Vitreous, Retina And Choroid Disorders
Posterior Vitreous Detachment (PVD)
Detachment of the vitreous Gel which located inside the eye ball in front of the retina. Occur naturally above 40 years old or might be sooner in high myopia ( high minus spectacles), blunt injury, or inflammation of the retina.
Patient might visualize some sort of shadow with many shape floating around following eye movement (floaters). The shape of shadow might resemble dots, hair, clouds, mosquitos. Sometimes sensation of a flash of light might occur in the corner of the eye.
Vitreous Detachment is a natural process. There are no specific treatment. Resting , antioxidant consumption can be beneficial. If simptoms getting worst or occur more frequent please consult to retina specialist
Detachment of retina from the supporting structure (Retinal Pigment Epithelium). Retinal Detachment can be caused by regmatogenous (break / tear), traction (fibrotic membrane), exudative (inflammation).
Symptoms are vary from minor loss of visual field (black curtain blocking the vision) to total loss of vision. Ussually begin with floaters or flashes.
Early detection and prompt treatment is necessary to prevent blindness. If retinal examination shows break without detachment then laser photocoagulation will be beneficial to this condition. If Detachment already occur then vitrectomy operation with special endotamponade (silicon oil or gas) is necessary. Post operation the patient will require specific face down position.
Diabetes melitus can caused this complication to the retina. Blood or exudates leaking from retinal microvascular. If the bleeding or exudation happen in sentral retina, there will edema of sentral retina (macula)
Early symptom is decreasing visual acuity or decreasing quality of vision. Usually after several episodes of high blood glucose level (above 200mg/dl)
Mild to moderate nonproliferative diabetic retinopathy will required regular observation of the retina and controlled blood glucose level. Modification of life style and dietary change is necessary to prevent further complication.
Proliferative Diabetic retinopathy is advance complication of Diabetes melitus to the retina. This stage is hard to manage. Panretinal Photocoagulation (PRP) will be necesarry to do sometimes combine with intravitreal anti VEGF injection to maintain vision. Sometime this condition require vitrectomy if there are fibrotic membranes threatening to make a traction to the macula.
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