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Retina And Vitreous
Retinoschisis
Retinoschisis is a genetic eye
disease that splits the retina, the light-sensitive
layer of cells lining the back of the eye. It occurs in
two forms, one affecting young children, the other older
adults. Both forms usually affect both eyes, though one
eye may be worse than the other.
Because the disease is inherited on the X chromosome,
childhood retinoschisis occurs in boys more than girls.
It is usually detected because of poor vision.
If the split retina involves the peripheral or side
retina, peripheral vision is lost. One is also at risk
for a retinal detachment. But more commonly,
retinoschisis affects the macula, the area of the retina
responsible for central vision. In this location, one
loses central vision.
Peripheral retinoschisis, more common in adults, is
usually caused by aging and does not affect vision, but
it can cause a retinal detachment. If detected early, a
retinal detachment can be treated with surgery or laser
therapy. |
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Stargardt's Disease
Stargardt's is an inherited disease
that affects the retina, the layer of light-sensitive
cells lining the back of the eye. It usually becomes
apparent between the ages of 8 and 14. Boys and girls
are equally susceptible and more than one child in a
family may have it.
Stargardt's disease begins with slightly blurry vision
that gradually gets worse. By the late 20s, vision is
typically about 20/200, the level labeled legally blind.
Remaining vision is good enough for most people to live
fairly normal lives, though they won't drive, or read
without using magnification devices.
A build-up of lipofuscin (fatty substance) in retinal
cells is thought to cause Stargardt's disease. The
buildup typically happens in the central retina, or
macula, where it resembles beaten bronze. Or, it can
occur in the side retina where it causes small white
flecks. This form is called fundus flavimaculatus.
Angiography, a special photograph of the retina, may aid
in the diagnosis. Although no specific medical or
surgical treatment is available, glasses and
magnification help affected people adapt to the disease. |
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Toxoplasmosis
Toxoplasmosis is a common parasitic
infection. When contracted by a pregnant woman,
toxoplasmosis can pose serious risks to the unborn baby.
Simple precautions can reduce the chance of infection.
Pregnant women should avoid handling litter boxes and eating
raw meat because the parasite may originate in cat feces or
undercooked meat. If acquired during the first trimester of
pregnancy, the infection can be devastating to an infant.
Toxoplasmosis affects the retina, the light-sensitive cells
lining the back of the eye. Both eyes are usually involved.
If the infection settles in the macula, the area of the
retina responsible for central vision, good vision is lost
forever.
When toxoplasmosis heals, it leaves a scar. The infection
may recur years later, sometimes near the previously
infected area. Swelling that fights the infection may cause
floating spots in one's vision, red, painful eyes, and poor
vision.
Treating toxoplasmosis with oral medications can be very
effective. Pyrimethamine and sulfa drugs are the classic
antibiotics although some doctors add or substitute
clindamycin. Occasionally steroids, laser, or freezing (cryotherapy)
treatments are prescribed.
Screening tests can identify women of childbearing age who
are at risk of passing the infection to an unborn child.
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Vitrectomy Surgery
Vitrectomy is a type of eye surgery
used to treat disorders of the retina (the light-sensing
cells at the back of the eye) and vitreous (the clear
gel-like substance inside the eye). It may be used to treat
a severe eye injury, diabetic retinopathy, retinal
detachments, macular pucker (wrinkling of the retina) and
macular holes.
During a vitrectomy operation, the surgeon makes tiny
incisions in the sclera (the white part of the eye). Using a
microscope to look inside the eye and microsurgical
instruments, the surgeon removes the vitreous and repairs
the retina through the tiny incisions. Repairs include
removing scar tissue or a foreign object if present.
During the procedure, the retina may be treated with a laser
to reduce future bleeding or to fix a tear in the retina. An
air or gas bubble that slowly disappears on its own may be
placed in the eye to help the retina remain in its proper
position or a special fluid that is later removed may be
injected into the vitreous cavity.
Recovering from vitrectomy surgery may be uncomfortable but
the procedure often improves or stabilizes vision. Once the
blood- or debris-clouded vitreous is removed and replaced
with a clear medium (often a saltwater solution), light rays
can once again focus on the retina. Vision after surgery
depends on how damaged the retina was before surgery. |
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