Did you know that lining the back of your eye is a thin membrane—only .5 to 1 mm thick—with profound implications for your ability to see the world around you? Despite its small size, this membrane, known as the retina, is a crucial tool for sending messages to the brain to help us process what we see! The retina is a thin layer of tissue that lines the back of the eye on the inside. It is located near the optic nerve. The purpose of the retina is to receive light that the lens has focused, convert the light into neural signals, and send these signals on to the brain for visual recognition.
Due to the retina’s vital role in vision, damage to it can cause permanent blindness. Conditions such as retinal detachment, where the retina is abnormally detached from its usual position, can prevent the retina from receiving or processing light. This prevents the brain from receiving this information, thus leading to blindness. Our retinal surgeon specializes in diagnosing and treating retina conditions such as diabetic retinopathy, age-related macular degeneration (AMD) and retinal detachment, all of which can lead to vision loss or blindness.
Common retinal conditions include floaters, macular degeneration, diabetic eye disease, retinal detachment. There are other issues that can occur, but these conditions are some of the most common and serious that a person can experience.
Common Retinal Diseases
If you notice spots in your vision, then you have floaters. They can be age-related, but they can also occur in cases of severe near sightedness. The jelly substance the eye is made of becomes more liquid and small clumps cast a shadow on the retina. However, floaters can also be the result of a torn retina. If the tear isn’t repaired, then it can lead to retinal detachment. This is due to fluid accumulating behind the retina, causing it to separate from the eye.
Macular degeneration is an age-related condition of the retina that causes central vision loss. It is very common in individuals over the age of 55 years of age. The symptoms tend to involve blurry central vision, warped straight lines, or difficulty focusing on fine details. Blind spots can develop as the condition worsens. Fortunately, there are treatments, such as an antioxidant supplement that can slow the progression by blocking unhealthy blood vessel development.
Diabetic Eye Disease
Those with diabetes are more susceptible to retinal damage. They notice blurry vision, floaters or dark spots. The good news is that laser surgery is a treatment that can help a person suffering from diabetic eye disease. It is also important to note that diabetics are also at increased risk of glaucoma and cataracts.
Retinal detachment can occur when too much fluid accumulates behind the retina, causing separation. However, there are other risk factors that increase the chances of retinal detachment. They are:
Previous retinal detachment in the other eye
Previous cataract surgery
The presence of other eye disorders
The presence of floaters indicates that retinal detachment may be occurring. There may also be flashes in the eye. If the condition isn’t quickly treated, it can cause permanent vision loss. If you suddenly notice floaters or you have had them and they have increased, see your doctor immediately. Other symptoms include a decrease in vision or seeing a grey curtain in your field of vision.
How To Diagnose Retinal Diseases?
Retinal diseases can be related to aging, diabetes or other diseases, trauma to the eye, or family history. To make a diagnosis, your ophthalmologist conducts a thorough eye exam and looks for abnormalities anywhere in the eye.
The following tests may be done to determine the location and extent of the disease:
Ambler Grid Test: Your doctor may use an Amsler grid to test the clarity of your central vision. He or she will ask you if the lines of the grid seem faded, broken or distorted and will note where the distortion occurs on the grid to better understand the extent of retinal damage. If you have macular degeneration, he or she might also ask you to use this test to self-monitor your condition at home.
Optical Coherence Tomography (OCT): This test is an excellent technique for capturing precise images of the retina to diagnose epiretinal membranes, macular holes and macular swelling (oedema), to monitor the extent of age-related wet macular degeneration, and to monitor responses to treatment.
Fluorescein Angiography: This test uses a dye that causes blood vessels in the retina to stand out under a special light. This helps to exactly identify closed blood vessels, leaking blood vessels, new abnormal blood vessels and subtle changes in the back of the eye.
Neocyanine Green Angiography: This test uses a dye that lights up when exposed to infrared light. The resulting images show retinal blood vessels and the deeper, harder-to-see blood vessels behind the retina in a tissue called the choroid.
Ultrasound: This test uses high-frequency sound waves (ultrasonography) to help view the retina and other structures in the eye. It can also identify certain tissue characteristics that can help in the diagnosis and treatment of eye tumours.
CT and MRI: In rare instances, these imaging methods can be used to help evaluate eye injuries or tumours.
How Retinal Diseases Are Treated?
The treatment of Retinal disease may be complex and sometimes urgent. Options include:
Using a laser: Laser surgery can repair a retinal tear or hole. Your surgeon uses a laser to heat small pinpoints on the retina. This creates scarring that usually binds (welds) the retina to the underlying tissue. Immediate laser treatment of a new retinal tear can decrease the chance of it causing a retinal detachment.
Shrinking abnormal blood vessels: Your doctor may use a technique called scatter laser photocoagulation to shrink abnormal new blood vessels that are bleeding or threatening to bleed into the eye. This treatment may help people with diabetic retinopathy. Extensive use of this treatment may cause the loss of some side (peripheral) or night vision.
Freezing: In this process, called cryopexy, your surgeon applies a freezing probe to the external wall of the eye to treat a retinal tear. Intense cold reaches the inside of the eye and freezes the retina. The treated area will later scar and secure the retina to the eye wall.
Injecting air or gas into your eye: This technique, called pneumatic retinopexy, is used to help repair certain types of retinal detachment. It can be used in combination with cryopexy or laser photocoagulation.
Indenting the surface of your eye: This surgery, called scleral buckling, is used to repair a retinal detachment. Your surgeon sews a small piece of silicone material to the outside eye surface (sclera). This indents the sclera and relieves some of the force caused by the vitreous tugging on the retina. This technique may be used with other treatments.
Evacuating and replacing the fluid in the eye: In this procedure, called vitrectomy , your surgeon removes the gel-like fluid that fills the inside of your eye (vitreous). He or she then injects air, gas or liquid into the space.
Vitrectomy: May be used if bleeding or inflammation clouds the vitreous and obstructs the surgeon’s view of the retina. This technique may be part of the treatment for people with a retinal tear, diabetic retinopathy, a macular hole, an infection, eye trauma or a retinal detachment.
Injecting medicine into the eye: Your doctor may suggest injecting medication into the vitreous in the eye. This technique may be effective in treating people with wet macular degeneration, diabetic retinopathy or broken blood vessels within the eye.
Implanting a retinal prosthesis: People who have severe vision loss or blindness owing to retinal disease may be a candidate for surgery. One surgical option not widely available is called retinal prosthesis.
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