![]() ![]() Or you may develop new, abnormal capillaries that break and bleed. This causes the retina to swell, which may blur or distort your vision. If you have diabetes, the tiny blood vessels (capillaries) in the back of your eye can deteriorate and leak fluid into and under the retina. This usually occurs when fluid passes through a retinal tear, causing the retina to lift away from the underlying tissue layers. A retinal detachment is defined by the presence of fluid under the retina. It's often accompanied by the sudden onset of symptoms such as floaters and flashing lights. A retinal tear occurs when the clear, gel-like substance in the center of your eye (vitreous) shrinks and tugs on the thin layer of tissue lining the back of your eye (retina) with enough traction to cause a break in the tissue. TypesĬommon retinal diseases and conditions include: Untreated, some retinal diseases can cause severe vision loss or blindness. Depending on your condition, treatment goals may be to stop or slow the disease and preserve, improve or restore your vision. She went on to run the NYC marathon in November.Treatment is available for some retinal diseases. Lattice in the right eye is treated with laser photocoagulation.ģ months post-op, the patient returned to her OD for a new refraction, and was 20/20 with correction. The areas of prior lattice and atrophic holes are scarred from the cryotherapy. Here is a post-operative widefield photo of the left eye.Ģ months post-operatively, we can appreciate that the retinal detachment has resolved, and the retina is sitting flat on the buckle. The patient underwent an uncomplicated encircling scleral buckle procedure, with drainage of the subretinal fluid, and injection of a small gas bubble at the end of the surgery. When an encircling band is chosen, the indentation of the globe will cause an axial elongation and a myopic shift post-operatively. Buckles may be segmental and placed in certain quadrants of the eye, or they may be encircling. The breaks are treated with cryotherapy to seal them. It is sutured into place in the oblique quadrants with permanent sutures.The goal of scleral buckling is to inwardly indent the eye wall, which brings the retinal pigment epithelium back to the neurosensory retina. The scleral buckle is made of inert silicone and is placed around the globe under the rectus muscles. Young myopes generally do not have an existing posterior vitreal detachment, and are phakic with clear lenses which makes scleral buckling a better choice. In young myopic patients, scleral buckling procedure is often preferred over pars plana vitrectomy for primary repair. The scleral buckling procedure has existed for decades and remains an important method for the primary repair of RDs. We planned a scleral buckling procedure for the patient’s left eye, and laser retinopexy of the patient’s lattice degeneration in the right eye. However, given the extent of the subretinal fluid, its posterior location in the inferior macula, and the strong family history of retinal detachments, we elected to proceed with surgical repair. In this case, the patient was asymptomatic. However, if the fluid extends posterior to the equator, generally, surgical repair is planned. If the detachment is localized or anterior to the equator, it may be amenable to barricade with laser. Patients may be asymptomatic or may complain of a scotoma in the vision. If atrophic holes begin to develop subretinal fluid, if left untreated and not monitored appropriately, patients may go on to slowly develop retinal detachments. ![]() However, in some instances, we elect to prophylactically treat lattice with laser retinopexy in the following circumstances: 1) the patient is symptomatic for flashes and floaters in an eye with lattice, 2) the patient has open atrophic holes that have subretinal fluid accumulation, 3) there is vitreal traction over the lattice 4) the lattice has an associated horseshoe tear. Even lattice with atrophic holes may be observed. Generally, lattice degeneration can simply be observed, with annual scleral depressed DFE recommended annually. Lattice degeneration is a common finding of the peripheral retina and can be seen commonly in myopes. Macula threatening rhegmatogenous retinal detachment in the left eye due to open atrophic holes with subretinal fluid.SD-OCT of the macula in both eyes was unremarkable. There are patches of lattice outside of the detachment, also with open atrophic holes. Widefield photo of the left eye showed an inferotemporal retinal detachment due to open atrophic holes. ![]()
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