Retinal detachment

The cause of exfoliation is considered to be ruptures of the retina. The retina does not move from its place if it is tight and there is no gap in it. If a gap has formed, then through it a liquid from the vitreous body penetrates under the retina and exfoliates it from the choroid .

The main reason for the formation of a retinal rupture is traction of the vitreous body when its normal state changes. In the presence of diseases, the vitreous humor changes, becomes cloudy, with compacted fibers that are connected to the retina. When the eye moves, the strands (fibers) pull the retina behind them, which can lead to its rupture.

Retinal tears can also occur with dystrophy (thinning). Large tears often occur with eye injuries .

Other, rarer causes of retinal detachment are traction from the altered vitreous body without the formation of retinal tears. This often happens with diabetic retinopathy , tumors , fluid accumulation.

The success of treatment for retinal detachment directly depends on the timely detection of the disease.

• The appearance of a veil in front of the eye. Patients unsuccessfully try to independently eliminate it by washing their eyes with tea or instilling drops. In this case, it is important to remember and tell the doctor on which side the veil originally appeared, since over time it can increase and occupy the entire field of view.
• Outbreaks in the form of sparks and lightnings are also a characteristic feature of the ongoing retinal detachment (photopsies).
• Distortion of the letters, objects in question, loss of sight of their individual sections indicates that the detachment has captured the center of the retina (metamorphopsia).
• The narrowing of the boundaries of the field of view, which correspond to the localization of retinal detachment.

Retinal detachment cannot be treated with medication . The only way to restore vision and save the eye is an urgent operation.

With detachment of the retina, nerve cells , rods and cones die, and the longer the detachment exists, the more these cells die and the worse the restoration of vision even after a successful operation.

With a running disease, there is a danger of chronic inflammation, the development of cataracts , complete loss of vision .

Diagnosis of retinal detachment requires the following studies:

• visual acuity testing determines the condition of the central region of the retina;
• a study of lateral vision ( perimetry ) to assess the state of the retina at its periphery;
• measurement of intraocular pressure ( tonometry ); with detachment of the retina, it may be lower than normal (the norm is 16–25 mm Hg );
• electrophysiological examination helps determine the viability of nerve cells in the retina and optic nerve ;
• fundus examination ( ophthalmoscopy ) allows you to accurately determine the location of retinal tears and their number, to identify thinned areas that can lead to new foci of the disease;
• ultrasound examination helps to obtain information about the size of the exfoliated retina and the state of the vitreous body. This study is especially important for clouding of the cornea , lens or vitreous body , when it is impossible to see the retina.

The goal of surgical treatment for retinal detachment is to detect retinal rupture and closure. To do this, inflammation is caused around the gap by cryopexy or laser, and subsequent scarring in the area of ​​the retina rupture. This procedure restores its tightness . To improve sealing , rapprochement of the membranes of the eyeball is performed. Depending on the specific type of retinal detachment, the following operations are performed:

• local filling in the area of ​​retinal rupture. It is carried out in cases when the retina is partially detached;
• circular filling. It is used with complete retinal detachment;
• vitrectomy is a method in which the altered vitreous is removed, one of the drugs is introduced instead: saline, liquid silicone, perfluorocarbon compound in the form of a liquid or a special gas that presses the retina from the inside of the choroid;
• laser coagulation of the retina to limit the area of ​​rupture and thinned sections of the retina.

The combination of these interventions is selected individually for each patient and depends on how much time has passed since the appearance of retinal detachment, what size it is, how many gaps in it, where they are located.

Depending on the specific case, the treatment can be carried out in one or several stages.

In some cases, retinal detachment can be prevented. If a person has myopia or dystrophy of the retina, you need to be regularly examined by an ophthalmologist , and if necessary, carry out preventive treatment in a timely manner. To prevent retinal detachment, laser radiation is used ( laser coagulation of the retina ) or, with the opacity of optical media, low temperatures ( cryopexy ).

With changes in the vitreous body, an operation to replace it can be performed.

To prevent eye injuries, which is a common cause of retinal detachment, especially in young men, basic precautions and safety rules should be followed both at work and at home.