Choroidal Rupture

Choroidal Rupture

Article
Eye & Vision
Diseases & Conditions
Contributed byKrish Tangella MD, MBAAug 13, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Rupture of Choroid

What is Choroidal Rupture? (Definition/Background Information)

  • Choroidal Rupture occurs when there is a tear/break/rupture in the choroid or its surrounding area. The rupture may take place due to a direct trauma to the eye
  • The choroid is a portion of the uvea (part of the eye structure) that is predominantly made up of the blood vessels. The choroid provides nutrients to the retina keeping it healthy
  • Choroidal Rupture results in signs and symptoms that depend upon the location and severity of the rupture. It may include hemorrhaging of any part of the eye along with visible external eye injury features, and sometimes, the presence of blind spots
  • A healthcare provider may diagnose Choroidal Rupture through physical (eye) exams and medical history evaluation. Mild cases that are asymptomatic may be monitored by the healthcare specialist. However, more severe conditions may be treated using medications and surgery (when required)
  • The prognosis for Choroidal Rupture depends on the individual's signs and symptoms and impact degree of eye injury. In a majority of cases, the prognosis is good with suitable treatment

Who gets Choroidal Rupture? (Age and Sex Distribution)

  • Individuals of all ages may be at risk for Choroidal Rupture through an eye injury
    • If the injury is sports-related, then a majority of the cases may be seen in individuals under the age of 30 years (children and young adults)
    • Middle-aged and older adults have a higher risk for occupational or industry-related eye injuries
  • Both males and females are affected and no particular predilection is noted
  • Individuals of different racial and ethnic backgrounds can be affected

What are the Risk Factors for Choroidal Rupture? (Predisposing Factors)

The risk factors for Choroidal Rupture may include:

  • Injury to the eye, due to participation in sports or occupation-related
  • Vehicular or other accidents
  • Violence and street-fighting
  • Physical abuse

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Choroidal Rupture? (Etiology)

Choroidal Rupture is mostly caused by an eye trauma that may be direct or indirect.

  • A direct trauma may be the result of a brute or blunt force on the eye and is the more common cause
  • An indirect injury is less common, and may result inadvertently from eye-related medical procedures, use of certain medications, or adverse health conditions
  • However, Rupture of Choroid is not known to be associated with any systemic disorders

What are the Signs and Symptoms of Choroidal Rupture?

The signs and symptoms of Choroidal Rupture depend on the type of eye injury, the severity of the injury, and the location of the rupture within the eye. The signs and symptoms may include:

  • Hemorrhage of the choroid and adjoining structures including the retina and vitreous membrane
  • Partial to significant vision deficiency due to the trauma
  • Presence of blind spots (scotoma) that may affect partial vision
  • External visible signs, such as bruises, black eye, or swollen eye, may be observed
  • Pain may depend on the degree of trauma to the eye; in some cases, the pain may be significant
  • The condition is normally unilateral and one eye is affected, but both eyes may be involved

Mild conditions may be asymptomatic and no significant symptoms may be noted.

How is Choroidal Rupture Diagnosed?

A healthcare professional may diagnose Choroidal Rupture using the following tests and procedures:

  • Physical examination and analysis of previous medical history
  • Eye examination by an eye specialist

Generally, no other laboratory testing or imaging scans may be necessary in diagnosing the condition. However, if required, the following procedures may be employed:

  • Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
  • Visual acuity test using a special and standardized test chart (Snellen chart)
  • Slit-lamp examination: Examination of the eye structure using a special instrument called a slit-lamp. In this procedure, the pupils are dilated and the internal eye structure is examined

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Choroidal Rupture?

Complications of Choroidal Rupture may lead to vision abnormalities and may include:

  • Choroidal neovascularization (CNV): An abnormal development of blood vessels in the choroid, which if left untreated can result in permanent loss of vision. This is observed in up to one-third of the individuals with Rupture of Choroid
  • Choroidal detachment and severe bleeding
  • Retinal detachment: An eye condition wherein the retina gets separated from the eye structures that holds the retinal layers together

How is Choroidal Rupture Treated?

The treatment of Choroidal Rupture is dependent on the severity of the signs and symptoms and may include the following measures:

  • Immediate first aid treatment of an eye injury can significantly help improve the individual's chance to maintain their vision
  • A ‘wait and watch’ approach to monitor the condition may be suggested by the healthcare provider for mild cases without any significant symptoms
  • Individuals showing signs and symptoms may be treated with medications
  • If choroidal neovascularization is observed, then laser therapy may be helpful
  • The healthcare provider may recommend surgical treatment to rectify the choroidal defect or reattach the choroid in case of severe rupture

It is important to note that steroids may not be used in all cases, since it can worsen the condition. A healthcare provider will provide the best treatment options based upon each individual’s specific circumstances.

How can Choroidal Rupture be Prevented?

It may be difficult to prevent Choroidal Rupture, but the risk for the condition may be lowered through the following measures:

  • Wearing protective gear (such as industrial goggles or protective glasses) during activities that have an increased risk for eye trauma
  • Individuals who participate in high-risk (for eye injury) sports should wear appropriate goggles, helmets, or face shields
  • Maintaining long-term follow-up checkups following any injury to the eye

What is the Prognosis of Choroidal Rupture? (Outcomes/Resolutions)

  • The prognosis of Choroidal Rupture depends upon the severity of the injury and the signs and symptoms. Individuals with mild signs and symptoms have a better prognosis than those with severe conditions
  • An early diagnosis and adequate treatment can ensure better prognosis than a delayed treatment
  • Choroidal Rupture can result in permanent loss of vision, if the condition is severe

Additional and Relevant Useful Information for Choroidal Rupture:

Please visit our Eye & Vision Health Center for more physician-approved health information:

http://www.dovemed.com/health-topics/vision-center/

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Krish Tangella MD, MBA

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