detachment

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detachment

 [de-tach´ment]
the condition of being separated or disconnected.
detachment of retina (retinal detachment) separation of the inner layers of the retina from the pigment epithelium, which remains attached to the choroid; it occurs most often as a result of degenerative changes in the peripheral retina and vitreous body, which produce holes or tears in the retina ranging from tiny breaks of less than 0.1 mm to extensive holes extending over the entire fundus. It is most common in persons over 40, and about two thirds of affected patients are myopic (nearsighted). Trauma to the eyeball, severe contusions, inflammatory lesions, and sometimes ocular surgery such as for a cataract can also lead to retinal detachment.
Symptoms. The onset of symptoms may be gradual or sudden, depending on the cause, size, number, and location of retinal holes. The patient usually sees flashes of light and then notices cloudy vision or loss of a portion of the visual field. Another common manifestation is the sensation of spots or moving particles in the field of vision. Treatment should be sought immediately when any of these occur. In severe retinal detachment there can be complete loss of vision.
Treatment. Retinal detachment is corrected surgically. Two outpatient modes of therapy currently in use are photocoagulation, using the light source of an argon laser; and cryosurgery, in which a freezing probe is used to penetrate the tissues of the eye and encircle the hole or tear in the retina. Scar tissue eventually forms and seals the opening.

Scleral buckling is another treatment, which places the retinal breaks in contact with the pigment epithelium and choroid. Adhesions form and bind the sensory retinal layers to these structures. In some cases, such as vitreous hemorrhage, the surgeon performs a combined vitrectomy and humoral retinal repair. The purpose of the surgery is to remove vitreous that is opaque because of accumulated blood, and to stabilize the retina in apposition to the choroid. Aqueous humor eventually fills the space.

Pneumatic retropexy, the most recently developed treatment, consists of injection of air or gas into the posterior vitreous cavity, followed by positioning of the patient so that the bubble rises, presses against the area of torn retina, and pushes it back into its normal position against the choroid. Laser photocoagulation and/or cryopexy is then done to create inflammation within the tissues, resulting in scarring and permanent reattachment of the area(s) of torn retina. This procedure is appropriate for only certain types and locations of retinal detachment.

Preoperative and postoperative care of the patient requires a thorough knowledge of the type of detachment afflicting the patient and the surgical procedure performed. Positioning of the patient and the level of physical activity allowed after surgery are determined by the surgeon. Before discharge from the hospital the patient will need instruction in follow-up care, especially the correct procedure for instilling eye drops.
Retinal detachment. From Frazier et al., 2000.

de·tach·ment

(dē-tach'ment),
1. A voluntary or involuntary feeling or emotion that accompanies a sense of separation from normal associations or environment.
2. Separation of a structure from its support.

detachment

Psychiatry A behavior pattern characterized by general aloofness in personal interactions; may include intellectualization, denial, and superficiality

de·tach·ment

(dĕ-tach'mĕnt)
1. A voluntary or involuntary feeling or emotion that accompanies a sense of separation from normal associations or environment.
2. Lack of connection to other people or the environment.
3. Separation of a structure from its support.
References in periodicals archive ?
In his speech, Villa asked the soldiers who will replace the Philippine military personnel in various island detachments to be vigilant at all times.
The lumad group Mapasu said the village council of Diatagon at Lianga, Surigao del Sur province, had revoked its resolution that allowed the military to set up a detachment at Kilometer 9 in Barangay Simuwao that triggered the evacuation.
If they pull on the retina hard enough, the tension that's created can cause a retinal detachment or tear.
The cheque was handed over at the detachment end of year gathering presentation night and Christmas gathering.
During preparation, Region 9 HQ coordinated with the potentially affected detachments and the respective RSOs to determine whether additional support from the Marine Security Augmentation Unit (MSAU) at MCESG would be required.
Excellent surgical technique, correct selection of patient, and nature of retinal detachment are equally essential for good surgical outcome.
New glasses, mentioned above, came in the day of surgery, but will have to be replaced to accommodate for the vision changes related to the detachment and surgery.
Material and Methods: Twenty one eyes (21 patients) that underwent surgery for retinal detachment associated with chorio-retinal colobomas were selected.
Complicated retinal detachments generally requires silicone for endotemponade.
The border service said in a message that the Kyrgyz border detachment rebuked the Uzbek border guards who were at the time on the state border.
AIMS AND OBJECTIVES: The study is a retrospective case series which was done to evaluate the visual outcome and the predictive factors in cases of pediatric rhegmatogenous retinal detachment. Study also aims to analyze characteristics of type of retinal breaks, other eye findings and etiological factors in pediatric RRD.