Doctor, yesterday I suddenly felt something blocking my left eye, but I didn't pay attention. Today, the area that I couldn't see has increased a lot. "In clinical practice, many patients have come to see this symptom and have been diagnosed by doctors as" retinal detachment caused by retinal holes ". Retinal detachment requires early detection and treatment, but many patients find it difficult to be aware of symptoms in the early stages. Delaying treatment not only worsens the condition and increases the difficulty of treatment, but also leads to poor prognosis. Therefore, it is very important and necessary to popularize the relevant content of retinal detachment caused by retinal holes.
1、 What is retinal detachment? The retina is located in the innermost layer of the eyeball and is an important tissue in the photosensitive process. It can be simply divided into two parts: the neuroepithelial layer and the pigment epithelial layer. Retinal detachment refers to the separation of the neuroepithelial layer and the pigment epithelial layer. Retinal detachment can be divided into retinal detachment caused by retinal holes, retinal detachment caused by traction, and retinal detachment caused by exudation. Among them, the most common is retinal detachment caused by retinal holes.
2、 Why can retinal detachment cause blindness? After retinal detachment occurs, the nutrition of the retinal photoreceptor cell layer is damaged. If not reset in time, the retina will shrink and degenerate, and visual impairment cannot be recovered. If there is long-term retinal detachment, low intraocular pressure and vitreous opacity may occur, and fibrous tissue proliferation in the upper and lower parts of the retina and vitreous body may form proliferative vitreoretinopathy. Retinal detachment that persists for a long time may also lead to iridocyclitis, pupil occlusion, concurrent cataracts, secondary glaucoma, and even eye atrophy. Therefore, retinal detachment should be treated as an emergency disease, and early diagnosis and surgery can improve the prognosis. Delaying the timing, even if the retinal anatomy is restored through surgery, cannot effectively save the patient's vision.
3、 The occurrence factors of retinal detachment caused by retinal holes
The onset of retinal detachment caused by retinal holes depends on three factors, namely retinal holes, vitreous liquefaction, and the pulling effect of vitreous on retinal holes, among which retinal holes are the key. Before the occurrence of retinal tears, there is often degenerative changes in the retina and vitreous body, such as grid like degeneration in the peripheral retina, vitreous liquefaction, and posterior vitreous detachment. The degenerative changes of the retina and vitreous are related to age, genetics, myopia, and trauma.
4、 What are the high-risk groups and prodromal manifestations of retinal detachment caused by retinal holes? Most patients with retinal detachment caused by retinal holes have symptoms before detachment, which are prodromal symptoms. Therefore, if there are any signs, they need to seek medical attention immediately. If retinal detachment is treated in a timely manner, it can greatly save the patient's vision, especially in high-risk groups.
(1) Individuals with high myopia: Those with myopia above 600 degrees have an increased axial length, which exacerbates the tension on the retina and causes degenerative changes in the fundus, making them highly susceptible to primary retinal detachment.
(2) Elderly people: Due to the contraction and liquefaction of the vitreous body with age and the degenerative thinning of the retina, they are prone to primary retinal detachment caused by retinal holes.
The majority of causes of primary retinal detachment are seen in vitreous liquefaction, with floaters, floating shadows, and flashes being the most common early symptoms of primary retinal detachment. As the extent of retinal detachment expands, central visual acuity immediately declines when the macular area becomes fatigued. Some patients do not realize it until the macula is affected.
5、 What are the possible surgical methods for treating retinal detachment caused by retinal holes? The key to treating retinal detachment caused by retinal holes is to find and seal all the holes. Retinal tears can be treated with retinal laser photocoagulation before the occurrence of retinal detachment or when there is only limited or small-scale retinal detachment. The retinal tears can be sealed or surrounded by laser to prevent the progression of retinal detachment. If the retinal tear has caused extensive retinal detachment, surgical treatment is needed. The surgery for retinal detachment mainly includes two categories: external surgery and internal surgery. External surgery refers to a surgical procedure performed from outside the eyeball wall, which causes minimal interference to the tissues inside the eyeball. Internal surgery is a surgical procedure that involves cutting the vitreous through an incision in the eyeball wall and then repositioning the retina. Whether it is internal or external surgery, or a combination of internal and external surgery, the purpose is to close the tear, drain the subretinal fluid, and restore the detached retina.