life, if the eyes are not careful
Being bumped into, smashed by something, or bounced
A lot of people after the pain is relieved
I thought it was okay if I didn't feel affected by it
But the eye may have been "internally injured"
This is the case with 54-year-old Uncle Gao (pseudonym) in Lin'an
Originally, he was just hit in the left eye by a walnut
dragged on for half a year, but almost dragged himself "blind"
Can eyes that have lost their sense of light regain their sight?
Crack the walnuts and break this place
There is little hope of regaining sight
Last autumn, Uncle Gao's left eye was unfortunately smashed by a falling walnut when he was playing walnuts at home, and he felt that his eyes were very painful, his eyeballs were red, and his vision was a little blurry, but he didn't care, and only took some anti-inflammatory eye drops.
"It's just a walnut bullet, what can be a big deal. "Uncle Gao, after a few days of medication, his eyes are not painful or red, although he is still a little unclear about seeing things, but he thinks it may be old and presbyopia, and he doesn't pay attention to it.
It wasn't until recently that he felt that his left eye was getting worse and clearer, so he came to the Department of Ophthalmology of the First Affiliated Hospital of Zhejiang University School of Medicine.
"After an initial examination on the outpatient basis, corneal and lens lesions were ruled out, and it was thought that there might be a retinal problem. According to Dong Feng, chief physician of the Department of Ophthalmology of the First Hospital of Zhejiang University, Uncle Gao's fundus photography of his left eye showed that he had retinal detachment - the retina that should have been as smooth and flat as wallpaper was completely detached from the wall of the eyeball, like a crumpled piece of paper, and the structure of the fundus was also quite disordered. The consequence of this is that the walnut smashed into the eye, causing the intraocular tissue to shake, and the retina was "pulled" under the traction of the vitreous.
Before the operation, the tall uncle's wrinkled retina
"Can this disease be cured? Is it just a matter of 'sticking' the retina back on?" Uncle Gao asked with concern. But the doctor's answer gave him another blow: difficult!
The retina is the part of vision that forms. On the one hand, Uncle Gao's left eye sensation came and went during the examination, and the doctor judged that he only had a faint light sensation, which indicates that most of his optic cells have "died", and this damage is irreversible.
On the other hand, because his retina is an old detachment that has not been treated, the retina not only becomes very hard, but also grows a lot of proliferative fibers that shrink, which makes the detached retina more wrinkled and makes it more difficult to treat.
"It's like a piece of paper that has been kneaded, and then it is smoothed out after a while, and it is more difficult to get back to the original state. Chief Physician Dong Feng explained that the retina cannot be replaced with a new one like wallpaper, so it can only be repaired and pasted back on.
Doctors perform difficult surgeries
Create miracles of light
"Doctor, no matter what the result is, I will have surgery, and no matter how bad it is, it will not be worse than being 'blind'. Although studies have shown that less than 10% of patients with weak or no light sensation can regain their vision above light perception after surgery, Uncle Gao's firm thinking and unconditional trust made the Department of Ophthalmology of the First Hospital of Zhejiang University decide to accept the challenge.
Before the operation, under the organization of Chief Physician Cui Hongguang, Director of the Department of Ophthalmology, the department held many expert discussions, believing that the few remaining optic cells of Uncle Gao were the basis for whether he could regain his vision, and the most critical step in determining the success or failure of the operation was whether the doctor could flatten the retina. We are constantly improving and refining the surgical plan, and we look forward to creating miracles.
During the operation, the doctor needs to remove the vitreous that stretches the retina, and then peel off the hypertrophic fibrous tissue everywhere to "reduce the load" on the retina, which will still cause retinal stiffness and contracture if it is not cleaned.
Then it comes to the crucial step of "repair" - applying the "film". The doctor needs to spread out the wrinkled retina under a microscope little by little to smooth it back to as smooth as possible, and then apply the retina back to the wall of the eyeball. A hard and wrinkled retina like Uncle Gao is a test of the doctor's patience and skill.
"During the surgery, we found that he also had choroidal detachment, macular hole, huge retinal tear in the upper retina, and several small tears around him. Chief Physician Dong Feng, the chief surgeon, said that the retinal tear was also closed by laser and cryotherapy during the operation, and finally the retina was tightly attached to the eye wall with silicone oil. The surgery takes nearly 2 hours, while the general retinal detachment surgery only takes half an hour to one hour.
"I see the light, I see it!" The day after the operation, when Uncle Gao's left eye felt the light and saw the hand shaking in front of him, the excitement spread throughout the ward.
Click on the blank space to view
Postoperative fundus photography
Postoperative fundus photography showed that his retina was very flat, like a white sheet of paper that had never been folded. One week after the operation, Uncle Gao's left eye was able to accurately distinguish between fingers and figures.
"This is a miracle for both doctors and patients!" said Director Cui Hongguang, who said that after 3-6 months of removing the silicone oil, the doctor will implant an intraocular lens for him depending on the situation, and there may be surprises in his vision at that time.
Eye trauma occurs
Prompt medical attention should be sought
The eye is actually a very fragile organ, with a lot of ocular contents and complex fundus structures. When an eye is traumatized, we can often only observe the ocular surface, and sometimes even if there are no signs of injury on the outside, it is impossible to rule out whether there is an "internal injury" in the eyeball.
Experts say that the recovery of vision after retinal detachment surgery is related to the extent and time of detachment before surgery, and the most important of which is whether and when the macular retina is detached. Generally speaking, if the macular retina has detached, surgery is best performed within 2-3 days, beyond which it will affect the prognosis of vision. Overall, the earlier a retinal detachment is treated, the better the effect.
The Department of Ophthalmology of the First Hospital of Zhejiang University has opened a "green channel" to ensure that patients with retinal detachment who come to the hospital can receive surgery within 24 hours.
In addition to some traumatic injuries such as contusions, eyelid tears, and blunt trauma caused by mechanical external forces, physical injuries caused by chemical reagents entering the eye, infrared rays, and thermal radiation all belong to the category of ocular trauma. Experts remind that eye injuries must be examined in the hospital, in addition, high myopia, diabetes and other high-risk factors for retinal detachment, when there is vision loss, visual distortion, etc., it is necessary to seek medical attention as soon as possible.
Source | The First Hospital of Zhejiang University