Things you need to know about retinoschisis

Retinoschisis affects the eye and causes central or peripheral vision problems.

Over time, a person’s vision continues to get worse. This is a natural result of aging in many situations, but it can sometimes be a symptom of an underlying condition. Retinoschisis occurs in some people at birth but it can also develop with age.

We provide more detail about retinoschisis in this article including the signs, causes, and treatment options.

What is retinoschisis?

With age a person may develop retinoschisis.
With age a person may develop retinoschisis.

Retinoschisis is a condition that affects vision when the retina divides into two layers.

The retina at the back of the eye is a sheet of tissue. The includes cone and rod cells, which filter light through the pupil going into the eye. The retina sends out visual signals across the optic nerve to the brain.

A layer of cells in the retina splits into two in individuals with retinoschisis. This abnormality can affect vision differently, depending on where it occurs in the retina.

There are several forms of retinoschisis which can be degenerative or inherited.

Individuals who have the disorder from birth are likely to have an inherited form of retinoschisis, such as X-linked juvenile retinoschisis.

With age, too, the disorder can worsen, in which case it is degenerative retinoschisis.

Signs and symptoms

Retinoschisis can impact the ability to see a human. How the disease affects vision may depend upon where it occurs in the retina.

The macula, for example, is a part of the retina that produces central vision. Retinoschisis has the potential to damage the macula and impair central vision.

Retinoschisis in the macula affects an essential part of the vision, allowing somebody to see shapes and colors directly ahead. Problems with central vision can make daily tasks, such as reading or driving, hard to perform.

Retinoschisis can also affect cells outside the macula, which contributes to peripheral vision issues. Such problems make it hard for a person to see things lying outside the main eye.

Causes

The cause of retinoschisis depends on its type.

Many cases of juvenile retinoschis product from a mutation in the gene RS1. This gene contains the knowledge the body needs to produce with retinoschisin. Studies suggest that this protein maintains a proper functioning retina.

Because of this mutation, when there is less retinoschisin, the retina can start splitting. This split occurs frequently in the macular area which affects central vision. The cause of juvenile retinoschisis is less evident in people without mutations to the RS1 gene.

The result of aging is degenerative retinoschisis. The cause is equally uncertain but in older adults, the disorder is more severe.

Treatment

Most cases of retinoschisis do not affect central vision and may not require treatment. However, there are some things that a person can try:

Carbonic anhydrase inhibitors: In people with juvenile retinoschisis, carbonic anhydrase inhibitors may help with symptoms.

Vitamin A: While some people take vitamin A, there is a lack of evidence to show that it is effective in treating retinoschisis

Surgery: Retinoschisis can lead to total retinal detachment in extreme cases, where the retina pulls away from the back of the eye. It may lead to complete loss of vision and may require surgery to push the retina back into place. If the detachment is the result of a tiny tear, a doctor may be able to repair it using laser or cryotherapy care.

Risk factors

Genetics is the primary risk factor for adolescent retinoschisis. The disease is more likely to develop for individuals with a family history of retinoschisis.

The principal risk factor for degenerative retinoschisis is age. Individuals over age 50 are more likely to develop retinoschisis.

For people with an increased risk of other eye problems, the probability of developing retinoschisis may also be greater. Some risk factors for retinal detachment, for example, include:

  • injuries to the eye
  • eye surgery
  • severe nearsightedness
  • diabetes that affects blood vessels in the retina

When to see a doctor

With age it’s common for vision to get worse. Glasses or contact lenses can help fix most of the mild vision issues.

If the problem gets serious and affects daily functioning, it may be worth a visit to a doctor or an eye specialist. A doctor can perform some diagnostic tests to check for damage in the retina, such as an electroretinogram. In reaction to light an electroretinogram tests the electrical activity in the retina.

Immediate consultation with a doctor is recommended when:

  • there is a sudden increase in small dots floating around
  • increased flashes of light affect the vision
  • a dark shadow appears over the visual field.

These are all signs of retinal detachment and require immediate medical attention.

Summary

Retinoschisis is a disorder that occurs when a retina layer breaks into two. It can be causing central or peripheral vision problems.

The condition is present at birth in some cases, and progresses over time in others.

Retinoschisis doesn’t need medication at all. Nonetheless, serious cases, including those in which there has been retinal detachment, would require surgery.

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