Macular retinal rupture

The internal photosensitive membrane of the eye (retina) consists of several layers of nerve cells that provide visual perception. Opposite the pupil on the opposite side of the eye on the retina is the macula (yellow spot), consisting of a huge number of closely fitting photoreceptors - cells in the shape of cones. They provide good vision.

Definition of disease

Most of the space inside the eyeball is filled with a kind of biological gel - a vitreous body.Its outer shell is fixed on the inner surface of the retina in the most important places, including the location of the macula. However, under the influence of various kinds of reasons, the volume of the biological gel decreases. In this case, there are two options:

• Good- the contact of the vitreous membrane with the macula and the optic nerve disc is interrupted;
instagram viewer
• Bad- contact in the area of ​​the macula remains, and a decrease in the vitreous volume causes the retina to begin to drag into the eye and at a certain stage breaks.

Such injuries most often appear in people in old age (after 50) and are the result of the deterioration of the eye structures.Characteristic development of pathological symptoms predominantly in women.

The danger is the slow development of pathology and almost complete absence of symptoms at the initial stage of the disease.

Causes

Pathology in 80% of cases appears with degenerative changes in the elderly, arising in the vitreous.Usually, this phenomenon occurs only on one eye. But in 10-15%, a pathological condition may appear on the second eye.

Read also about the causes of retinal detachment.

Structure of the eye

Among other possible causes of macular rupture are:

• Injuries.Since the retina has the thinnest thickness at the location of the yellow spot, it is the macula that is damaged by a strong impact. Such damage occurs in about 10%;
• Strong myopia. In this case, damage to the macula is possible, and this kind of rupture is very difficult to treat and is usually accompanied by detachment of the retina;
• Postoperative period. When performing surgery for retinal detachment, 1% of patients in the postoperative period have a likelihood of rupturing the macula. In this case, the atrophy of photoreceptors, the development of epiretnial fibrosis, and the disruption of hydraulic pressure become the causes of the rupture.

In the event of a discontinuity due to age-related causes, the lesions may affect all 10 layers of the retina or be partial.

Symptoms

The initial symptoms of lesions may not be initially visible to the patient.Therefore, it is necessary to carefully monitor the level of vision in order to undergo the examination at the very first signs:

• Reducing the quality of vision both far and near;
• Distortion in perception of outlines of objects;
• Change in the correct assessment of the size of objects with the diseased eye;
• The emergence of difficulties when working with small items, when reading;
• The appearance of a cloudy spot in the center in the field of view;
• Incorrect color perception.

If at least one of the symptoms starts to worry, you need to urgently make an appointment with an ophthalmologist, since the success of treatment directly depends on the degree of damage. But even the weakest symptoms of a macular rupture tend to progress continuously.

Possible complications

Undoubtedly, every patient will try to visit an ophthalmologist with a deterioration of vision, and even more so with distortion of visual perception. After all, good vision is necessary for a quality life, and its loss or reduction in severity can significantly worsen a patient's ability to perform all necessary functions independently.

The most severe complication in untimely treatment is the retinal detachment, which causes the patient to lose sight (in whole or in part).

Treatment

Diagnosis of the disease requires the most thorough research. For this we use:

• Visometry(examination of the level of vision using special tables);
• Investigation of the funduswith the help of an ophthalmoscope;
• Amsler test- a method for testing the central field of vision using a special grid;
• Ophthalmic microscopy with contact lens;
• Fluorescent angiography.

The most accurate results can be obtained by using optical coherence tomography - a method that creates a three-dimensional image of the desired area of ​​the retina and allows you to determine the extent and dimensions breaks.

Optical coherence tomography

Medication Therapy

Macular retinal rupture in most cases is treated surgically. Sometimes the gap is so insignificant that it can not be operated on or the tissues are restored themselves (for example, with trauma). In this case, the treatment consists only in the implementation of the doctor's recommendations: the use of various optical instruments (glasses, lenses, loops).Improvements in vision can be achieved with the use of hardware treatment, as well as computerized visual simulators.

Surgically

Since surgical treatment of the rupture is a rather complicated process, with a mass of possible complications and relapses, in most cases The operation is meaningful only if there is a rupture in both eyes, when there is a threat of complete blindness, or with the risk of detachment retina.

The operation is carried out in the following order:

• First step-vitrectomy(extraction of the affected vitreous with vitreotome);
• Second phase-removal of the vitreous body attached to the retina;
• For the favorable outcome of the operation, the inner border membrane of the retina (a film several microns thick) is removed in the central zone;
• After that, a gas bubble is introduced into the eye, so that it squeezes the edges of the hole.However, according to the law of Archimedes, under normal eye position, the gas will rise upward. Therefore, in order to achieve the best result, the patient should be in the position with the head down, after the operation. Thus, the gas bubble will press on the macula.

  Performing an operation to treat the rupture

After the operation, the doctor prescribes eye drops, and the bandage will not be needed after a day. However, the operated eye will not yet be seen normally due to the gas bubble. In the "bubble" position, the patient is recommended to stay for 3 to 8 days. For many patients, this presents considerable complexity. The recommended position is sitting at the table and resting your head on the folded hands. In this case, you can put a book or tablet on your knees. You can also walk, trying to look at your feet. To ensure the right position during sleep, some put their head in the mattress, while others sleep sitting.

It takes 15 to 20 days for the gas to disappear.At this time, the sight on the diseased eye will be carried out as if through an aquarium. During this period it is forbidden to carry out air travel.

After about a week, it is possible to return to normal life with some limitations:

• Prevention of extraneous stimuli(soaps, shampoos, chlorinated water, high and low t);
• Avoiding contact with vectors of infections(in case of infection, immediately get an appointment with a doctor);
• Elimination of increased physical activity.

Within a month after the disappearance of the bladder, vision is restored to the level before the operation and should not fall below. Over the course of a year, vision improvement is projected to be up to 50%.In 90-95% of cases, the operation is successful.

During the operation, the patient can be discharged on the same day, after the necessary eye preparations have been prescribed (antibiotics and anti-inflammatory) and the doctor's recommendations for observing the necessary regimen, as well as a schedule of mandatory consultations.

Folk remedies

Even if you have met recipes for the treatment of macular ruptures of the retina, you should include the logic: even official medicine can not fight the disease with conservative methods (medicines). And this means that the people's means can not have any effective effect here.

Therefore, do not delay the appearance of symptoms of a visit to a doctor, especially since the success of surgical treatment directly depends on the severity of the rupture.

Prevention

The main rule of prevention for preventing ruptures and detachment of the retina are regular preventive examinations with an ophthalmologist,especially for persons at risk:

• Pregnant;
• Patients with diabetes mellitus, hypertension, myopia;
• Persons with suffered head or eye injuries.

Such examinations should be conducted at least once a year, and if the initial symptoms are noticed, then more often.

If the first signs of the disease are found, patients may be assigned peripheral restrictive laserocoagulation, which can prevent the development of detachment.

.

Causes of different pupils in size in an adult

A stagnant disc of the optic nerve - what this is and how to treat this pathology will tell this article.

Visometry - how it is carried out and when it is assigned http://eyesdocs.ru/medicinaoperacii/diagnostika/vizometriya-osobennosti-metoda-i-tipy-tablic.html

.

Other prevention measures include:

• Limitation of physical and visual loads;
• Compliance with the daily routine;
• Restriction in the choice of certain professions;
• For pregnant women - a recommendation for a cesarean section.

Special care should be taken for people over the age of 60: to exclude the possibility of stress, overstrain of general nature and with the increased work of the eyes, avoid injuries to the head and eyes, and do not forget about preventive inspections.

Video

conclusions

Macular retinal rupture is a serious defeat of one of the most important eye systems responsible for the quality of vision, and it can be treated only surgically. However, with timely qualified care, the treatment prognosis is quite favorable, and the successful outcome of the operation depends on the stage of the disease on which the treatment is performed.

Also read about what is macular degeneration of the retina and what is optic neuritis