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Detachment Of The Retina: The Signs That Must Alert

If you have the simultaneous sensation of flying flies, bright flashes with your eyes closed and especially a shadow in the field of vision, you must consult. The retina is composed of two layers, the neuroepithelium and the pigment epithelium, separated by a virtual space in the normal state, and the eye cavity is filled by a gel called vitreous, lining the retina.

When a tear in the retina occurs, under the effect of traction of the vitreous, liquid passes between these two layers and raises the retina.

This detachment progresses more or less quickly depending on its location, and comes to lift the macula causing the loss of central vision. In the absence of treatment, retinal detachment leads to blindness.

Although rare – this condition affects one to two people in every year – the retinal detachment can have dramatic repercussions. If nothing is done when certain symptoms appear, there is a risk of becoming blind. What exactly should we watch for?

The process is triggered if the retina separates from the pigment epithelium, that is, from its support, allowing liquid to infiltrate. In 99% of cases, it is small tears that are responsible for it: they are themselves due to movements of the vitreous body, substance that fills the eyeball. It may also be fluid accumulation, due to a choroidal tumor, a richly vascularized layer located outside the retina. This can also be the result of various diseases of the retina – for example, diabetes or cataract surgery. Still, this detachment is never painful and does not make red eyes.

Some people are particularly prone to retinal detachment. In addition to certain genetic diseases, glaucoma is considered a factor to consider at the time of diagnosis. It is the same, side visual defects, for the high myopia (6 diopters or more), and this especially for young people or if the person practices sports at risk of visual trauma such as boxing, kickboxing, karate…

Interventions with excellent results

What are the signs that need to alert? First there is the sensation of flying flies, though one looks at it. Only this symptom should not worry. But if it appears in a brutal way, that it is accompanied by bright lightning persistent with closed eyes and, especially, of a shadow or a black veil at the edge of the field of vision, one must then go to the faster to ophthalmic emergencies. Because the retina can retract very quickly. And as Professor Jean-Philippe Nordmann, head of the ophthalmology department at the Paris Hospital of Quinze-Vingts, points out, “it is important to intervene early because recovery is not always good in case of prolonged damage. , especially if there is a decrease in visual acuity.

In some cases, a laser treatment may suffice. But when the separation becomes too important, following a tear, the operation is required. To restore contact between the two layers of retina, surgeons generally practice what they call “cryo-indentation”. Specifically, we close the tears by burning the retina by hot or cold, by laser photocoagulation or cryosurgery. The retina is then held in place by means of silicone fasteners, which may possibly surround the entire eye like a belt by strapping. Of course, you must first drain the eye of the accumulated liquid. And sometimes it is necessary to replace the vitreous body with gas or silicone oil. Still, these interventions give excellent results. If several operations are necessary like the retinal detachment treatment, the detachment of the retina is repaired at one time in 90% of cases, with a preserved view.

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