In the article, we will consider what constitutes a condition such as retinal detachment.
The retina is responsible for the interaction between the brain and the eyes. Its main role is to convert light signals into nerve impulses. When functioning is impaired or detached (when the choroid and retina are separated), vision deteriorates and the quality of life of a person suffers.
Reasons
Retinal detachment can be either primary or secondary. The main cause of the primary type is retinal rupture and fluid accumulation in areas of its detachment. The source of secondary exfoliation is various neoplasms. So, the predisposing factors are:
- stress situations;
- circulatory disorders;
- viral diseases;
- human ophthalmic interventions;
- retinal dystrophy;
- too much exercise;
- eye injuries;
- high degree of myopia;
- diabetes mellitus;
- pregnancy.
The causes of retinal detachment should be determined by a doctor.
Symptoms
If a person knows the first symptoms of retinal detachment, he will be able to go to the doctor in time and prevent serious complications. These signs are:
- the appearance of a shadow or veil in one of the fields of view, when moving the head, it may fluctuate;
- the appearance of a large number of black dots in the field of view, indicating areas of outpouring of blood in the vitreous body;
- feeling of sharp bright "flashes", "sparks", "lightning" (such "visions" are mainly noted in the eye area, which is located closer to the temple).
The above signs of retinal detachment will be accompanied by visual impairment. The patient may notice the curvature of the lines and shapes of objects. If the retinal detachment is fresh, there may be a syndrome of improvement in the quality of vision in the morning. This is because the fluid that accumulates in the areas of detachment is slightly absorbed overnight. Most patients think that such symptoms are a sign of fatigue, and therefore the visit to the ophthalmologist is postponed, and the process begins to progress at a rapid pace.
If the pathological process occurs in the upper parts of the eye, then the symptoms of retinal detachment spread much faster than in the lower ones. This is explained by the fact that, according to physical laws, the accumulated fluid begins to sink down, provoking retinal detachment in the departments locatedbelow. In these parts of the organs of vision, retinal breaks are dangerous because they can proceed for a long time with almost no symptoms, revealing themselves only after spreading to the central (macular) region of the eye. The type of retinal detachment affects the severity of symptoms. It is most pronounced in rhegmatogenous detachment, while in the exudative or traction variety, the manifestations are more meager, which develop slowly and are diagnosed only after damage to the ocular macula.
Retinal detachment in the photo is difficult to convey.
Diagnosis
If there is the slightest suspicion of retinal detachment, a thorough ophthalmological examination is performed. Diagnostic methods are divided into three types: special, standard, laboratory. Standard ways include:
- perimetry - analysis of the field of view in order to establish its boundaries and diagnose defects (cattle);
- tonometry - determination of pressure inside the eye;
- visometry - establishing visual acuity through special tables;
- ophthalmoscopy - analysis of the fundus using an ophthalmoscope and a fundus lens to assess the condition of the optic nerve head, retina and fundus vessels;
- biomimicroscopy - a thorough examination of eye structures, which is performed using a slit lamp;
- analysis of entopic phenomena - makes it possible to assess the preservation of retinal functions.
In the number of special studiesincluded:
- B-mode ultrasound - allows you to examine the eyeball in two dimensions and visualize the contents of the latter and the orbit;
- EPS (electrophysiological methods) - they include electroretinography, electrooculography and electroencephalography, which registers the sensitivity of the optic nerve and conditioned potentials of the visual area of the cerebral cortex.
Laboratory research methods may include:
- blood tests: for hepatitis C and B, HIV, syphilis, general, biochemistry;
- urine test - for sugar and general.
Ophthalmoscopy is of particular importance in diagnosing retinal detachment. With the help of such a study, it is possible to establish the extent of detachment, the location of areas of retinal breaks and dystrophy, and the shape. Retinal detachment is ophthalmoscopically manifested by the disappearance of a normal red reflex at the bottom of the eye in one of its zones. In the area of exfoliation, it acquires a grayish-white color. With a long detachment, coarse folds and star-shaped scars appear on the retina. The retina becomes immobile and rigid upon detachment. Areas of discontinuity appear in various shapes and in red. The use of all methods of examination of the organs of vision in the aggregate makes it possible to obtain the most informative picture, which makes it possible to draw up the most effective and adequate treatment plan.
Treatment and recovery
The only effective way to dissecting the retina is surgical therapy. Carrying it out at the earliest stages of thispathological process allows you to get the best results, increases the possibility of restoring lost vision. The main goal of treatment is to block existing tears in patients, reduce the volume of the eyeball and restore the interaction between exfoliated areas.
Surgical interventions to eliminate retinal detachment are divided into:
- laser;
- endovitreal;
- extrascleral.
The tactics of surgical therapy is chosen purely individually, depending on the degree and causes of retinal detachment.
Effective eye drops for retinal detachment:
- "Tauron".
- "Emoxipin".
They have the same effect. However, "Emoxipin" gives an unpleasant burning sensation, causes discomfort. Therefore, if "Emoxipin" did not suit you, then it is possible to replace it with "Tauron". Of course, before using these drugs, you should consult an ophthalmologist, and in the process of using them, monitor the change in condition.
Extrascleral treatments
The operation with extrascleral methods of surgical therapy is performed on the surface of the sclera. These techniques include filling and ballooning.
What does the first way mean? This procedure is performed on the surface of the sclera, its main purpose is based on the convergence of the surface of the pigment epithelium anddetached area of the retina. Before the operation, the exact zone of detachment is determined. The required size of the seal is made of a soft silicone sponge. The surgeon cuts the conjunctiva and applies the prepared element to the required area of the sclera. Depending on the type of retinal detachment, filling can be performed using a sectoral, circular or radial technique. If necessary, it is possible to remove the accumulated liquid. Some clinical cases require the introduction of a special gas or air into the eye cavity. After the intervention is completed, the surgeon will suture the incision of the conjunctiva. This operation can be complicated in some cases. So, in the early period after the intervention, infection of the wound surface, impaired functioning of the oculomotor muscles, detachment of the vascular membrane and drooping of the upper eyelid, and increased pressure inside the eye can be noted. In the late period after surgery, the following are possible: exposure of the implant, development of cataracts, formation of membranes, degeneration foci and microcysts in the macula area, as well as a change in ocular refraction towards myopia. If the intervention for extrascleral filling is performed unprofessionally, then there may be no snug fit of the exfoliated area and retinal detachment.
After the intervention of extrascleral filling, vision is restored within two to three months (a longer period - in old age). In most cases, it will be incomplete, depending on the duration of the detachment and the degree of pathology of the central retina. Priceextrascleral filling is determined by the prestige of the medical institution and the volume of procedures performed.
What does extrascleral ballooning mean? During the procedure, a balloon with a special catheter is inserted behind the eye. With the help of a balloon, pressure is applied to the sclera, the inner shell is fixed with a laser. The balloon is removed five to seven days after laser coagulation. Extrascleral ballooning in some cases can be complicated by increased intraocular pressure, hemorrhages and cataracts.
Contraindications for such an operation are:
- extensive jagged line breaks and breaks;
- fixed folds that take up more than ¾ of the fundus;
- rupture is complicated by the outpouring of blood into the vitreous body.
Such an intervention is low-impact, carried out for 30-50 minutes. Its effectiveness is determined by the timeliness of contacting a doctor and can give positive results in 98% of cases. The cost of the procedure depends on the medical institution where it is performed and the severity of the retinal condition.
What else is the treatment for retinal detachment?
Endovitreal treatments
The endovitreal method is performed inside the eyeball. This operation is called a vitrectomy. It refers to the partial or complete removal of the vitreous body. Thanks to this, the surgeon gains access to the posterior wall of the eye cavity. Furtherthe pulled out vitreous body is replaced with a special material, which must have the right degree of viscosity and high transparency, be hypoallergenic, long-lasting and non-toxic. To do this, in most cases, they use special balanced s alt solutions, bubbles with gas or oil, artificial polymers.
Vitrectomy has the following contraindications:
- gross disorders of the optic nerve or retina;
- pronounced corneal opacity.
During vitrectomy, the surgeon removes the necessary areas of the vitreous body through very thin punctures. Then laser coagulation of the retinal zones is performed, the detachment thickens, the integrity of the retina is restored. A vitreous body substitute is inserted into the formed cavity, which keeps the retina in a normal physiological state. Possible complications of vitrectomy: lens defects, bleeding, retinal detachment or breaks. In the period after the operation, there may be repeated hemorrhages, the development of inflammation processes, an increase in pressure inside the eye, changes in the cornea, as well as re-stratification of the retina. The operation can last from one and a half to two to three hours. This type of intervention has proven to be an effective way to preserve and restore vision. The cost of this surgical technique is determined by the following circumstances: the condition of the eye, the authority of the medical institution and the nature of the intervention.
Laser treatment
Retinal Detachment Therapyeyes with a laser can be carried out only at its initial stages. This procedure is called peripheral restrictive laser coagulation. It is aimed at the prevention of retinal detachment. Its essence is based on the impact of a laser beam on thinned damaged areas of the retina. The laser radiation "solders" them, forming a soldering of the retina and tissues located below. Restrictive peripheral coagulation ultimately leads to an increase in blood flow velocity, normalizes nutrition and blood supply to pathological areas of the inner ocular membrane, blocks the flow of fluid under the retina. Two weeks after the operation, laser vision correction can be performed.
The use of a laser for retinal dissection has the following contraindications:
- gross changes in the bottom of the eye;
- presence of obvious epiretinal gliosis (a film forms on the retina);
- rough rubeosis (pathological vascular growth) of the retina;
- insufficient transparency of optical media.
The intervention can be carried out on an inpatient and outpatient basis during one session. It lasts from five to fifteen minutes. Treatment of retinal dissection by laser surgery is easily tolerated by patients, it is not complicated by anything. The price of restrictive peripheral coagulation is determined by the area of the retina exposed to the laser, as well as the authority of the medical organization.
Folk remedies
Traditional medicine uses the following tools:
- blueberries (rawinside as an antioxidant);
- mistletoe (you need to make a decoction and drink it - it reduces pressure inside the eye);
- elderberry (for eyewash);
- eyebright (for compresses);
- fennel (for lotions);
- blackberry (ingestion - antioxidant, contains vitamin C);
- hawthorn (used in the form of a tincture, thanks to which oxygen supply and blood circulation of tissues improve).
In case of retinal detachment, it is strictly forbidden to replace surgical intervention with traditional medicine. They will not cope with the violation that has begun, but will only alleviate the symptoms and slow down the course of the disease.
Attempts to treat retinal detachment with folk remedies can significantly impair vision and lead to blindness. It is not worth wasting time on such unreasonable therapeutic methods - at the first symptoms you need to urgently consult a specialist.
Let's consider the prevention of retinal detachment and its consequences.
Prevention and consequences
The main consequence of pathology is blindness. Surgical intervention in this pathology should be carried out as early as possible, since only this method can help avoid complete loss of vision and achieve its maximum recovery.
Unfortunately, few people know how serious retinal detachment and its consequences are.
The main preventive measure to prevent the disease is a regular visit to the ophthalmologist by patients from risk groups (patients with diabetes,myopia, hypertension, traumatized eyes or head, pregnant women, etc.). The frequency of such examinations is set individually (at least once a year), the doctor's examination should include the diagnosis of peripheral areas of the retina against the background of an enlarged pupil. Such a group of patients should know the first symptoms of retinal detachment in order to immediately seek medical help if they occur. If areas of retinal dystrophy or breaks are found, patients may be prescribed restrictive peripheral laser photocoagulation that can prevent the development of detachment. To prevent retinal detachment, patients may be advised to give up heavy sports, somewhat limit the choice of professions, and give special advice on visual load on the eyes. If pregnant women have a risk of retinal detachment, then a caesarean section is recommended for obstetrics. In order to prevent such a disorder, patients at risk and other groups of the population should observe a normal regimen of visual and physical activity, not lift weights, and avoid injuries to the eyes and head.
Retinal detachment reviews
Patient feedback generally boils down to the effectiveness of laser treatment, the discomfort during this procedure is much less than with other types of interventions, and the recovery period is much shorter. People talk about almost complete painlessness (although some claim that discomfort is present) andthe success of the treatment. Among the shortcomings, patients note the high cost of intervention, headache after and burning in the eyes. However, most consider this a trifle compared to possible blindness.
In principle, everyone definitely recommends surgery, since the detachment will not resolve on its own.
