Retinal detachment, separation of the retina from the underlying layer of the eye (the choroid), may be caused by a tumor, hemorrhage, or injury to the eye (Fig. 18-8). This condition interferes with vision and is commonly repaired with laser surgery.
Degeneration of the macula, the point of sharpest vision, is a common cause of visual problems in the elderly. When associated with aging, this deterioration is described as age-related macular degeneration (AMD). Macular degeneration typically affects central vision but not peripheral vision (Fig. 18-9). Other causes of macular degeneration are drug toxicity and hereditary diseases.
Circulatory problems associated with diabetes mellitus eventually cause changes in the retina referred to as diabetic retinopathy. In addition to vascular damage, there is a yellowish, waxy exudate high in lipopro-
FIGURE 18-8. Retinal detachment. (Reprinted with permission from Smeltzer SC, Bare BG. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)
teins. With time, new blood vessels form and penetrate the vitreous humor, causing hemorrhage, detachment of the retina, and blindness.
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