What types of dystrophies are there?
The retina is a thin, light-sensitive membrane that lines the inside of the eye. At the periphery it is thinner and the blood supply is weaker, so this is where changes appear more often. Some types of dystrophies are practically safe, others are associated with an increased risk of ruptures, especially if in these places the vitreous body is tightly fused with the retina. Doctors describe the type of dystrophy, its extent, the presence of breaks and signs of traction. These characteristics determine whether only observation or preventive laser treatment will be prescribed.
- Lattice dystrophy is the most significant for the risk of ruptures
- Snail track dystrophy
- Frost-like dystrophy
- Cobblestones - usually safe
- Retinoschisis - retinal separation
- Retinal tears without detachment
Causes and risk factors
The exact causes of dystrophies are not fully known. Hereditary features of the structure of the retina and choroid play an important role. With myopia, the eyeball is elongated, the retina stretches and thins, so the risk of degeneration and rupture is higher, and it does not always depend on the degree of myopia. Dystrophies are more often found in relatives of people with retinal detachment. Changes are caused by eye and head injuries, inflammatory diseases, eye surgeries, including cataract removal. Age-related changes in the vitreous body increase traction on the retina.
- Myopia
- Hereditary predisposition
- Retinal detachment in the other eye or in relatives
- Eye and head injuries
- Eye surgeries
- Age-related vitreous detachment
Symptoms
Peripheral dystrophy without ruptures proceeds unnoticed: visual acuity remains the same, the person does not experience pain or discomfort. Therefore, it is detected during a preventive examination, examination before laser vision correction, or during pregnancy. Symptoms appear when there are complications. A retinal tear is often accompanied by flashes of light and the sudden appearance of many floaters. When a detachment begins, a shadow, veil or curtain appears from the periphery of the visual field, and straight lines may be distorted. These signs require an examination by an ophthalmologist on the same day.
- More often - asymptomatic
- Flashes of light when breaking
- Flow of new flies
- Shadow or curtain in sight
- Distortion and decreased vision during detachment
Diagnostics
A normal examination without pupil dilation does not allow the extreme periphery of the retina to be seen. Therefore, the ophthalmologist instills drops that dilate the pupil and examines the fundus of the eye using an ophthalmoscope and a three-mirror Goldmann lens, sometimes with light pressure on the sclera. Optical coherence tomography helps evaluate retinal structure and vitreous traction. For opaque media, such as hemorrhage or cataracts, an ultrasound of the eye is performed. People with myopia are recommended to undergo such an examination at the first visit and then periodically as prescribed by a doctor.
- Fundus examination with pupil dilation
- Inspection with a three-mirror lens
- Optical coherence tomography
- Ultrasound of the eye
- Checking visual acuity and refraction
- Wide-field fundus photography
Treatment and lifestyle
Most dystrophies require only regular monitoring. In case of high risk - ruptures, severe lattice dystrophy, symptoms, detachment in the fellow eye - preventive limiting laser coagulation is performed. The laser creates microscars around the danger zone, which firmly seal the retina with the underlying membranes. The procedure is performed on an outpatient basis using drops. Medicines and exercises do not cure dystrophy. For people with dangerous changes, your doctor may temporarily limit heavy lifting, jumping, and contact sports. Pregnant women undergo a retinal examination in advance; Dystrophy itself is often not an indication for cesarean section; the method of delivery is determined by the obstetrician-gynecologist.
- Regular examinations with pupil dilation
- Limiting laser coagulation according to indications
- Examination of the retina before laser vision correction
- Pregnancy check-up
- Limiting exercise as recommended by a doctor
- Urgent treatment for flashes and shadows
