wavy or objects may look smaller or larger than they are.

Why it matters :- Blurred vision may result from the retina not being in its correct position to process visual information accurately.

Loss of Peripheral Vision

Gradual or sudden loss of side vision can be a hallmark symptom of a developing retinal detachment.

Why it matters :- As the retina detaches, the peripheral visual field becomes compromised. This often progresses inward and can result in total vision loss if untreated.

When Is Scleral Buckling Surgery Recommended?

Scleral buckling surgery is usually recommended when :-

1. There is a confirmed retinal detachment with a tear.

2. The tear is located in a place accessible through scleral buckling.

3. The detachment is recent and has not yet reached the central retina (macula).

4. The patient is not an ideal candidate for vitrectomy or pneumatic retinopexy due to eye anatomy or pre-existing conditions.

Your ophthalmologist may use diagnostic tools like indirect ophthalmoscopy, fundus photography, or optical coherence tomography (OCT) to assess the extent and location of detachment before recommending the procedure.

Who Is at Risk for Retinal Detachment?

Understanding risk factors can help you stay vigilant about your eye health. Individuals at higher risk include :-

1. People over 50 years of age

2. Those with severe nearsightedness (myopia)

3. Individuals who have had eye trauma or injury

4. Patients with a family history of retinal detachment

5. Those who’ve had previous eye surgeries, especially cataract removal

6. People with diabetic eye disease

7. Individuals with certain inflammatory eye conditions

If you fall into any of these categories and begin noticing warning signs, prompt screening can save your vision.

How Does Scleral Buckling Surgery Work?

Scleral buckling is a well established, outpatient surgical procedure typically performed under local or general anesthesia.

Steps Involved :-

1. Identifying and treating the retinal tear :- The surgeon first locates the retinal tear or hole and seals it using cryotherapy (freezing) or laser photocoagulation.

2. Placing the scleral buckle :- A silicone band or sponge is stitched onto the outside of the white part of the eye (sclera). This indents the eye wall, relieving traction and allowing the retina to reattach to the underlying tissue.

3. Draining sub retinal fluid (if needed) :- In some cases, the fluid under the retina may be drained to help it reattach properly.

4. Closing the eye :- The incisions are closed, and antibiotic ointment is applied.

The buckle remains in place permanently and is not visible from outside the eye.

Recovery After Scleral Buckling Surgery

Recovery can vary depending on the extent of detachment and individual healing. General guidelines include :-

1. Mild discomfort or irritation for the first few days

2. Eye patching or protective shield usage post-surgery

3. Antibiotic and anti-inflammatory eye drops

4. Vision may be blurry initially but improves over weeks

5. Avoiding strenuous activities and protecting the eye from trauma

Most patients resume daily activities within 1–2 weeks, though full visual recovery may take longer.

Potential Complications of Untreated Retinal Detachment

If retinal detachment is left untreated, it can result in :-

1. Permanent vision loss

2. Macular damage, leading to distorted central vision

3. Retinal scarring (proliferative vitreoretinopathy)

4. Blindness in the affected eye

That’s why early detection and surgical treatment such as scleral buckling can be life-changing.

Alternatives to Scleral Buckling Surgery

While scleral buckling is a proven method, some cases may require alternative or additional treatments:

• Vitrectomy :- Involves removing the vitreous gel and is preferred for complex or tractional detachments.

• Pneumatic Retinopexy :- Involves injecting a gas bubble into the eye to press the retina back into place.

The choice of treatment depends on the type and severity of detachment, as well as patient-specific factors.

Conclusion

Scleral buckling surgery can be a vision-saving procedure for individuals experiencing retinal detachment. The key to successful outcomes lies in early detection of symptoms like floaters, flashes, vision loss, and visual distortion.