Retinal detachment: symptoms and treatment

Detachment of the retina is a serious disorder that begins to progress due to a rupture of the connection between the choroid of the eye and the retina itself. In such pathological areas, excess exudate begins to accumulate gradually. The larger the gap, the stronger the visual function is disturbed, since the photosensitive cells do not receive the necessary volume of nutrients from the blood vessels. In the absence of timely treatment, pathology can even lead to complete blindness. It is worth noting that the disease occurs in adults more often than in children.



Etiology

The reasons for the appearance of such an ailment may be different. Identify the «primary source» of pathology can only be a qualified ophthalmologist by conducting a comprehensive diagnosis. It is worth noting that one of the most frequent causes of progression of retinal detachment is trauma of the eye.

Retinal detachment can occur due to previously transferred pathologies:


  • Tumors
  • diabetic retinopathy;
  • viral infections;
  • vascular ailments
  • damage to the central zone of the fundus (a common cause leading to retinal detachment)
  • inflammation of the choroid of the eyeball.

Risk Factors:


  1. genetic predisposition
  2. the occurrence of visual defects with changes in the fundus
  3. PVCHRD
  4. congenital pathologies
  5. Professional activity. Retinal detachment can occur due to systematic exposure to the eyeball of high temperatures.

Classification

In medicine, the classification of this ailment is used, which includes several criteria:


  • the reasons for the occurrence;
  • degree of mobility;
  • the prevalence of the lesion

By the prevalence of the lesion:


  1. Local. In this case, a detachment of ¼ of the retina will occur;
  2. widespread. Half of the total volume is affected;
  3. subtotal. Detachment of ¾ area
  4. total. In this case, a complete detachment is observed. To restore vision is not real.

By the degree of mobility:


  • mobile. About its development speak in the event that after 2 days of strict bed rest the retina completely adjoins to other layers. But this does not mean that such a pathological condition is not subject to full treatment;
  • rigid. The retina does not adhere to other shells, even in the case of prolonged bed rest.

Depending on the reasons for the progression:


  1. rhegmatogenous. It is also called primary. Its development is indicated in the case of retinal dystrophy on the background of vascular insufficiency. As a result, it gradually thinens, as it receives less nutrients, and ultimately is simply ruptured. The rupture leads to the fact that the exudate from the vitreous humor seeps into the retina and disrupts its functioning
  2. exudative or secondary. Pathology begins to develop due to previously transferred pathologies of the visual apparatus, such as retinal neoplasms of benign and malignant nature, intraocular infections and the like. Pathology is accompanied by the accumulation of excessive exudate inside the eye;
  3. Traumatic. The main cause is trauma to the eyeball. It is worth noting that the pathology can develop both immediately after the injury, and after some time after that;
  4. Traction. Occurs less often, but difficult to treat. Develops in the case of a strong retina strain from the vitreous humor.

Symptoms

The first signs that indicate a retinal detachment are as follows:


  • the appearance of floating «black flies»
  • the veil appears before your eyes (the most alarming sign);
  • photo effects — lightning and sparks

Symptoms of retinal detachment may differ depending on which stage of the ailment the patient has developed. There are three stages in the progression of the pathological process:


  1. Initial. The first sign is a photopsy. The appearance of lightning and sparks in the eyes is noted quite often, so the patient can easily identify them. It is important, if available, to consult a doctor immediately for diagnosis and treatment. Pathology at this stage is easier to treat. Later, photopsy is accompanied by a decrease in the perception of the sharpness of objects, a violation of coordination of movements;
  2. floating stage. Its name fully corresponds to the symptoms, which supplement the clinical picture. When perceiving the image, the patient notes that on his background there are various floating objects — flies, threads and dots. But it should be noted that these signs are not a symptom that indicates only the progression of retinal detachment. This can be observed with the destruction of the vitreous humor;
  3. the final stage. The appearance of opacities is noted. In medicine, this phenomenon has a special term — the ring of Weiss. As a rule, it has a round shape. Also all the other symptoms that were mentioned above are also manifested. This condition is very dangerous, because against the background of detachment of the retina, a separation of the posterior membrane can occur. The only true method of treatment is emergency surgical treatment. If this is not done, you can completely lose sight, without the possibility of its recovery in the future.

Diagnostics

It is important when you have the first signs to see a doctor for the diagnosis of pathology. The standard diagnostic plan includes an ophthalmological examination, laboratory techniques and specific methods.

Ophthalmological examination:


  • Visometry
  • evaluation of visual fields
  • measurement of intraocular pressure;
  • assessing the condition of the anterior part of the eye
  • assessment of the fundus in the dilated pupil.

Laboratory techniques:





  1. blood test
  2. urinalysis

Specific methodologies:


  • Ultrasound of the eye;
  • electrophysiological research methods.

Treatment

In the case of diagnosis of retinal detachment, only surgical treatment is indicated. Other methods are not effective. The earlier the operation is performed, the greater the chances of preserving the functionality of the retina.

The main goal of surgical treatment is to restore the retina of the retina to other tissues and ensure its full blood supply. Depending on the access paths, the following are distinguished:


  1. eccentric surgery. Two methods are used: ballooning or sealing of the sclera. In the first version, the doctor performs a hemodialysis to the sclera in the retinal rupture zone with a catheter with a small balloon. The device is extracted only when retina adhesions with a number of located tissues are formed. In the second variant, the sclera indentation portion is created by sealing with silicone sponges. This method of treatment is most often used



  2. endovitreal interventions. In this case, surgery is performed directly from the inside of the eye. Resort to this method of treatment only in extreme cases — hemorrhage in the eye tissues, ruptures of the giant size of the retina.