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

/de·tach·ment/ (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.

detachment

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.

detachment

the condition of being separated or disconnected.

retinal detachment
separation of the inner layers of the retina from the pigment epithelium, which remains attached to the choroid. Retinal detachment occurs most often as a result of degenerative changes in the peripheral retina and vitreous body, which produce holes or tears in the retina that can range from minute breaks no larger than 0.1 mm to extensive holes that extend over the entire fundus. Causes include trauma to the eyeball, severe contusions, inflammatory lesions and sometimes ocular surgery.
rhegmatogenous detachment
retinal detachment with holes.
nonrhegmatogenous detachment
retinal detachment with no holes present.
References in periodicals archive ?
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.
Material and Methods: Twenty one eyes (21 patients) that underwent surgery for retinal detachment associated with chorio-retinal colobomas were selected.
13-16 PVR was more commonly observed in cases with PPV + scleral buckling as compared to PPV alone in rhegmatogenous retinal detachments with inferior breaks according to some authors.
In response to the Kyrgyz servicemen's demands not to violate the state border and carry out patrol at a certain distance from the state border, the Uzbek border detachment opened fire on the Kyrgyz servicemen," said the message.
Case records of all subjects aged 0-18 yrs with retinal detachment intervened from June 2006 to January 2009 were reviewed retrospectively.
Petinglay also said that soldiers from the Katiku Detachment suffered one fatality and three wounded in the encounter.
Through the process of clarifying roles among battalions, detachments, and groups, gaps between training doctrine and operations were also identified.
10) Detachment can also be present after alkaline injuries, bleeding from deep corneal vascularization, blunt trauma or, rarely, in atypical keratoconic eyes, even in intact Descemet's membranes.
This is the story of one of these detachments, the Naples AACS Detachment at Capodichino Airfield, Italy.
If, however, the macula is detached from the underlying RPE ('macula-off' detachment) then the VA will be reduced and successful re-attachment together with good visual recovery is unlikely; for this reason, 'macula on' detachments must be referred to a retinal specialist on a same-day basis.
The Bulgarian military has sent in new detachments of land and air forces to tackle the major wildfires raging in Bulgaria on Wednesday.