Understanding Retinal Detachment

Retinal detachment is a very serious fundus disease. Once it occurs and is not treated in time, it can eventually lead to serious consequences such as blindness and atrophy of the eye. The retina is divided into the neuroepithelial layer and pigment epithelial layer. When fluid enters and accumulates between the two layers, causing the neuroepithelial layer to leave its original anatomical position, it is called retinal detachment. Causes: It is related to the condition of the retina itself, the vitreous condition and the eye itself and even genetic factors. Pathogenesis: Retinal fissure and vitreous liquefaction detachment pull the retina and cause pathological adhesion to the retina, which are the two necessary conditions to cause primary retinal detachment, one cannot be missing. Risk factors (1) Relationship with myopia: Retinal detachment mostly occurs in myopic patients. Among the cases of hole-derived retinal detachment, there are many patients with myopic refraction of -6.00D or more. The age of onset of foraminogenic retinal detachment in myopic eyes is younger than that in orthoptotic eyes. (2) The effect of extraocular muscle movement: The stop of the four straight muscles is located in front of the serrated edge, and their movement has little effect on the retina. While the oblique muscle stops at the posterior part of the eye, the upper oblique muscle pulls the eye downward, plus the gravitational effect of the vitreous body, which may have some relationship with the retina in the superior temporal quadrant being prone to fissure. The macula is prone to cystic degeneration, which can secondary into a fissure, and some believe it is also related to the pulling of the inferior oblique muscle during movement. (3) Relationship with ocular trauma: sawtooth edge disconnection occurs after blunt contusion of the eye, which can develop into retinal detachment. The prevalence of adolescent ocular trauma in retinal detachment is high, accounting for 18.71% to 20%. Animal experiments have confirmed that eye deformation at the moment of eye contusion can cause a tear in the distal peripheral part of the retina. In addition, severe trauma can produce retinal lacunae directly in the equatorial region. Trauma-induced stagnation of capillary circulation in the posterior pole, retinal oscillations and vitreous traction can produce macular lacunae or develop from macular cystoid degeneration and then into holes. Except for these retinal detachments that are clearly related to trauma, in most cases, the retina and vitreous body are already degenerated or adherent, and have the intrinsic factors of retinal detachment, and trauma only acts as a trigger to induce retinal detachment. (4) Relationship with heredity: Some cases of retinal detachment occur in the same family, indicating that the disease may have genetic factors, and there may be recessive or irregular inheritance. Most pathological myopia has a more certain heredity and more retinal detachments occur. In addition, in patients with bilateral retinal detachment, the lesions in the fundus of both eyes are mostly symmetrical, which also indicates that some retinal detachment may be closely related to congenital growth and development factors. IV. Clinical manifestations: The most common symptom of retinal detachment is that the vision is suddenly affected, as if there are clouds in front of the eyes, but the patient’s eyes are not red or painful. Many cases start with a sensation of flashing light and a lot of flying mosquitoes suddenly appear. V. Factors affecting the recovery of vision after retinal detachment surgery: (1) How long did the retinal detachment take before receiving surgery. (2) Whether there is detachment in the macula. (3) Whether the patient has other eye diseases such as cataract or diabetic retinopathy. (4) Any other complications during or after the surgery. (5) Whether there is any gas or silicone oil injected into the eye during the surgery. Sixth, retinal detachment requires more bed rest in the early stage after surgery: pay attention not to untie the bandage or rub the operated eye to avoid causing infection and inflammation in the operated eye. If silicone oil or gas is injected into the eye, the doctor will instruct the patient to maintain a certain posture (such as facing down, lying on the side, half sitting, etc.), which should be strictly enforced to the extent that their body can bear, which can promote disease recovery and avoid recurrence of retinal detachment. Pay attention to eye cleanliness and avoid the flow of sewage into the eyes when washing hair. Avoid bruises, regular drops and follow-up appointments, and no air travel until the gas in the eye has been absorbed. Avoid picking up objects with your head down and carrying heavy objects, avoiding shocks, and not diving or diving to avoid the results of the surgery. During the recovery period, in addition to using medications prescribed by the doctor on time, you should eat nutritious and easily digestible food to promote recovery. Eat more fruits and vegetables to prevent constipation, and do not drink alcohol and eat stimulating and hard foods.