Sunday, January 15, 2006

retinal detachment

Retinal detachment is the separation of the sensory retina from the underlying pigment layer. Retinal detachment can be caused by a hole in the retina that allows fluid to seep behind the retina and strip it off (rhegmatogenous detachment) or by traction on the retina caused by fibrous tissue shrinkage (traction detachment). Retinal detachments are seen more frequently in people who have had eye surgery, especially cataract surgery, or who have diabetes, myopes, or following ocular trauma. The occurrence of retinal detachments increases approximately 200 times after removal of the natural lens of the eye. Thus, a large portion of retinal detachments are seen in people over age 65 who have had cataract extractions.
Symptoms of retinal detachment include light flashes, floaters, and a decrease in side vision. This is described as a curtain pulled in from the side, or a cobweb appearance, which later may lead to a decrease in central vision when the macula is involved. Treatment of retinal detachment involves prompt surgery. A flat detachment, in which a hole is present with little fluid behind the retina, may be treated with transpupillary laser therapy around the hole. With elevation of the retina the usual form of treatment consists of cryotherapy applications to promote adhesions between the retina and choroid drainage of the subretinal fluid, and placement of an encircling band. It is important to recognize early symptoms of retinal detachment. If a retinal detachment is detected before the central vision is impaired, surgery generally can restore good vision. If the central area is affected, surgery may not be as beneficial and may not be suggested.
Newell, F. W. Ophthalmology Principles and Concepts, 6th ed. St. Louis: C. V. Mosby Co., 1986.
Slatt, B. I., and Stein, H. A. The Ophthalmic Assistant Fundamentals and Clinical Practice, 4th ed. St. Louis: C. V. Mosby Co., 1983.

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