vitreous disease
Introduction
Introduction to Vitreous Diseases Vitreous disease is a pathological change such as degeneration, hemorrhage, and exudation caused by the influence of the surrounding tissue lesions, which is manifested by vitreous opacity, liquefaction, formation and contraction of fibrous membranes. The vitreous body is located behind the lens and occupies a large part of the ocular cavity. It is a transparent colloidal tissue. Its composition is 99% water, and the rest is collagen tissue and hyaluronic acid. It is a major refractive intermediate and maintains the eyeball. Shape and refraction function. The vitreous itself has no blood vessels, so inflammation does not occur. The vitreous of the eyeball is located in the center of the eye in front of the retina behind the crystal. It is a transparent intraocular tissue. It has a gel-like appearance and a volume of about 3.9 to 4.5 ml, which is 2/3 to 3/4 of the total volume of the eye. Under normal conditions, the vitreous fills the entire vitreous cavity, and its fibrils are attached to and mixed with the fibrils of the inner limiting membrane of the retina. basic knowledge The proportion of illness: 0.04% Susceptible people: no specific people Mode of infection: non-infectious Complications: cataract vitreous hemorrhage glaucoma
Cause
Cause of vitreous disease
Hemorrhage of embryonic cells or tissues, retina or uvea that are congenital in the vitreous body invades the vitreous, hypertension, diabetes, haemorrhagic hemorrhage or exudate invade the vitreous, and vitreous degeneration of the elderly with high myopia The glass body is liquefied and turbid. Vitreous opacity can also occur in other cases such as ocular trauma, long-term retention of foreign bodies in the eye, parasites or tumors.
Prevention
Vitreous disease prevention
1. Usually pay attention to rest, do not overuse the eyes, avoid the formation of myopia. Avoid "eyes", pay attention to frequent and complete blinking movements, often blinking to reduce the time the eye is exposed to the air, to avoid tear evaporation.
2. Air conditioners that do not blow for too long, avoid airflow through the seats, and place tea near the seats to increase the humidity around them.
3. Eat more fruits, especially citrus fruits, and eat more green vegetables, food, fish and eggs. Drinking plenty of water can also help to reduce dry eyes.
4. Maintain good living habits, sleep well, and stay up all night.
5. Maintain a good working posture. Maintaining the most appropriate position, allowing both eyes to look flat or look down slightly on the screen, so that the neck muscles are relaxed and the area of the eye exposed to the air is minimized.
Complication
Vitreous disease complications Complications, cataract, vitreous hemorrhage, glaucoma
Vitrectomy sometimes causes complications, so prevent complications from surgery and, if so, promptly. The common complications of vitrectomy are the following.
(1) corneal edema: often occurs in diabetic patients. Because the density of corneal endothelial cells in diabetic patients is reduced, if combined crystal cutting is more likely to occur, it usually resolves on its own.
(2) Cataract: Diabetic patients are prone to cataract after surgery, and sometimes cataract can be removed at the same time. The effect of perfusate sometimes causes temporary crystal turbidity. It is best to use glutathione-sodium bicarbonate-Linger's solution. The cutting head should not be close to the posterior capsule of the crystal or cut against the posterior capsule of the crystal to avoid traumatic cataract.
(3) Vitreous incarceration: the vitreous is incarcerated in the incision, which can produce fibrous vascular membrane and vitreous traction. Therefore, the vitreous that may be present in the incision should be completely removed.
(4) vitreous hemorrhage: can be caused by intraoperative and postoperative. Intraoperative bleeding can increase the perfusion bottle to increase the perfusion pressure, and can also be electrocoagulated with water to stop bleeding. Photocoagulation of the diseased retina during surgery can prevent bleeding. Most of the postoperative bleeding can be absorbed by themselves, and it can be operated again after 3-6 months of non-absorption.
(5) Glaucoma: a common complication after surgery. If it is caused by temporary trabecular edema or inflammation, the drug can be controlled. If it is a blood-stained cell glaucoma, it should be treated with drugs first, and stubborn cases can be used for anterior chamber irrigation. Neovascular glaucoma can also occur after surgery, drug therapy is generally ineffective, try filtration or ciliary body cryotherapy.
(6) Retinal tears or retinal detachment: Intraoperative poor illumination, or unclear tissue, may occur when the cutting head directly attracts the retina or pulls the vitreous cord attached to the retina. Therefore, there must be a good microscope and contact lens during the operation, the illumination should be sufficient, the cutting head must be sharp, and the rope should not be pulled. Low suction and high cutting rate are applied in the near retina cutting. Retinal tears were found during surgery, and intraocular laser was used to prevent photocoagulation. When the omentum is detached, it can be treated by intraocular laser or condensed sealing, vitreous gas injection, extrascleral pressure, cerclage and the like.
(7) Endophthalmitis: less common. Treated as usual. It is also possible to perform vitrectomy.
(8) Sympathetic ophthalmia: comparable to other intraocular surgery rates. Symptomatic treatment.
Symptom
Symptoms of Vitreous Diseases Common Symptoms Visual Disorders Scleral Hemorrhage The vitreous has blood stains through the pupils...
In addition to aging and degeneration, the vitreous body is generally less troublesome. The more common diseases are as follows:
(1) hereditary vitreoretinal degeneration.
(2) vitreous opacity.
(3) vitreous hemorrhage.
Dilated slit lamp and three-sided mirror examination of the vitreous liquefaction, detachment, turbidity, hemorrhage, proliferation and other changes and retinopathy.
The change in vitreous liquefaction begins at the center and gradually spreads to the surrounding area, eventually invading the bottom. The vitreous body liquefied under the slit lamp exhibits an optical cavity state, and the fibrous tissue of the mesh-like stent becomes dense or broken due to syneresis, and is incomplete, sometimes forming a fragmented floating mixture. When the eyeball moves, the turbidity has a large amplitude, and fine white particles can be seen in the meantime; in addition, in the elderly, the film in front of the vitreous is blurred or disappears. Patients have no symptoms, because the transparency of the vitreous is good, and it has no effect on vision. Individual patients sometimes have flying mosquitoes or flashing sensations.
Examine
Examination of vitreous diseases
1 Under the slit lamp, there are bright red blood clots in the vitreous, or old brown and brown bleeding.
2 Under the ophthalmoscope, see dust, strips and blocky turbidity floating, or only see rare red light, or no red light.
3 Repeated bleeding, proliferative cords or membranes in the vitreous, accompanied by new blood vessels.
B-mode ultrasound examination.
Diagnosis
Diagnosis of vitreous disease
1. Ask about the history of myopia, trauma, bleeding and other eye diseases. The general performance is 1 sudden onset, often repeated. 2 There is a smoke column or black cloud shadow in front of the eyes, and some are quickly blind, leaving only the light.
2. Dilated slit lamp and three-sided mirror to check whether the vitreous has liquefaction, detachment, turbidity, hemorrhage, proliferation and other changes and retinopathy.
3. Type B ultrasound examination.
