At what age does retinal detachment threaten and what about it …

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What is retinal detachment

Retinal detachment is a serious pathology in which the retina of the eye exfoliates from the vascular, destroying its integrity. As a result, the retina does not receive the necessary nutrients and ceases to transmit light impulses to the optic nerve and brain, and communication with the higher parts of the visual system is disrupted.

There are three types of retinal detachment:

  • rhegmatogenous – occurs against the background of rupture or peripheral dystrophy of the retina and the ingress of fluid from the vitreous body under it. Tears can occur spontaneously due to trauma, falls and bumps, as well as strenuous exercise;

  • traction – occurs during the formation of strands of the vitreous body (often occurs against the background of advanced diabetes mellitus), when tension, traction of the vitreous body lead to detachment and (or) rupture of the retina;

  • exudative – is formed when there is an accumulation of fluid (exudate) under the retina, for example, due to a neoplasm of the choroid.

Signs of the disease and risk factors

Retinal detachment is a dangerous disease: the pathology can develop unexpectedly, without tangible symptoms, when the patient does not know about the problem for a long time or writes everything off as eye fatigue. Because of this feature, often breaks and peripheral retinal dystrophies can remain invisible to patients for many months. However, it is important to keep in mind that there are certain risk factors that increase the chance of retinal detachment, including:

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  • genetic predisposition;

  • age – as a rule, people over 40 years of age are susceptible to pathology;

  • refractive errors: myopia and astigmatism;

  • peripheral retinal dystrophies;

  • retinal detachment in the other eye;

  • diabetes;

  • hypertonic disease;

  • previous eye surgeries;

  • eye and head injuries, high physical exertion.

Symptoms of the disease can be different, but you need to remember that the disease will not go away on its own, but will only progress. The main signs of an incipient retinal detachment are sparks, floating dots and threads in front of the eyes, clouding of part of the visual field in the form of a shadow, the appearance of a persistent veil before the eyes and a sharp decrease in visual acuity. At the same time, in the early stages of retinal disease, they go unnoticed and are detected only during examination in the clinic.

Diagnostic methods

In order to determine the presence of this pathology, it is necessary to undergo a thorough comprehensive diagnosis by an ophthalmologist. If a retinal detachment is suspected, testing may include:

− ophthalmoscopy of the central region and periphery of the retina,

− photographing the fundus with a fundus camera,

− perimetry;

− measurement of the optical density of macular pigment on a densitometer;

– psychophysical methods, such as the study of spatial contrast; sensitivity;

− optical coherence tomography;

− fluorescein angiography.

Based on the results of the examinations, the doctor understands whether there are signs of retinal diseases, what they are and what treatment will be optimal. In the case of a diagnosed retina, only surgical treatment is possible, so it is important not to delay going to the doctor when the first signs of the disease appear. A person with healthy vision without visual impairment should be diagnosed at least once a year to exclude the asymptomatic onset of detachment.

Retinal treatment

As we have already said, the treatment of retinal detachment occurs only surgically. The main goal of the treatment of retinal detachment is to create a adhesion of the retina with the underlying tissues in the place where there is a break, and fix its position. There are several treatments for retinal detachment:

  • Endovetral surgery – involves vitrectomy, the essence of which is the partial or complete removal of the altered vitreous body. Instead, special heavy liquids or gases are introduced into the cavity, and the rupture site is coagulated, that is, “sealed” with a laser. Today it is the main treatment for retinal detachment. Quite often it consists of two or three stages.

  • Extrascleral (episcleral) – represented by filling or ballooning. In the first case, during the operation, a silicone filling is sutured to the albuginea, which presses on the outer sclera to prevent the spread of the retinal rupture and promote the absorption of fluid accumulated under it.

  • Laser coagulation – consists in the partial destruction of retinal proteins during the operation of the laser. It is used for “adhesion” of breaks and allows you to stop the progression of diseases, especially in the case of early detachments. This technique also helps to strengthen the retina, as the laser beam “fixes” the fusion of the retina and choroid.

As a rule, in the treatment of retinal detachment, not one, but several methods are used, depending on the pathology, the condition of the retina and the severity of the disease, as well as taking into account other existing eye diseases.


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