Retinal Services

The Medical/Surgical retina service is the major consultative and treatment centre in South Australia for diseases of the retina and vitreous, including:

• Retinal detachment
• Macular hole
• Epiretinal membrane
• Diabetic retinopathy
• Trauma
• Vitreous hemorrahage
• Age related macular degeneration

Dr. Henry Newland, Dr. Grant. Raymond and Dr Jagjit Gilhotra supervise the service with the assistance of medical and surgical retinal Fellows and registrar.

Investigations and procedures available include fluorescein angiography, optical coherence tomography, ultrasonography, laser treatment, immunologic diagnosis and vitreo-retinal microsurgery.

The Retinal service has an active teaching and research program with a busy established fellowships in surgical and medical retinal training. These funded positions are usually a year fellowship commencing in January.

Disease process / Introduction

The retina lines the inside of the eye and is a thin tissue composed of layers of light-sensitive cells which send visual information to the brain. The retina is held in place by the vitreous humour which is a transparent gel composed of water and collagen and lies in the centre of the globe of the eye between the retina and lens.

A retinal detachment occurs when the retina pulls away from inside wall of the eye causing loss of vision. This is often due to a hole or tear in the retina produced when the vitreous contracts with the aging process.
Trauma may also lead to retinal detachment. The vitreous may also become filled with blood, particularly in association with severe diabetic eye disease where traction may detach localised areas of retina.

The operation

The indications for retinal surgery include:

• removal of vitreous haemorrhage
• peeling of epiretinal membranes
• treatment of macula holes
• most frequently retinal detachment.

Small holes or tears in the retina may be treated with laser photocoagulation or cryopexy (freezing).

Laser photocoagulation consists of pinpoints of laser which creates minute burns around a small hole in order to help the retina adhere to the wall of the eye. It can also be used to treat areas of the retina which have a poor blood supply. Cryopexy is a procedure which freezes the area around a hole to the wall of the eye.

Scleral buckling is a surgical procedure used in large retinal detachments in which a synthetic band is placed around the outside of the eye in order to push the wall of the eye against the detached retina.

Vitrectomy is the surgical removal of diseased vitreous and the insertion of an artificial substance to push the retina back against the wall of the eye. The substance may consist of an expandable gas or silicone oil. The gas is slowly absorbed by the body after a couple of weeks. The silicone oil may be removed surgically when the doctor decides it is necessary.