Description of retinal detachment
Sight is one of the major human senses, which allows us to perceive up to 85% of the perceptionsof our surroundings. This perception is mediated by a complex sensory organ – eye.
The actual part of the eye where the image is created, called the retina, which is the innermost layer of the eyeball. Here are found photosensitive cells – rods and cones which are the perception of light and vision most important, and nerve cells that transmit light-induced irritation of the optic nerve to the brain. Other layers of the wall of the eye towards the surface represent the choroid (the nourishing eye tissues with oxygen and nutrients), and sclera (popularly called sclera). The internal space of the eye is filled with a transparent gel – vitreous.
Before we get to describe itself retinal detachment, it is necessary to mention here two things:
The retina is nourished indirectly – nutrients to her receiving indirectly from the choroid – hence its separation from other layers leads to rapid death svetlocivnych elements.
The retina is like in the cup is inserted into the cell layers, which because they contain a lot of dye (pigment) said pigment. These two layers to each other firmly urge but the actual connection between them is not, which greatly facilitates the gapping retina.
Retinal detachment is a serious eye disease. It can occur at any time during their lives, but most often affects people middle-aged and elderly.
The retinal detachment occurs, if they are present in small cracks or holes. Once this occurs, the fluid can penetrate the vitreous space beneath the retina which is lifted and separated from Pim epithelium and other layers of the eye wall – starts gapping retina. Photoreceptor cell, which thus have a reduced supply of oxygen and other nutrients quickly degenerate and die. Very often they tear in the retina disposed over its periphery – Detachment thus starts at the edge (periphery). If not timely treatment commenced, gapping progresses toward the center, where is the place of the sharpest vision. Leads to a significant impairment of vision.
It has great influence and shrinking vitreous. It is a natural phenomenon of aging, but it can also cause eye inflammation, injury or excessive growth of the eye with a high degree of myopia.Vitreous is normally associated with the retina in only a few places. Aging process leads to formation of small deposits of degeneration of the retina, where they can create new connections between the vitreous and the retina having at its shrinkage resulting rapture piece of retinal tissue and the formation of cracks or holes.
Risk factors for retinal detachment
More likely to have retinal detachment, if
- you are nearsighted, especially with a higher degree of myopia
- in your family, this disease has already occurred
- you have experienced an eye injury due to blunt blow, so penetrating injury, which violated the integrity of the eye
- rarely can lead to retinal detachment based birth defect, there is retinal disorders occur in childhood
Prevention of retinal detachment
If you belong to one of the risk groups, it is certainly good to regularly visit your ophthalmologist, who will eyesight and eye fundus examination. In the event that detects changes that could result in retinal detachment, you can perform outpatient preventive laser treatment of the retina.
The symptoms of retinal detachment
There are a number of warning signs that indicate changes to the eye, but does not necessarily be a sign of gapping retina.
Belongs with flashes, sparks front of the eye – called. Phosphenes. This is a false phosphenes, often at the edge of the field of view caused by pulling vitreous insertions per retina.
Further, it is called. Flies that you see as tiny specks or fibers vision, the best if you are looking for a white box. Their causes are structural changes in the vitreous, which is or spinning and fluid.
When the crack into the vitreous releases a smaller amount of blood, which seems to us falling soot. In the event that there was a greater bleeding can be significantly impaired vision.
Signs of an incipient gapping of the retina is called. Curtain. It is a dark or grayish shadow that affected initially perceived on the edge of her vision, though often at the bottom of the nose. This is how the gapping during the hours and days continues increasing until it ultimately extends into the central visual field. It means that the detachment was hit and instead called sharpest vision. Macula (macula). Eyesight gradually decreases to the uncertain light perception to the patient stops on the affected eye can see. If the patient finds the ophthalmologist to at this stage of the disease, the treatment is arduous and it may happen that the return of vision in the affected eye does not occur.
Sometimes it can lead to the development of the entire above-described situation abruptly.
Diagnosis of retinal detachment
If it is suspected that there was a retinal detachment, followed by various examinations, helping detect the cause of the disease. Ophthalmologist examines the eye with a device called an ophthalmoscope. This enables the “look” to the eye – on the retina. A tour of the fundus retinal scans holes and cracks, determine the extent and height of detachment and its layout provides an approximate length of its duration.
For a more detailed and thorough examination of such a serious diagnosis ophthalmologist almost always accesses testing for so-called. Slit lamp. This is actually a special microscope, which can be perfectly viewed the eye (retina). Before this examination the patient is dripped into the eye special drops to help widen the pupil, so that the doctor can view the entire eye background. Then, before the eye adjusts a special magnifying lens (lens Volkova), which enlarges the image that they see small details. For full clarity, the entire retina – and with its edge – the physician may still přisoupit for examination using a special lens (Goldman lens) which, after anesthesia is applied directly to the eye.
To determine the impairment of the visual field examination is used through the perimeter.
If it is not possible eye fundus inspect for any reason (corneal opacity, dense cataract, vitreous severe bruising), utilizes the ultrasound examination of the eye.
Treatment of retinal detachment
Retinal holes and cracks are detected before the development of retinal detachment are treated on an outpatient basis using preventive laser coagulation. The aim is “connected” to the other layers of the retina eye wall and therefore prevent the development of retinal detachment.
If retinal detachment demonstrated, the only treatment that can prevent vision loss is surgery.From the diagnosis after the operation is ill hospitalizovám, usually dressing cover both eyes, and the dressing usually has more following surgery.
In most cases the operation is performed under general anesthesia. If the patient’s condition does not allow this, you can opervovat and local anesthesia.
There are two options for surgical treatment:
Promrazení
With less extensive retinal detachment with cracks and holes around promrazí. Low temperatures in theater induce formation of fine jizévek by means of which the retina cleave to the other layers of the eye wall. From the external side is in place to crack the wall of the eye sutured so. Seal (it is made of soft porous biologically harmless silicone rubber). It causes mild injection of the sclera and the choroid toward the interior of the eye. This is called. External tamponade. The aim of surgery is to facilitate engraftment of the retina, but also decrease tensile any future vitreous joints retina.
vitrectomy
For more complicated cases, you need to select a different operating procedure. The surgery is performed inside the eye. Called a vitrectomy. In this type of operation is removed vitreous stripes svrašťující retina significantly changed vitreous is sucked away. Retinal přihojí by laser treatment.Place the removed vitreous eye filled with gas or silicone oil, which presses the retina inside – ie. Internal tamponade.
For uncomplicated detachment, the patient can get up practically from the first day after surgery. In complicated cases – after vitrectomy and internal tamponade – must be maintained for several days, a stable head position.
How to help treat retinal detachment
If you are already a detachment occurred in any event not help themselves. It is necessary to seek medical help immediately.
Complications of retinal detachment
Permanent visual impairment after suffering a retinal detachment is largely influenced by the extent of detachment, its duration, early diagnosis and treatment tight.
The earlier the disease is diagnosed, the better cures and consequences are minor. About 40% successfully operovných vision is very good for the rest is satisfactory, at least for a normal life, but sometimes even repeated operations and prevent detachment of the affected eye eventually go blind.
Other names: retinal detachment, retinal detachment, retinal amotio