Hole in the retina - retinal holes

Retinal holes - unnoticed harbingers of retinal detachment

A retinal hole (retina) or retinal tear in the eye can result in almost no symptoms or pain. Thus, these retina (retina) affections often go unnoticed. Without appropriate treatment, however, there is a risk of retinal detachment (retinal detachment, retinal detachment). To prevent serious consequences for the eyesight, including blindness, early diagnosis and treatment is extremely important. Regular eye examinations are advised for people of advanced age and for certain risk factors.

contents

• Retinal holes - unnoticed harbingers of retinal detachment
• A short overview
• definition
• symptoms
• causes
• diagnosis
• treatment
• Naturopathic treatment

A short overview

A hole or tear in the retina is often not perceived by those affected, but is a serious alteration of the retina that threatens eyesight. The following brief overview provides important information to enable early detection and treatment. In addition, the article contains detailed descriptions about the clinical picture, such as the causes, symptoms and treatment options.

A hole or tear in the retina threatens the eyesight and requires a quick treatment. (Image: DKcomposing / fotolia.com)

Problems with the eyes - how to recognize a retinal hole and what to do?

Often sufferers notice a retinal hole or a crack late. This painless damage to the retina often remains completely symptom-free, especially in the early stages. Signs that may indicate retinal holes are various disturbances in visual perception that appear as mobile opacities or visual field images. These are often described as follows:

• Fog, smoke or shadow,
• "Flying mosquitoes" (dancing black dots),
• "Soot rain" (drooping black dots),
• Lightning (with eyes closed).

If such complaints occur, an ophthalmological examination should take place immediately. With appropriate diagnosis, the earliest possible treatment is an important criterion for the preservation of vision. In advanced age and for people who suffer from diabetes mellitus or suffer from myopia, regular eye examinations are advised.

definition

The retina, known in Latin as the retina, is located on the inside of the eyeball. It is pressed by the vitreous to the choroid and adheres to it by so-called adhesion forces, only loosely. Only in the area of ​​the optic nerve and the outer Netzhaugeirkumferenz vein and retina are fused. At these margins, the retina may have thin spots called retinal degenerations. Due to various causes, these areas are particularly susceptible to holes and tears or even retinal detachment.

The retina is pressed by the vitreous body loosely against the choroid. This connection ensures the supply and function of the retina. (Image: bilderzwerg / fotolia.com)

The retina consists of several layers, each fulfilling different functions. Taken together, she captures the incoming light and complex light information, sorts it, and transforms it into nerve impulses. The preprocessed visual information is then relayed to the brain via the optic nerve. Thus, the retina plays a special role in visual perception. Damage or degeneration can cause serious vision impairment.

symptoms

As a rule, damage to the retina is not associated with pain. The existing nerve fibers do not transmit pain information to the brain, but transmit other impulses. Especially small openings can initially remain completely symptom-free. Most of the time, however, the first damage worsens and then different complaints occur later on.

Symptoms that indicate retinal holes are primarily disorders in visual perception. As a rule, only one eye is affected. The occurrence of a hole or tear often damages small blood vessels and leads to bleeding, which can cause a variety of images and visible cloudiness in the vision. The following phenomena are often described by those affected:

• Foggy or smoky shadows in the field of view that are perceived as black or red images,
• black, dancing points in front of the eyes ("flying mosquitoes"),
• occurring lightning with closed eyes,
• drooping black dots ("soot rain").

Not always do symptoms occur. In addition to various visual disturbances, vision may blur when the macula (the location of sharpest vision) is affected. (Image: HNFOTO / fotolia.com)

If more bleeding occurs, vision may be impaired to a greater extent. If the macula (macula lutea) is damaged, then you can expect a reduced visual acuity. The macula is also referred to as a "yellow spot" and is a very small part in the posterior, central area of ​​the retina. In this tiny area, there is a very high density of photoreceptive cells that ultimately provide sharp and focused vision.

If ophthalmic fluid enters the retina, a true retinal detachment can result from a hole or tear and complete vision loss is imminent.

causes

Mostly, holes and cracks in the retina are caused by the so-called posterior vitreous detachment. This refers to a lifting of the soft eye inner body, together with the vitreous membrane, in the back of the retina. This is often triggered by an age-related shrinkage of the vitreous and is therefore not a pathological process.

However, pronounced visual disturbances, such as severe myopia, increase the risk of damage to the retina. An elongated eyeball may be the reason for this poor eyesight. This is accompanied by a correspondingly dilated and partially dilute retina, which statistically has more frequent degeneration, holes and cracks. In addition, injuries to the eye area or previous cataract surgery can increase the risk of damage to the retina. In addition, genetic factors or the presence of diabetes mellitus (diabetes mellitus) also promote the occurrence of retinal damage (diabetic retinopathy).

Diabetes mellitus promotes numerous sequelae, including impaired eyes and the retina (diabetic retinopathy). (Image: Henrie / fotolia.com)

The vitreous consists of 98 percent water and fills in the eyes of children in childhood. With the age-related shrinkage of the vitreous body, the vitreous body gradually collapses due to an increasing loss of water and different retinal pulling forces occur. In certain areas of the retina, in particular on thinner areas and the contact points to the vitreous, then holes or tears may arise.

diagnosis

Retinal changes can only be diagnosed by a thorough ophthalmological examination. In order to be able to examine the fundus, non-invasive ophthalmoscopy (ophthalmoscopy or funduscopy) usually takes place. But also digital retinal examinations are offered nowadays.

In the classical form of ophthalmoscopy there is a direct and an indirect examination method. For both variants, the pupil, by the administration of eye drops, medicinally expanded. As a rule, further examination takes place in a darkened room. An electric light beam is then directed through a concave mirror through the pupil directly onto the retina to illuminate the fundus. In order to make the structures and possible changes easily recognizable at maximum magnification, a magnifying glass or a contact glass are used. A contact glass is placed on the eyeball and it requires preliminary superficial anesthesia.

Eyesighting diagnoses damage to the retina. (Image: bilderzwerg / fotolia.com)

In direct ophthalmoscopy, the examination is performed from a distance of about ten centimeters; in the indirect method, the distance is about half a meter. A larger distance means less detail view, but a better overall view of the eye.

If bleeding in the vitreous obstructs the view of the fundus, an ultrasound scan can also be used. This method is painless and allows a quick and detailed information about changes in the retina. It is also possible to recognize the nature of a replacement and to delimit similar-looking clinical pictures.

Regular ophthalmological checks, especially from the age of 40 and in people with an increased risk, are used for the early detection of damage to the retina. These could otherwise go unnoticed and cause serious vision problems or even blindness.

treatment

The sooner the damage is recognized and the smaller it is, the greater the success of the treatment is as a rule. Early therapy minimizes the risk of retinal detachment. However, there is neither the possibility of drug treatment nor can the openings be otherwise closed directly. If there is a diagnosis of a retinal hole or a tear, attempts are made to create the conditions for the hole to close again.

Most often, and especially with very small holes and without detachment of the retina, an outpatient laser treatment (laser coagulation) is used. With a targeted laser beam, a stable scarring of the retina with its underlay, the choroid, caused in the region of the defect edges. This type of "welding" of the two layers should cause a permanent sealing.

The laser treatment of holes in the retina is a successful method and is often used. (Image: romaset / fotolia.com)

If it is greater damage is a cold treatment (cryocoagulation) for sealing the edges in question. With the help of a cold probe, the affected areas are strongly cooled. Here then also larger scars, which should guarantee a stable seal.

Because the treatments are a bit uncomfortable, both methods usually involve local anesthesia. The treated should be in the wake for up to ten days and spare, for example, renounce sports. During this time, the lasered area will scar and provide a permanent seal. In most cases, therapy is successful and vision is restored without further impairment. However, it is not completely ruled out that the treatment causes further injuries with bleeding, infections or other reactions that impair the success of therapy.

In the late stages or in very complicated cases, which are usually accompanied by a (proportionate) detachment of the retina, however, only a surgical intervention can enable the preservation of vision. Unfortunately, even with successful treatment, there is a risk of significant vision loss or blindness in these severe conditions.

The maintenance of a healthy eye can be supported by orthomolecular medicine. (Image: Sven Bähren / fotolia.com)

Naturopathic treatment

Existing damage to the retina always requires specialist medical care. Considering the connection with signs of aging or diabetes mellitus, however, preventive measures from the field of naturopathy can reduce the risk of contracting retinal damage.

Here, especially the approach of orthomolecular medicine (OM) is used. This therapy is based on the administration of antioxidant and circulation-promoting substances. Various products containing certain minerals, vitamins and other important nutrients are said to have a supportive effect on overall health, including the maintenance of the eyes and retina. In this case, age-related symptoms or diabetic retinopathy and various other indications require a technically sound consultation before taking the appropriate nutrient preparations. Self-medication is strongly discouraged. In principle, a sufficient supply of fluid (especially in the form of water) from many aspects health-promoting, even for the eyes. (jvs, cs; updated 10/09/2018)