Someone suffering from the eye disorder retinoschisis has a condition where the retina, the light sensitive layer at the back of the eye, splits into two layers; the term comes from combining obviously the word retina with the Greek word for splitting or breaking up – schizein.
When that someone needs to talk about their condition, more information than just the word “retinoschisis” needs to be divulged as otherwise the full story of what is happening can’t really be understood.
There are two main types of retinoschisis with different causes, symptoms and treatments and importantly different age of sufferers – it is this age difference that is used to basically distinguish between the two:
• Juvenile Retinoschisis – diagnosed in childhood quite often with symptoms becoming more noticeable in early teen years
• Senile Retinoschisis – is found almost entirely in the over forty age group, although it’s not entirely unknown to find someone in their thirties suffering from it.
The terms “juvenile” and “senile” are of course used in the strictly medical sense to identify age and not in the context of normal conversation.
Juvenile is a word often use to describe a young person who is immature or childish, and senile is a word used to denote someone who is doddering, confused and “past it” – so if you are diagnosed with senile retinoschisis it shouldn’t be taken that you are thought to be senile!
So what are the differences other than the age of sufferers?
• Cause – juvenile retinoschisis is inherited, so family history is important, but senile retinoschisis is an acquired age related disorder without any real cause, but does have similarities with forms of macular degeneration and retinal detachment.
• Who gets it?– juvenile retinoschisis affects only the male population whilst senile retinoschisis affects both men and women
Juvenile retinoschisis symptoms may give misleading diagnoses of strabismus (which is the inability of the eye to focus on to something properly, also called “lazy eye”) and nystagmus where the eyes jump around without reason.
Senile retinoschisis gives no indication of its start up or progress except that during later stages “floaters” (cobweb like structures imagined to be seen) can occur as well as some loss of field vision. Once diagnosed it’s quite probable that no real changes occur and there is generally little further progression that requires attention.
There is no treatment currently recommended for juvenile retinoschisis but in a worst case scenario surgery can be carried out to repair retinal detachment if and when it occurs.
In the rare case that progression and further degeneration occurs in senile retinoschisis then surgery can be contemplated, but at present there isn’t a specific procedure that produces a reliable outcome.
• Outcome – in juvenile retinoschisis central vision is usually lost and in addition around half of people with the condition will suffer from peripheral vision loss. The disorder may lead to very limited vision but only on very rare occasion blindness.
With senile retinoschisis since there is limited risk of long term degeneration – ongoing monitoring may be all that is required.
And what if the retinoschisis is not juvenile or senile?
There are two other types of retinoschisis that are sometimes diagnosed:
• Tractional retinoschisis – related to the vitreous humour inside the eye
• Exudative retinoschisis – affecting the central part of the retina, a treatment involving laser photocoagulation has shown great promise.