A Retinal detachment is an acute eye disease. If there is any suspicion, an ophthalmologist should be consulted immediately to prevent possible blindness.
What is retinal detachment?
The Retinal detachment within the human eye is a disease that occurs relatively rarely.However, once a retinal detachment has occurred, this represents an absolute ophthalmological emergency, as progress towards the visual center can often be observed. Immediate extensive surgical measures are then required to preserve the patient's eyesight.
There are various causes of retinal detachment, but overall they are usually easy to treat. The majority of affected patients are usually between 40-70 years old. So it is a typical old age disease.
In the back of the eye, the retina rests on a section of tissue made of pigments and contains sensory cells called rods and cones. These rods and cones are interlocked with the cells of the pigment tissue in a special way; this interlocking serves to maintain suction forces within the eye. The retina is responsible for transmitting the optical sensory stimuli to the brain. If it detaches itself from the pigment tissue on which it lies, then one speaks of a retinal detachment.
causes
If tensile forces act on the connection points between the retina and pigment tissue, these connections are interrupted and there is a risk of loss of vision. The one from one Retinal detachment Affected people are usually between 50 and 70 years old. This means that the retinal detachment is age-related in most cases, whereby the group of nearsighted patients has a greater risk of being affected by a retinal detachment.
With age, the retina can crack as the vitreous humor of the eye changes over time. Adhesions may also develop on the cracks, so that the vitreous humor pulls the retina with it when it begins to shrink. This pulling effect can be so strong that a network house is detached. Some pre-existing conditions that affect the eye can also be the cause of retinal detachment.
These diseases include, for example, diabetes, Coats disease, borreliosis and tuberculosis. In these diseases, the fluid exchange in the eye is disturbed. This leads to deposits that drive a wedge between the retina and the underlying tissue layer. This then leads to a detachment of the retina. A tumor of the eye can also cause retinal detachment, as it can displace the retina.
Symptoms, ailments & signs
Typical characteristics of a retinal detachment are expressed through changes in visual perception. Flashes of light that occur in the field of view can primarily be seen in the dark. When those affected move their eyes, the pulling force is transferred to the stressed retina and triggers these photopsias.
In more severe cases, patients suffer from so-called soot rain, some of which are similar to flying swarms of mosquitoes. Tears or even bleeding lead to a momentum in their movement patterns. They do not remain in the same position as in the case of cell clumps in the vitreous body. If the eyesight is completely reduced in certain zones, doctors speak of a visual field loss (scotoma).
This phenomenon often spreads slowly. Those affected describe a slowly growing shadow that increasingly covers the field of vision. The course of the spread is usually opposite to the position of the detachment. A falling dark curtain indicates problems with the lower retina. Such manifestations are considered emergencies and require immediate treatment by an ophthalmologist.
All symptoms described are not necessarily found in isolation. A combination with each other is possible. In addition, some symptoms only appear for a short time. Especially spontaneous flashes of light without further consequences are characteristic of a detachment at the outer edge of the retina.
Smaller damage often goes unnoticed. If the sharpest point of vision (macula) is affected, patients suffer from extremely severe impairment of vision due to distortions and blurring. The position of the amotio retinae therefore remains decisive for the overall expression of the symptoms.
Diagnosis & course
In the case of the patient, one makes itself Retinal detachment first noticeable through irritation of the visual field. Those affected suddenly see small flashes of light, points, wisps of fog or lines. The signs of retinal detachment can also be felt in the form of a kind of “soot rain”.
It is also possible to perceive shadows or a dark curtain. If such visual disturbances occur, an ophthalmologist should be consulted immediately and without hesitation, it could be a detachment of the retina! The doctor will use special examination methods to determine whether there is a detachment of the retina and initiate further treatment measures.
Complications
Several complications can arise when treating retinal detachment. After a successful operation, there is the risk that the retina will detach again, which makes another surgical procedure necessary. In this case, a pars plana vitrectomy, which involves removing the vitreous humor from the eye, may also be required.
In rare cases, materials used to treat retinal detachment, such as foam seals or tapes attached around the eyeball, can trigger intolerance and immune reactions on the part of the body. In such a case, the materials must be removed again. In a pars plana vitrectomy, the vitreous body of the eye is replaced with gas or silicone oil.
The latter can lead to cataracts in the patient and must be removed from the eye after one year. Basically, with all interventions on the retina there is a risk of secondary glaucoma, in which the intraocular pressure increases. Even with successful treatment of a retinal detachment, the patient's quality of vision in the affected eye remains impaired.
If an inflammation or a tumor disease is the cause of the retinal detachment, the successful treatment depends to a large extent on the subsidence of the inflammation or the removal of tumorous tissue. Retinal detachment should be treated in any case, as it otherwise leads to blindness of the eye.
When should you go to the doctor?
A sudden decrease in vision should be brought to a doctor immediately. If the eyesight decreases significantly within a few minutes or hours, there is an acute health condition that must be presented to a doctor immediately. Without a quick medical consultation, there is a risk of further loss of vision. In severe cases and without treatment, the affected person becomes blind.
Blurred vision, impaired perception or an inability to see certain objects must be examined and treated immediately. If the usual outlines of people or buildings in the immediate vicinity can no longer be clearly defined, there is an eye disease that requires action to be taken more quickly. If the person concerned can no longer clearly recognize or assign movement patterns of people or passing cars, there is cause for concern. If the person concerned has the feeling that a swarm of mosquitoes is in front of their field of vision or if they report other peculiarities of visual perception, a doctor should be consulted.
Distortion or color changes in vision are further signs of an existing irregularity. If the person concerned reports of a black curtain that he sees in front of his field of vision, a doctor must be consulted. From the patient's point of view, the curtain seems to be slowly loosening and this continuously worsens vision.
Treatment & Therapy
Should the suspicion be borne out that a Retinal detachment has occurred, surgical treatment of the affected eye can usually not be avoided. The type of treatment the ophthalmologist ultimately decides on depends on the exact causes and the extent of the respective retinal detachment.
If there are only small cracks on the retina, these can be repaired with the help of laser probes. Cold probes are also sometimes used. If the vitreous has withdrawn inwards and in this way pulled the retina with it, then it must be artificially dented. This is done through the use of silicone seals.
If the glass body is already too much deformed, it may have to be removed and replaced with other suitable materials, such as a special silicone oil.
The vast majority of cases of retinal detachment can be cured surgically, even if a few patients can experience permanent deterioration in vision after retinal detachment.
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Without treatment, the retinal detachment deteriorates progressively, resulting in blindness. The sooner diagnosis and treatment start, the better the prognosis usually is. In addition to the specific cause of the retinal detachment, the affected area of the retina also proves to be very important for the prognosis. Almost fifty percent of all retinal detachments can be avoided by taking preventive measures.
The rhegmatogenic retinal detachment caused by cracks has the best prognosis - almost all rhegmatogenic retinal detachments can be repaired by surgery. If a retinal detachment lasts for a long time, this can promote a so-called proliferative vitreoretinopathy. This is a reactive increase in tissue around the vitreous body. The consequences are severe visual disturbances - blindness cannot be ruled out.
Another complication can manifest itself in the involvement of the second eye. If, for example, a rhegmatogenic detachment of the retina is present in one eye, there is a twenty percent risk of retinal detachment in the other eye over time. Therefore, patients at risk from the age of forty should undergo a retinal check about once a year.
In the case of retinal holes in healthy eyes, it seems advisable to treat them prophylactically via laser or cold treatment. In any case, an ophthalmologist should be consulted immediately in the event of sudden deterioration or if symptoms of retinal detachment occur (again).
prevention
An important prerequisite for a successful treatment for a once occurred Retinal detachment, is the timely consultation of an ophthalmologist. For this reason, every alarm signal, no matter how small, should be taken very seriously. If you experience sudden visual disturbances or visual deterioration, there is no need to think twice.
You should see a doctor quickly because it could be a detachment of the retina. People over 40 and diabetics are advised to see an ophthalmologist once a year, who can identify possible changes in the retina and initiate treatment before retinal detachment occurs.
Overall, it can be said that retinal detachment has lost its horror nowadays. If you carefully observe the above advice on how to behave when a retinal detachment is suspected, in most cases, impairment of vision as a result of a retinal detachment can be prevented by treatment in an ophthalmological practice.
Aftercare
After surgical treatment of the retinal detachment, check-ups are carried out by the ophthalmologist at regular intervals. The first examination takes place a few days after discharge from the hospital. The inspection appointments extend over several months.
Depending on which surgical procedure is used, postoperative pain may occur after the procedure. However, they can usually be treated well with the administration of painkillers. In addition, the patient receives an eye ointment or eye drops afterwards. How long they need to be administered depends on the respective findings.
The patient does not have to carry out special rehabilitation measures. However, he should refrain from lifting heavy loads and refrain from sporting or similar physical activities. The same applies to moving the eyes back and forth quickly, for example when reading. In contrast, watching TV is possible without any problems, as is going for a walk, washing your hair and showering. Any restlessness or rubbing of the eyes should be avoided. During the first week, the patient wears a bandage or protective glasses during the day.
Caution is particularly advised in the first six weeks after the operation, as this is the period during which the risk of complications is highest. If symptoms such as deterioration of eyesight, darkening or lightning flashes, treatment by an ophthalmologist or an eye clinic must take place immediately.
You can do that yourself
Retinal detachment is always a medical emergency that requires immediate medical examination and treatment. In the area of self-help in everyday life, there is no way to treat a retinal detachment yourself. Precisely because a retinal detachment requires treatment as quickly as possible, any consideration of waiting or taking medication such as painkillers is not advisable.
Retinal detachment therapy consists of performing surgery as quickly as possible to repair the detachment. There is no other way to prevent vision loss. In this respect, the possibility of self-help is rather limited to recognizing possible symptoms of a retinal detachment and then acting quickly.
Retinal detachment can in principle affect anyone and does not necessarily have to be announced in advance. Nevertheless, people who, due to individual risk factors, belong to a group of people at risk, should know which symptoms may indicate a detachment of the retina.
After a successful operation, patients must regularly attend all follow-up examinations in everyday life and take medication such as intraocular pressure as planned. Consistent cooperation from the patient's point of view is the best way to prevent the retina from detaching again in the area of self-help.
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