Retinal detachment - is the most dangerous disease of the eye that can in a relatively short time lead to a complete loss of vision. According to statistics, 72% of all cases of blindness are due to the onset of retinal detachment.
Called retinal membrane lining the eye and the inside consisting of several layers of light-sensitive cells, which are the main link in the perception of the image and transmit it to the brain. This shell is tightly connected to the choroid and vitreous pressed to her body.
In some cases, a pathological process in which one or more portions of the retina is detached from the choroid. In the fracture enters the vitreous fluid that detaches the retina. The retina, detached from the choroid, stops receiving blood supply, resulting in atrophy and die. If at this stage no immediate action is taken, the liquid penetrates further may cause total detachment of the retina, leading to loss of vision in the affected eye.
Causes of retinal detachment
The immediate cause of retinal detachment is the formation of micro-breaks in it, and liquefaction of the vitreous, allowing free fluid gets into tears. Such a condition can occur as a result of injury, and not necessarily a direct trauma to the eye, and hit on the head, or even excessive exercise, or suffering stress. Also cause retinal detachment may be common diseases of the body, such as diabetes, hypertension, kidney disease, systemic (scleroderma, rheumatoid arthritis, systemic lupus erythematosus, etc..) And infectious (especially viral infections) disease, and diseases of the endocrine glands (thyroid, adrenal, parathyroid glands).
What matters is the age factor and as often retinal detachment occurs in people after sixty years, although it can occur at any age.
Types of retinal detachment
Retinal detachment can be primary or secondary.
- Primary. It arises in the case of any liquid from the liquefied vitreous retinal tear.
- Secondary. It occurs when between the retina and the choroid appears neoplasm. It may be a tumor, hemorrhage, diabetic retinopathy or inflammatory infiltrate.
According to the degree of mobility retinal detachment may be movable or rigid. Diagnostics of retinal detachment to determine its mobility is as follows: the patient is prescribed a two-day stay in bed, and then check the status of the retina. If the adjacent retina is completely talk about mobile, if not, determine the different degrees of mobility or stiffness in full if the fit is not all over.
Retinal detachment can be high if the accumulated underneath the liquid gathered in the bladder, or flat, in which the retina is gathered into folds.
Also accepted classification of retinal detachment on the prevalence of:
- Local - within one quadrant
- Distribution - takes two quadrants
- Subtotal - within three quadrants
- Total retinal detachment - the retina peeled throughout
Symptoms of retinal detachment
Symptoms of retinal detachment manifest themselves as visual impairment. Early symptoms of retinal detachment is the appearance before the eyes of the small dark spots of irregular shape, in the form of flakes of soot, as well as the emergence of the "dark curtain" or gray shade in sight.
In the early stages a common symptom of retinal detachment is the improvement of the morning, when after sleeping almost completely disappears curtain before his eyes and recovered his sight. But during the daytime activity shroud reappears, and in the evening the symptoms of retinal detachment reached its peak - "curtain" becomes so dense that through it almost nothing can be seen.
Another symptom of retinal detachment are flashes of light at the periphery of vision, there may be large moving spots before his eyes. The pain is not characteristic of retinal detachment as the retina has no pain receptors, but sometimes the pain is present during the formation of the primary gaps.
As soon as the disease progresses, symptoms of retinal detachment is increasing, and vision in the affected eye is deteriorating.
Diagnostics of retinal detachment
Diagnostics of retinal detachment held ophthalmologist with the following studies:
- Ophthalmoscopy (fundus examination), direct and indirect. It allows you to identify the precise localization of breaks, state of retinal detachment.
- Electrophysiological study, which gives an idea of the extent of violations that have occurred in the delaminated areas of the retina and optic nerve.
- Definition of visual acuity, which gives an idea of the central portion of the retina
- Computer perimetry showing the state of the peripheral retina.
- Ultrasound examination of the eye that allows you to assess the degree of retinal detachment.
- Tonometry - measurement of intraocular pressure.
Treatment of retinal detachment
Treatment of retinal detachment is only surgical method. Operation of retinal detachment is the only reliable method to eliminate the pathology, therapeutic methods may be used only as an extra.
In the event that a small detachment of the retina, the operation can be performed by laser or cryotherapy (cryopexy). When exposed to laser or cryotherapy at the break formed aseptic (bezinfektsionnoe) inflammation, subsequently causing the appearance of scar tissue, tightly soldered to the retina choroid. Liquid has penetrated under the retina, gradually dissolves.
If retinal detachment has occurred over a large area, or apply extrascleral endovitrealnye operation.
- Extrascleral retinal detachment surgery. Surgery is performed on the surface of the sclera. These include extrascleral balonirovanie or extrascleral filling, thus achieve a snug fit of the retina to the choroid, and then produce a point "welded" laser.
- Endovitrealnye retinal detachment surgery. In this case, the impact on the retina after vitrectomy (extraction vitreous).
Important in the treatment of retinal detachment - is the earliest possible start of it, as the retina, long time no contact with the choroid, atrophies and ceases to perform its functions. In this case, treatment of retinal detachment is performed.
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