Retinal detachment is defined as the separation of the retina from the underlying tissue.
Retinal detachment is often preceded by a posterior vitreous detachment and the following are symptoms of posterior vitreous detachment :
- Photopsia (flashes of light often very brief in the extreme peripheral part of vision)
- A sharp upsurge in the number of floaters
- Slight feeling of heaviness in the eye
Most cases of posterior vitreous detachments don’t progress to retinal detachments but when progression occurs, the following symptoms are often seen:
- Dense shadow beginning from the peripheral vision and slowly progressing towards central vision.
- The impression of a curtain or veil being drawn over the field of vision.
- Positive Amsler grid test (straight lines suddenly appearing curved).
- Central visual loss.
Entire Body System
This is the first report of vitreous surgery for traction retinal detachment in a patient with type III Gaucher disease with multiple vitreous opacities. [ncbi.nlm.nih.gov]
At 32 weeks of gestation, the 34-year-old Japanese woman underwent cesarean section due to HELLP syndrome. [ncbi.nlm.nih.gov]
Abstract A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. [ncbi.nlm.nih.gov]
The prompt and conscientious vitreoretinal examination of each patient older than 45 years of age who experiences vitreous floaters, even though limited to one or two, should be undertaken without delay. [ncbi.nlm.nih.gov]
floaters, conjunctival haemorrhage, eye irritation, foreign body sensation in eyes, lacrimation increased, blepharitis, dry eye, ocular hyperaemia, eye pruritus et Nii pikalt ette pole me veel mõelnud en The most common side effects with Lucentis (seen [et.glosbe.com]
Early symptoms of rhegmatogenous detachment may include dark or irregular vitreous floaters (particularly a sudden increase, flashes of light (photopsias), and blurred vision. [msdmanuals.com]
In some cases, there may be significant vitreous floaters, inflammatory cells, or blood in front of the retina, obscuring the doctor's view. In such cases, ultrasound may be used to determine if the retina detached. [emedicinehealth.com]
Symptoms are blurred vision, flashes of light, vitreous floaters, and loss of visual acuity. [medical-dictionary.thefreedictionary.com]
Rhegmatogenous retinal detachment Posterior vitreous detachment Peripheral retinal lesions (eg, enclosed oral bays, meridional folds, cystic retinal tufts, lattice degeneration) Myopia Senile retinoschisis Cataract extraction Trauma Intraocular inflammation [web.archive.org]
The interplay between vitreoretinal traction and predisposing retinal lesions is associated with retinal detachment. [radiopaedia.org]
Family history of retinal break or detachment: there may be a tendency towards inherited myopia or degenerative retinal lesions. [patient.info]
Laser photocoagulation, cryotherapy and scleral buckling have been used in the prophylaxis of predisposing retinal lesions (in particular, in patients with RRD as a feature of genetic syndromes). [institut-vision.org]
RESULTS: A 41-year-old woman was referred with a 2-week history of decreased vision and scotoma in the left eye. She was in her sixth month of pregnancy. [ncbi.nlm.nih.gov]
[…] due to perforating injuries or intraocular surgery Retinoblastoma Malignant melanoma of the choroid References: Pathophysiology Clinical features Prodromal symptoms Floaters Flash of light (photopsia) Localized retinal detachment: scotoma [amboss.com]
[…] response to local tumors–eg, melanoma, local inflammation, or malignant HTN, idiopathic, trauma, aging, tumors, inflammation; in premature infants, RD is caused by retinopathy of prematurity Clinical Progressive loss of visual field, often accompanied by scotomas [medical-dictionary.thefreedictionary.com]
Macular degeneration is the leading cause of painless sudden vision loss in older patients, but the scotoma is central and the peripheral field is intact. [aafp.org]
Cryotherapy There is often an associated transient lid chemosis. Other complications include transient diplopia, vitritis (inflammation of the vitreous) and, rarely, maculopathy. [patient.info]
Examination for retinal detachment can be completed by ophthalmoscopy or fundus photography . Fundus photography generally needs to be completed with instruments larger than the ophthalmoscope but is has the distinct advantage of make the image available to be viewed by a specialist elsewhere. It also delivers photo documentation for future reference. Modern fundus photographs often reproduce much larger areas of the fundus than what can be seen at any point in time with the aid of handheld ophthalmoscopes.
There are different treatment procedures for a detached retina but each of them is dependent on finding the breaks that have formed in the retina and closing them . All three of the procedures generally follow the same principles.
- Discovering all retinal breaks
- Sealing all retinal breaks
- Relieving present and future vitreoretinal traction
The major types of treatment include the following:
- Cryopexy and laser photocoagulation
- Scleral buckle surgery
- Pneumatic retinopexy
The visual prognosis is difficult to predict in retinal detachment because the retina is a neuro-sensitive tissue . On average however, retinal detachment devoid of macular involvement generally has better final prognosis.
Retinal detachment has various etiologic and risk factors some of which are :
In the United States, around 6% of the general population are believed to have retinal breaks . Most of these however, are asymptomatic benign atrophic holes which are often without any accompanying pathology. This means a greater percentage of retinal leaks do not lead to retinal detachment. The annual incidence is approximately 1 in 10,000 or about 1 in 300 over a lifetime.
Worldwide, the most common etiologic factors associated with retinal detachment are aphakia, pseudophakia, myopia and trauma . Around 40%-50% of all patients with detachments have myopia, 30%-40% have had cataract correction surgeries while 10%-20% have had direct ocular trauma.
There is no gender or racial predilection for retinal detachment incidence and the condition is mostly seen in people aged 40-70 years.
The retina refers to a thin layer of light sensitive tissue often found on the back wall of the eye. The optical system of the eye focuses light on the retina just as it is seen in the camera where light is focused on the film . The retina then translates the focused image into neural impulses, before sending them to the brain through the optic nerve. Retinal detachment disintegrates the retinal pigment epithelium (RPE).
Separation of the sensory retinal from the underlying RPE happens in three different ways:
- Rhegmatous RD: Here there is a hole, tear or break in the neuronal layer which allows fluid from the vitreous cavity to seep in between the sensory and RPE layers separating them in the process.
- Traction from inflammatory or vascular fibrous over the surface of the retina, which is connected normally to the vitreous body.
- Exudation of material into the subretinal space from retinal vessels as seen in hypertension, central retinal venous occlusion, vasculitis, or papilledema.
Any of the above three mechanisms can be triggered by metabolic disorders, trauma (also including previous ocular surgery), degeneration, vascular disease, choroidal tumors, high myopia, disease affecting the vitreous.
There is no clear prevention path for retinal detachment . However, permanent loss of vision can be prevented by taking note of the main signs of a detached retina which include bright flashes of light, sudden increase in floaters, a shadow or curtain that appears across the field of vision.
People older than 40 years of age who notice any of these signs, those who have a family member with a case of retinal detachment and those with extreme myopia should seek instant medical attention with any or all of these symptoms present.
Retinal detachment (RD) refers to a medical emergency of the eye where the retina is affected, peeling away from the supporting tissue beneath it . Initially, detachment may be localised or partially broad but without quick treatment, the entire retina may detach and this often leads to blindness. Permanent damage kicks in following 72 hours of inaction.
Retinal detachment is an emergency disorder where an important layer of tissue in the back of the eye known as retina pulls away from the layer of blood vessels that supply it with nourishment and oxygen.
When the detachment is complete, the retinal cells are left in need of oxygen. Leaving the retinal detachment untreated for long greatly increases your chances of permanently losing your eyesight.
Retinal detachment however has symptoms which are clear warning signs. Early diagnosis by an ophthalmologist and treatment of retinal detachment will save your vision 85% of the time. The condition is seen mostly in people aged 40 and above.
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