Retinal Detachment

I was recently treated for a retinal detachment, and I still have a small gas bubble. Can I dive this weekend?

A retinal detachment is very serious and should be treated urgently due to the risk of permanent vision loss in the affected eye. It occurs when the retina at the back of the eye separates from its normal position, which can occur spontaneously or as the result of an injury. Symptoms can include sudden floaters, flashes of light, blurred vision, a reduction of peripheral vision and a shadow over the field of vision.

Surgery is required to repair a detached retina, but the type of surgery depends largely on how severe the detachment is and what method your surgeon feels is best for you. Pneumatic retinopexy involves injecting a bubble of gas into the fluid (vitreous) cavity. The bubble pushes the affected area of the retina against the eye wall, preventing fluid from collecting in the space behind the retina. The surgeon then repairs the detachment by freezing the area, causing a scar that secures the retina to the eye wall. Another option is a scleral buckle, where the surgeon sews a piece of silicone material over the detachment and secures it to the sclera (white) of your eye. The third option, a vitrectomy, is removal of the vitreous and any other tissue pulling on the retina from the vitreous space. The surgeon replaces the fluid and tissue by injecting a gas bubble or silicone oil into the vitreous space, flattening the retina.

The recommended waiting period after a retinal detachment repair is a minimum of two months regardless of the procedure performed. With pneumatic retinopexy or vitrectomy, additional time may be required to allow all intraocular gas to be reabsorbed. Any presence of a gas bubble will delay your return to diving since any changes in pressure could cause intraocular barotrauma (a pressure injury) resulting in intraocular hemorrhage (bleeding). It is important to always follow the advice of your surgeon.

After surgery, the integrity of the eyeball may be weakened and more susceptible to rupture in the case of direct trauma. You can mitigate this risk by avoiding mask squeeze: Exhale through the nose, and remember to always keep your face mask on your face to prevent injury. AD
 Lana Sorrell, EMT, DMT

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