Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Eun-Ha Park

Eun-Ha Park, MD

Ophthalmology

Welcome to My Doctor Online, a website my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. If you are a patient who sees me regularly, you can reach my office directly at 415-833-5110.

My Offices

Daly City Medical Offices
Appt/Advice: 650-301-5800

See all office information »

subContentURL_nobackslash = resources/dc/condition

firstActiveTabUrlFragment = resources/dc/conditionlist

subContentURL_nobackslash = resources/dc/condition

JSP2Include = /mdo/presentation/conditions/condition.jsp?nocache=true

Overview

The retina is a thin layer of tissue that lines the inside wall of your eye. Retinal detachment occurs when the retina separates from the eye wall.

The retina converts light entering the eye into electrical signals that travel to the brain via the optic nerve. The brain then interprets these signals as images. If the retina detaches, it can no longer communicate effectively with the optic nerve. In addition, the retina is no longer attached to the other layers underneath it that supply the retina with nutrients and oxygen. If the retina is deprived of oxygen and nutrients for too long, cells can die and some permanent vision loss can occur.

The retina can detach for a number of reasons including:

  • Aging
  • Trauma
  • Nearsightedness
  • Medical condition such as diabetes

The retina may tear first or develop a hole. Fluid from the vitreous (the jellylike substance that lies in front of the retina) may then leak through the tear or hole. Eventually this separates the retina from the wall of the eye.

A retinal detachment needs to be treated to reduce the risk of permanent vision loss. Based on the type of retinal detachment, we may repair it in an office procedure or it may require treatment in the operating room.

Additional References:

Symptoms

If you experience a retinal detachment, you may notice a number of symptoms. They include the following:

Sudden increase in "floaters" or flashing lights

Most people experience floaters and flashing lights in their visual field sometime in their lives. 

Floaters are small flecks of protein or vitreous gel that look like gnats, threads, dots, circles, lines, or cobwebs drifting about in your field of vision. They commonly occur as part of the normal aging process, and most of the time they are harmless.

Flashing lights may appear as either quick or long bursts of light that go on and off in your eye, often to one side of your field of vision. They usually persist, even when the eye is closed. 

A sudden increase in the number of floaters, or persistent flashing lights can be a symptom of several conditions. These include liquefaction of the gel in the eye, a retinal tear, or a retinal detachment.

Vision deterioration and loss

If the retina has detached, you may see a shadow or blacked out area in your field of vision. This may get larger if the area of detachment continues to increase. 

Most of the time, chronic floaters do not indicate a serious eye problem. However, if you suddenly have many new floaters in your eye that don't go away, or you experience persistent flashing lights that don't get better, these may be symptoms of a posterior vitreous detachment (PVD), retinal tear, or retinal detachment, which requires prompt evaluation.

If you experience either of these symptoms and/or an area in your field of vision seems to be blocked or blacked out, call our offices and request an urgent appointment. If you have a decrease in vision or obstruction in your peripheral vision, you may be advised to go directly to the Emergency Department if you are calling after regular clinic hours or on a weekend.

Additional References:

Causes and Risk Factors

There are a number of factors that can increase the risk that you will develop a retinal detachment, including the following: 

  • Diabetes. High blood sugar can damage the retina and lead to abnormal blood vessel growth and scar tissue formation, increasing the likelihood of eye problems.
  • Age. Retinal detachment is more likely to occur in elderly people, although it can occur in children. As we grow older, the jellylike vitreous that makes up most of the inner part of the eye shrinks and becomes more liquid. As it shrinks, the vitreous gel tugs on the retina. This is called a posterior vitreous detachment (PVD) and is a normal part of the aging process. Most people will see floaters or flashing lights when this happens, but the retina is not damaged in most cases. However, in rare cases, strands of vitreous can tug too hard on the retina and cause it to tear or detach.
  • Family history. If you have an immediate family member who has experienced a detached retina, you may be at increased risk.
  • Being very nearsighted.  
  • Previous eye injury.

Diagnosis

If you have sudden vision changes, contact us to schedule an urgent appointment in Ophthalmology. We will ask you about your symptoms and examine your eyes. If we suspect a retinal tear or detachment, the examination will include the following tests:

  • Ophthalmoscopy. We use a strong light and magnifying lens to examine your retina and macula for signs of scar tissue and damage. We usually administer eyedrops first to dilate your pupils so that we can see the structures at the back of your eye clearly.
  • Visual acuity test. This tests the strength of your central vision by requiring you to read a chart.

Treatment for Retinal Tears

If we find a retinal tear that has not yet progressed to a detachment, we will discuss a number of treatment approaches with you. Some people with nearsightedness develop small retinal holes or have visible thin spots in the retina called lattice degeneration. These often produce no symptoms. We may recommend observation or 'watchful waiting' if these holes or spots are at low risk of progressing to a retinal detachment. 

We may recommend a procedure to repair the tear if:

  • There are multiple tears.
  • A tear is associated with vitreous tugging. This puts the retina at higher risk for detachment.
  • You have symptoms and your eye exam indicates that  detachment is likely.

Procedures include the following:

Photocoagulation

We use a laser to create burns in the retinal tissue adjacent to the tear and isolate it from the rest of the retina. As the burns heal, scar tissue forms around the hole, reinforcing the area, which reduces the chance of a retinal detachment developing.

Cryopexy (freezing)

This procedure is similar to photocoagulation except we apply extreme cold rather than extreme heat. We apply a freezing metal probe to the surface of the eye, above the area of the retinal tear. The freezing process causes inflammation. The eye tissues respond to the inflammation by creating scar tissue around the tear to seal it off from the rest of the retina. This is a particularly effective option if the tear is located in an area of the retina that is difficult to reach with a photocoagulation laser.

Treatments for Retinal Detachments

Treatment options vary depending on the cause of the detachment and the retinal damage that need to be repaired. 

Pneumatic retinopexy

We usually use local anesthetic for this procedure. Once your eye is numb, we inject a bubble of gas into the vitreous. We then move your head into a specific position, in order to float the bubble toward the tear. Holding your head in this position causes the gas bubble to press against the retina, sealing the tear that caused the detachment. With the tear closed, fluid can no longer pass under the retina. Over several days, any fluid that has leaked between the retina and the eye wall will be absorbed by the body. As the fluid dissipates, the gas bubble gently holds the retina in place against the wall of the eye while it heals. 

The gas bubble will eventually dissolve, which means that we need to perform either photocoagulation or cryopexy to permanently seal the retinal tear. We may do this before we inject the gas bubble or after the pneumatic retinopexy procedure. This will depend on the size and location of the detachment.

You will need to keep your head carefully positioned for most of the time for several days to weeks. We sometimes advise you on specialty devices and cushions that can make positioning more comfortable for you.

Scleral buckle surgery

For this procedure, either we will numb your eye with local anesthetic or we may recommend general anesthesia, depending on the complexity of the surgery. During the procedure, we place a band of silicone onto the outside wall of the eye, the sclera. This band is not visible after surgery. If the detachment is large, or if you have several tears and holes, we may attach the band all the way around the eye. We attach the band tightly around the eye so that the wall of the eye buckles. The buckling effect pushes the wall of the eye toward the detached area of the retina. Once the retina is back in contact with the wall of the eye, we will usually use photocoagulation or cryopexy to repair any tears or holes. The band is usually left in the eye permanently. If you have an extensive detachment, we may perform a vitrectomy at the same time as scleral buckle surgery.

Vitrectomy

This procedure is used to remove the vitreous gel and any scar tissue from the eye. We use microsurgical instruments to make tiny incisions in the sclera. We then:

  • Suction out the vitreous gel through the incisions. Removing the vitreous gel can help prevent traction on the retina and reduce the risk of further damage.
  • Replace the vitreous gel with a gas bubble or silicone oil to maintain normal pressure in the eye and hold the retina in place while it heals.

Surgical Results

Repairing a retinal detachment is usually successful. However, healing may take weeks and require face down positioning and limited activity. Sometimes, additional surgeries or procedures may be needed to ensure optimum recovery of vision.

How much vision you regain will depend on a number of factors including the size, duration, and location of the detachment. If the retina was deprived of oxygen and nutrients for an extensive period before surgery, some vision loss may be permanent. Similarly, if the detachment extended to the macula, the area of the retina responsible for our central vision, then you may be less likely to recover all of your central vision. The healing response is also different in each individual patient.

All surgeries pose some risk. Pneumatic retinopexy and a vitrectomy may increase your risk of developing cataracts earlier than you otherwise would. In addition, scleral buckle surgery can change the shape of your eye. This may cause vision changes that need to be corrected. We will evaluate your eyesight a few months after your surgery and tell you if you need a new prescription. With any eye surgery there is a small risk of infection, bleeding, and the need for additional surgery in the future.

Your Care With Me

If your optometrist suspects that you have a torn or detached retina during your regular eye exam, he or she will make an appointment for you to see me, or one of my colleagues, in the Ophthalmology department. If you are not scheduled for a regular eye exam, and you notice symptoms such as a sudden increase in floaters or flashing lights, or reduced vision, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you.

Your first appointment is likely to take at least 1 hour and possibly longer. During your office visit, we will discuss your medical and family history and I will perform a comprehensive eye exam and some diagnostic tests.

I may administer eyedrops to dilate your pupils so that I can clearly see the structures of your eyes. Your pupils will remain dilated for several hours, so you may wish to bring someone who can drive you home after your exam.

I will explain the findings of your exam and answer any questions or concerns you may have. If you notice any new changes, please let me know.

If we decide that you need further evaluation, or further treatment or surgery, I will discuss the treatment options that are available, and together we will create a treatment plan that is right for you.

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the "After Visit Summary" that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:
  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.

If surgery or a procedure is a treatment option

I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Related Health Tools:

Videos

See more Health Tools »

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

Content loading spinner