Choroidal Nevus– Usually a flat lesion with or without pigment lying in the stroma of the tissue. Large choroidal nevi are difficult to differentiate from malignant melanomas. Their flat appearance and especially their lack of growth on repeat serial examinations are important in the differential diagnosis from malignant melanoma’s.
Rhegmatogenous Retinal Detachment
Rhegmatogenous is the most common form of a detached retina.
The two other forms include:
- Serous (common in pregnancy/eclampsia or in uveitis/posterior scleritis)
- Tractional (common in diabetic retinopathy).
Rhegma (Greek for break) identifies the reason for the retinal detachment—a preexisting retinal break or creation of a doorway somewhere through the retina that allows fluid to pass from the surface of the retina to the underside of the retina lifting the retina away from the choroid. This subretinal fluid is the detached retina. Breaks in the retina can be in the form of a retinal hole or retinal tear.
Symptoms of a torn retina include flashing lights (photopsias) with (floaters). Most patients have a lot of floaters because when the retina tears, there is often bleeding into the vitreous. The individual red blood cells account for hundreds of tiny floaters. These red blood cells also make the vision hazy like red food coloring in a clear glass of water.
If these warning symptoms are ignored and the retinal tear is not detected and treated, then the tear can progress to a detached retina. Symptoms of a detached retina include a dark curtain in your vision that progresses.
Many patients who develop a detached retina are myopic (near sighted) or have a history of lattice degeneration.
Surgery is needed for repair and often needs to be performed in hospital or ASC. Surgery can include; laser or cryopexy with scleral buckle, vitrectomy, or a gas bubble.
Lattice Degeneration- Lattice degeneration is the most common of the inherited vitreoretinal degenerations, with an estimated incidence of 7% of the general population. Lattice degeneration is an appearance of localized round, oval, or linear retinal thinning, with pigmentation, branching white lines, and whitish-yellow flecks; the hallmarks of the disease are the thinned retina punctuated by sharp borders and firm vitreoretinal adhesions at the margins.
Retinitis Pigmentosa- Is a hereditary degeneration and atrophy of the retina. Also known as “tunnel vision”.
Toxoplasmosis/Histoplasmosis- Ocular Toxoplasmosis is caused by Toxoplasma gondii, an obligate intracellular protozoan. Cats and changing of the cat litter are one of the causes. Histoplasmosis the patient usually has “punched out”spots in the peripheral fundus. These are small, irregularly round or oval, depigmented areas, sometimes with a fine pigmented border, sometimes called “Histo-spots.”