Retinal Disease: See the Best So You Can See Your Best
As we age, the chances increase of our eyes developing complicated retinal problems. It is important to stay aware of early symptoms as they relate to the retina. The thin inner lining at the back of the eye, the retina, contains millions of light-sensitive cells and nerve tissue that are largely responsible for your ability to see. Anything affecting this area can harm your vision.
Our Retina Specialty Group are leaders in clinical care, research and education. We have trained many of the ophthalmologists in this region – the next generation of eye doctors. Our group of retinal specialists diagnose and treat various different retinal diseases and conditions, many of which share common symptoms and require complex treatments. The goal is always to stop or slow the disease and preserve, improve or restore vision.
Our approach includes a multi-specialty and integrated subspecialty team model for complex cases, so patients get the best collective opinion of our on-staff specialists. Additionally, the research division of Sabates Eye Centers is actively enrolled in clinical trials involving retinal diseases that are available for qualified patients.
Worried you might have a retinal condition? Schedule an appointment.
Diabetic retinopathy is a complication of diabetes in which extended high blood sugar levels cause damage to vessels of the retina. It’s the most common cause of irreversible blindness in working-age Americans and occurs in more than half of all diabetics. The longer a person lives with diabetes and the less controlled their blood sugar, the more likely they are to develop the condition. Age, diabetes, prior eye surgery and other factors can increase chances of developing the condition.
Diabetic retinopathy may not present with symptoms in early stages and can subsequently cause damage before patients notice symptoms. These symptoms, which can occur in one or both eyes, may include:
- Blurred or double vision
- Difficulty reading
- Spots, commonly called “floaters,” in your vision
- A shadow across the field of vision
- Eye pain or pressure
- Difficulty with color perception
Physicians diagnose diabetic retinopathy with a dilated eye exam. Special eye drops are used to enlarge the pupils allowing a better view inside the eye. A physician will look for swelling of the retina, blood vessel issues indicative of poor circulation, abnormal blood vessels and new blood vessels or scar tissue on the retinal surface.
Other testing can include various types of imaging. Regular exams are important for patients for both prevention and treatment diabetic retinopathy.
Treatment and Prognosis
Several treatments are available for diabetic retinopathy, including small medication injections into the eye, laser treatments, and vitreous and retina surgery. These procedures are designed to prevent, treat, or reverse damage from diabetic retinopathy. Depending on the severity of the condition, your ophthalmologist will discuss the recommended procedures in detail with you.
Age-Related Macular Degeneration
Age-related macular degeneration (AMD) is a problem with your central retina. It happens when a part of the retina called the macula is damaged. With AMD you can lose your central vision. You cannot see fine details, whether you are looking at something close or far, but your peripheral (side) vision will still be normal. For instance, imagine you are looking at a clock with hands. With AMD, you might see the clock’s numbers but not the hands.
In early stages, AMD may have no symptoms at all. Symptoms that can appear as the disease progresses are distortion (bending) of straight lines, a decrease in the intensity or brightness of colors, blurred or distorted central vision or a gradual or sudden loss of center vision. Peripheral vision is usually not affected, and therefore complete visual impairment usually can be avoided.
Macular degeneration often emerges in only one eye, making it difficult to notice vision loss because the better eye takes over. The disease is detected through a comprehensive eye exam. There are two forms of macular degeneration; wet and dry. If signs of the dry form are discovered, a patient will be encouraged to stop smoking and take antioxidant vitamins.
The wet form of macular degeneration is treatable with a relatively painless technique that injects specially developed medications into the eye. They inhibit the growth of new blood vessels and work to dry up excess fluid within the retina.
There is no treatment for dry macular degeneration, though the Age-Related Eye Disease Studies (AREDS), conducted by the National Eye Institute, found a nutritional supplement formula may delay and prevent intermediate dry AMD from moving to the advanced wet form.
The AREDS-2 supplement formula, which is widely available over the counter, contains:
- Vitamin C
- Vitamin E
Although patients with either form of AMD may experience a severe decrease in visual acuity, they will almost never be completely blind.
Visual loss can be slowed down and sometimes reversed with early detection and treatment. Even with the disease, however, patients can still maintain a normal lifestyle.
The retina lines the back wall of the eye, and is responsible for absorbing and converting light into an electrical signal sent to the brain via the optic nerve allowing you to see. Several conditions may lead to a retinal detachment wherein the retina separates from the back wall of the eye. Before detaching, the retina often experiences a tear.
Signs that can indicate a retinal tear include seeing flashes and floaters. These signs can be alerting you to a potential detachment. Prompt evaluation by an ophthalmologist may find the retinal tear before it causes a retinal detachment. Laser surgery can often prevent the retina from detaching, helping patients avoid a more serious procedure.
With an actual retinal detachment, in addition to floaters and flashing light, patients often experience a progressively enlarging curtain or dark shadow in one eye. The curtain usually starts in the peripheral vision and eventually may spread to the central vision. The severity of symptoms correlate to the extent of the detachment. Quick evaluation and treatment are crucial to repair and prevent further damage.
A Sabates retina specialist can perform a detailed eye exam, which includes examination of the peripheral retina. Further testing may include additional imaging of the retina to determine if a tear or detachment is present and the precise location of the problem.
Several surgery approaches can be used to repair retinal detachments and tears, each one designed to treat different types and severities of detachments or tears. The goal is to re-attach the retina to the back wall of the eye and/or seal tears or holes that caused the detachment.
Most cases result in successful re-attachments, though more than one procedure is sometimes needed to do so successfully. Vision recovery depends on the patient’s pre-operative vision and other individual factors.
In the central portion of the retina is a small area called the macula. It provides all of the sharp central vision for activities such as reading and driving. If this area is damaged, the central vision can be affected.
Macular holes may occur as the result of age-related traction on the macula, from trauma or inflammation, from diabetic eye disease or from other factors. The hole results in progressive central vision loss.
Patients who develop macular holes most commonly notice a gradual decline in the central (straight ahead) vision of the affected eye. The decline can occur as blurring, distortion and waviness and a dark spot in the central vision. The size of the macular hole and the stage of its development affects the severity of the symptoms. In some cases, the other eye compensates enough that the patient notices no vision loss until they cover the good eye. The peripheral or side vision remains unchanged.
Optical coherence tomography (OCT) is the most effective tool for diagnosing, staging and managing macular holes. The imaging technology delivers high resolution imagery using specific lighting to help differentiate holes from other similar conditions.
Macular holes can be closed with an operation called vitrectomy. The surgery is usually an outpatient procedure, and eye drops will be needed after surgery. Other treatment options are used for specific macular hole conditions and sizes. Your doctor will discuss with you surgery, recovery and your individual case in greater detail.
Recovery from surgery (vitrectomy) can take several weeks and is successful in the majority of patients with some or most of lost vision regained.