| Retinal
Detachment |
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of Contents |
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Alternative
Names
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Defination
The retina
is a thin tissue composed of layers of cells that lines the inside back
wall of the eye. In part, it contains the light-sensitive cells that send
visual information to the brain. It is held in place by the vitreous,
a transparent gel composed largely of water and fibers of collagen, that
fills the center of the eye and lies between the retina and the more anterior
tissues, such as the lens. When a retinal detachment occurs, the retina
pulls away from the wall of the eye, causing impairment or loss of vision.
Once retinal tissue dies, the body cannot replace it.
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Causes,
Incidence and Risk Factors
The first
step to most retinal detachments is the "clumping" of collagen fibers
in the eye, with release of water. The vitreous can pull away from the
retina and where an adhesion exists, cause a small hole in the retina.
Fluid from the vitreous cavity can seep through the hole or tear and lift
it away from the wall of the eye.
Besides a
change in or a shrinkage of the vitreous gel, a retinal detachment may
occur as a result of a traumatic injury to the eye. Injury can also cause
abnormal vitreous shrinkage.
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Prevention
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Symptoms
While retinal
detachments can happen at any age, they most commonly occur in people
over the age of 60. Although detachments sometimes occur for no identifiable
reason, several pre-existing conditions (such as high myopia, Marfan's
syndrome, retinopathy of prematurity, ocular inflammation, complications
following cataract surgery, or hereditary factors) may prompt a retinal
detachment.
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Signs
& Tests
The warning
signs of Retinal Detachment are
- Light
"flashes" and blurred central vision.
- The presence
of a "veil," or shadow, over part of the field of vision.
- Large
"floaters" or spots that travel across the field of vision, possibly
indicating a partial retinal detachment or of clumped vitreous collagen
fibers.
Patients
should report any of these warning signs to their ophthalmologist immediately.
The best chance for restoring sight relies on prompt treatment
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Treatment
Small holes
and tears and very limited retinal detachments are usually treated with
laser photocoagulation or cryopexy. These procedures are usually administered
in the physician's office. Laser photocoagulation is a procedure whereby
pinpoints of laser light are used to create tiny burns around a small
hole to "weld" the retina back to the wall of the eye. Cryopexy is a similar
procedure which, instead of using heat, freezes the area around a hole
back into place.
Extensive
detachments are treated surgically with a procedure called scleral buckling.
In scleral buckling, a tiny synthetic band is implanted on the outside
of the eyeball to gently push the wall of the eye against the detached
retina. If necessary, a vitrectomy may also be performed to treat more
severe cases. During a vitrectomy, the diseased vitreous is surgically
removed and an artificial substance is inserted to push the retina back
against the eye wall.
If treated
early, sight is usually improved in 80% of the patients with the first
treatment. In other cases, more treatments are necessary to remedy the
damage
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Expectations
(Prognosis)
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Complications
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| Calling
your doctor/health care provider |