Scleral Buckling

Scleral Buckle Surgery: What Is It?

The word “buckle” comes from the Latin word “buculus”, which means a strap or band. A buckle is a strap with two loops sewn into it, so that when one loop is tightened, the other loop will tighten as well. When the straps are pulled tight, they hold up your clothes. They were originally used to fasten armor pieces together during battles.

In ancient times, the Romans used buckles to secure their mail shirts. The buckle was made out of bronze or iron and had a small hole through which the wearer could breathe. Buckles were usually worn around the neck.

Today, many people wear them on their belts. The holes in these buckles are called sclera (the Latin word for eye). They allow air to enter and exit your eyes while wearing your mail shirt or armor piece.

When you put on your mail shirt or armor piece, the buckle is tightened. If there is no space between the buckle and your skin, then pressure builds up inside your head until it causes pain. This happens because the muscles in your skull cannot move freely due to the tension in the buckles.

Your brain tries to push against these muscles and cause some relief from this pressure. The pressure is so strong it can make you feel nauseous. If you have a weak stomach, the pressure might make you vomit. For this reason, it’s best to avoid wearing a metal helm or armor piece for long periods of time.

Fortunately, most metal harnesses are fitted with scleral buckles so that they can be taken on and off quickly. Sometimes, the buckle is fastened around your forearm so that it cannot be tightened too much. This allows your head to adjust to the pressure before removing the harness completely.

The slightest tightness in the neck can cause pain.

If you have a puffy face or if you are obese, then you should avoid wearing metal altogether. It’s best to wear a leather helmet and metal gauntlets if you insist on wearing metal. A tightly-fitted leather mask will also suffice.

Scleral buckle surgery is a simple procedure in which we insert a scleral buckle under your eyelid. This lifts the skin away from the eye, so that it cannot be pinched by the metal helm or armor piece. The buckle is made out of either metal, leather, or fabric.

It’s secured in place using stitches. If you don’t stitch the buckle in place, then it might fall out of your eyelid.

Scleral Buckle vs. Pterygium

Nowadays, the word “buckle” has many meanings. It can be a fastener used to secure a belt or harness or it can describe an eye condition in which the thin, translucent membrane covering the front of your eye (the conjunctiva) turns into a lumpy growth. This lumpiness is usually caused by constant exposure to wind or sun.

Sources & references used in this article:

Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study by …, Scleral Buckling versus Primary Vitrectomy in … – Ophthalmology, 2007 – Elsevier

Twenty-year follow-up for scleral buckling by SG Schwartz, DP Kuhl, AR McPherson… – Archives of …, 2002 –

The scleral buckling procedures: 1. Surgical techniques and management by CL Schepens, ID Okamura… – AMA Archives of …, 1957 –

Refractive changes after scleral buckling surgery by WE Smiddy, DN Loupe, RG Michels… – Archives of …, 1989 –

Scleral buckling for retinopathy of prematurity by MT Trese – Ophthalmology, 1994 – Elsevier

Vitrectomy without scleral buckling for primary rhegmatogenous retinal detachment by RF Escoffery, RJ Olk, MG Grand, I Boniuk – American journal of …, 1985 – Elsevier