This article needs additional citations for
verification. (January 2009) |
Retinal detachment | |
---|---|
Ultrasound of a retinal detachment in a patient presenting with complete vision loss and light perception only. | |
Specialty | Ophthalmology |
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. [1] Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a surgical emergency. [2]
The retina is a thin layer of light-sensitive tissue on the back wall of the eye. The optical system of the eye focuses light on the retina much like light is focused on the film in a camera. The retina translates that focused image into neural impulses and sends them to the brain via the optic nerve. Occasionally, posterior vitreous detachment, injury or trauma to the eye or head may cause a small tear in the retina. The tear allows vitreous fluid to seep through it under the retina, and peel it away like a bubble in wallpaper.
As the retina is responsible for vision, persons experiencing a retinal detachment have vision loss. This can be painful or painless.[ citation needed] Symptoms of retinal detachment may include: [1]
Ultrasound, MRI, and CT scan are commonly used to diagnose retinal detachment.[ citation needed]
There are 4 main types of retinal detachment: [3]
A small number of retinal detachments result from trauma, including blunt blows to the orbit, penetrating trauma, and concussions to the head. A retrospective Indian study of more than 500 cases of rhegmatogenous detachments found that 11% were due to trauma, and that gradual onset was the norm, with over 50% presenting more than one month after the inciting injury. [5]
The risk of retinal detachment in otherwise normal eyes is around 5 in 100,000 per year. [6] Detachment is more frequent in the middle-aged or elderly population with rates of around 20 in 100,000 per year. [7] The lifetime risk in normal eyes is about 1 in 300. [8]
Although retinal detachment usually occurs in one eye, there is a 15% chance of developing it in the other eye, and this risk increases to 25–30% in patients who have had cataracts extracted from both eyes. [9]
A retinal detachment is commonly but not always preceded by a posterior vitreous detachment which gives rise to these symptoms:
Sometimes a detachment may be due to atrophic retinal holes in which case it may not be preceded by photopsia or floaters.
Although most posterior vitreous detachments do not progress to retinal detachments, those that do produce the following symptoms:
There are several methods of treating a detached retina which all depend on finding and closing the breaks which have formed in the retina.
85 percent of cases will be successfully treated with one operation with the remaining 15 percent requiring 2 or more operations. After treatment patients gradually regain their vision over a period of a few weeks, although the visual acuity may not be as good as it was prior to the detachment, particularly if the macula was involved in the area of the detachment. However, if left untreated, total blindness will occur in a matter of weeks.[ citation needed]
Retinal detachment can sometimes be prevented. The most effective means is by educating people to seek ophthalmic medical attention if they have symptoms suggestive of a posterior vitreous detachment. [15] Early examination allows detection of retinal tears which can be treated with laser or cryotherapy. This reduces the risk of retinal detachment in those who have tears from around 1:3 to 1:20.[ citation needed]
There are some known risk factors for retinal detachment. There are also many activities which at one time or another have been forbidden to those at risk of retinal detachment, with varying degrees of evidence supporting the restrictions.[ citation needed]
Cataract surgery is a major cause, and can result in detachment even a long time after the operation. The risk is increased if there are complications during cataract surgery, but remains even in apparently uncomplicated surgery. The increasing rates of cataract surgery, and decreasing age at cataract surgery, inevitably lead to an increased incidence of retinal detachment.[ citation needed]
Trauma is a less frequent cause. Activities which can cause direct trauma to the eye (boxing, kickboxing, karate, etc.) may cause a particular type of retinal tear called a retinal dialysis. This type of tear can be detected and treated before it develops into a retinal detachment. For this reason governing bodies in some of these sports require regular eye examination.[ citation needed]
Individuals prone to retinal detachment due to a high level of myopia are encouraged to avoid activities where there is a risk of shock to the head or eyes, although without direct trauma to the eye the evidence base for this may be unconvincing. [9] Some doctors recommend avoiding activities that suddenly accelerate or decelerate the eye, including bungee jumping and skydiving but with little supporting evidence. Retinal detachment does not occur as a result of eye strain, bending, or heavy lifting. [ attribution needed]
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This article needs additional citations for
verification. (January 2009) |
Retinal detachment | |
---|---|
Ultrasound of a retinal detachment in a patient presenting with complete vision loss and light perception only. | |
Specialty | Ophthalmology |
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. [1] Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a surgical emergency. [2]
The retina is a thin layer of light-sensitive tissue on the back wall of the eye. The optical system of the eye focuses light on the retina much like light is focused on the film in a camera. The retina translates that focused image into neural impulses and sends them to the brain via the optic nerve. Occasionally, posterior vitreous detachment, injury or trauma to the eye or head may cause a small tear in the retina. The tear allows vitreous fluid to seep through it under the retina, and peel it away like a bubble in wallpaper.
As the retina is responsible for vision, persons experiencing a retinal detachment have vision loss. This can be painful or painless.[ citation needed] Symptoms of retinal detachment may include: [1]
Ultrasound, MRI, and CT scan are commonly used to diagnose retinal detachment.[ citation needed]
There are 4 main types of retinal detachment: [3]
A small number of retinal detachments result from trauma, including blunt blows to the orbit, penetrating trauma, and concussions to the head. A retrospective Indian study of more than 500 cases of rhegmatogenous detachments found that 11% were due to trauma, and that gradual onset was the norm, with over 50% presenting more than one month after the inciting injury. [5]
The risk of retinal detachment in otherwise normal eyes is around 5 in 100,000 per year. [6] Detachment is more frequent in the middle-aged or elderly population with rates of around 20 in 100,000 per year. [7] The lifetime risk in normal eyes is about 1 in 300. [8]
Although retinal detachment usually occurs in one eye, there is a 15% chance of developing it in the other eye, and this risk increases to 25–30% in patients who have had cataracts extracted from both eyes. [9]
A retinal detachment is commonly but not always preceded by a posterior vitreous detachment which gives rise to these symptoms:
Sometimes a detachment may be due to atrophic retinal holes in which case it may not be preceded by photopsia or floaters.
Although most posterior vitreous detachments do not progress to retinal detachments, those that do produce the following symptoms:
There are several methods of treating a detached retina which all depend on finding and closing the breaks which have formed in the retina.
85 percent of cases will be successfully treated with one operation with the remaining 15 percent requiring 2 or more operations. After treatment patients gradually regain their vision over a period of a few weeks, although the visual acuity may not be as good as it was prior to the detachment, particularly if the macula was involved in the area of the detachment. However, if left untreated, total blindness will occur in a matter of weeks.[ citation needed]
Retinal detachment can sometimes be prevented. The most effective means is by educating people to seek ophthalmic medical attention if they have symptoms suggestive of a posterior vitreous detachment. [15] Early examination allows detection of retinal tears which can be treated with laser or cryotherapy. This reduces the risk of retinal detachment in those who have tears from around 1:3 to 1:20.[ citation needed]
There are some known risk factors for retinal detachment. There are also many activities which at one time or another have been forbidden to those at risk of retinal detachment, with varying degrees of evidence supporting the restrictions.[ citation needed]
Cataract surgery is a major cause, and can result in detachment even a long time after the operation. The risk is increased if there are complications during cataract surgery, but remains even in apparently uncomplicated surgery. The increasing rates of cataract surgery, and decreasing age at cataract surgery, inevitably lead to an increased incidence of retinal detachment.[ citation needed]
Trauma is a less frequent cause. Activities which can cause direct trauma to the eye (boxing, kickboxing, karate, etc.) may cause a particular type of retinal tear called a retinal dialysis. This type of tear can be detected and treated before it develops into a retinal detachment. For this reason governing bodies in some of these sports require regular eye examination.[ citation needed]
Individuals prone to retinal detachment due to a high level of myopia are encouraged to avoid activities where there is a risk of shock to the head or eyes, although without direct trauma to the eye the evidence base for this may be unconvincing. [9] Some doctors recommend avoiding activities that suddenly accelerate or decelerate the eye, including bungee jumping and skydiving but with little supporting evidence. Retinal detachment does not occur as a result of eye strain, bending, or heavy lifting. [ attribution needed]
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)