Diabetic Retinopathy
Diabetic retinopathy is a complication of diabetes mellitus. Diabetes damages the normal circulation of the body. That is why diabetics have problems with the circulation to their legs, kidneys, heart, brain and eyes. Initially, diabetes causes the retinal vessels to leak resulting in retinal swelling (macular edema) and vision loss. The leaking vessels can be sealed with a laser to resolve the swelling and prevent further vison loss. Significant macular edema may be present even if your vision is excellent.
As diabetic retinopathy advances, the normal retinal vessels close (retinal ischemia). The retina now is not receiving adequate blood nourishment. In an effort to compensate for the lack of normal circulation, the retina grows new, abnormal blood vessels (proliferative diabetic retinopathy). The abnormal vessels are not helpful and can lead to severe loss of vision with bleeding, scar tissue growth, and retinal detachment. The abnormal blood vessel growth can be halted with timely laser treatment or surgical removal (vitrectomy surgery). Just like macular edema, you can have severe abnormal blood vessel growth in your eye and still have excellent vision. It is important for diabetics to have at least a yearly eye exam to monitor for significant retinopathy. Early and aggressive treatment of diabetic retinopathy is extremely successful in preventing severe vision loss. In order to maximize the health of your retinal circulation, as well as the circulation to the heart and kidneys diabetics should lower their vascular risk factors: don't smoke, control hypertension, exercise, lower your cholesterol, eat a low fat diet and follow your family doctor's instructions.
As diabetic retinopathy advances, the normal retinal vessels close (retinal ischemia). The retina now is not receiving adequate blood nourishment. In an effort to compensate for the lack of normal circulation, the retina grows new, abnormal blood vessels (proliferative diabetic retinopathy). The abnormal vessels are not helpful and can lead to severe loss of vision with bleeding, scar tissue growth, and retinal detachment. The abnormal blood vessel growth can be halted with timely laser treatment or surgical removal (vitrectomy surgery). Just like macular edema, you can have severe abnormal blood vessel growth in your eye and still have excellent vision. It is important for diabetics to have at least a yearly eye exam to monitor for significant retinopathy. Early and aggressive treatment of diabetic retinopathy is extremely successful in preventing severe vision loss. In order to maximize the health of your retinal circulation, as well as the circulation to the heart and kidneys diabetics should lower their vascular risk factors: don't smoke, control hypertension, exercise, lower your cholesterol, eat a low fat diet and follow your family doctor's instructions.
Retinal Vein and Artery Occlusions
Vein occlusions are blockages of the central (main) vein or one of its four branches draining the retina. Although there are many causes of vein occlusions, the most common identified risk factors include advanced age, high blood pressure, diabetes and glaucoma.
Branch retinal vein occlusion blocks small veins in the retina, the layer of light sensing cells at the back of the eye. If the blocked retinal veins are ones that nourish the macula, the part of the retina responsible for straight-ahead vision, some central vision is lost. During the course of vein occlusion, sixty percent or greater will have swelling of the central macular vision area. Several treatment options exist for treatment of the complications caused by vein occlusions and all available at our facility.
Branch retinal vein occlusion blocks small veins in the retina, the layer of light sensing cells at the back of the eye. If the blocked retinal veins are ones that nourish the macula, the part of the retina responsible for straight-ahead vision, some central vision is lost. During the course of vein occlusion, sixty percent or greater will have swelling of the central macular vision area. Several treatment options exist for treatment of the complications caused by vein occlusions and all available at our facility.
Dry Age-Related Macular Degeneration
The macula is the center or "bullseye" of the retina. The macula is responsible for our reading vision, driving vision, color vision, and our ability to see faces. As we age, the tissue under the retina (retinal pigment epithelium-RPE) may degenerate, just as our hair turns grey or our bones weaken. When aging spots (drusen) are detectable under the retina, this is called age-related macular degeneration (ARMD), the "dry" or nonexudative type. The majority (90%) of patients with ARMD have the dry type and maintain good vision. Treatment of dry macular degeneration frequently involves taking specific eye vitamins, which are proven to delay progression of this disease.
Wet Age-Related Macular Degeneration
Bleeding and leakage (choroidal neovascularization) may occur around the aging spots-this is called the "wet" or exudative form of ARMD. Significant vision loss is associated with exudative ARMD. Progression from the dry to wet form of macular degeneration may be detected by utilizing a macular home test-the Amsler Grid. Intraocular injection treatment to stop the leakage may be indicated for exudative ARMD. The decision to treat or not treat the leakage is determined from the fluorescein angiogram. The angiogram pinpoints the leakage, its size and definition. Potential exudative ARMD should be evaluated by a retinal specialist.
Retinal Detachment
The vitreous is a clear liquid that fills our eyes and gives them shape. When we are young, the vitreous has a thick, gelatinous consistency and is firmly attached to the retina. As we age, the vitreous thins and separates from the retina. Although this usually results in nothing more than a few harmless floaters, tension from the detached vitreous can sometimes tear the retina.
If liquid seeps through the tear and collects behind the retina or between its nerve layers, the retinal tear can become a retinal detachment. Retinal detachment can cause significant, permanent vision loss and requires immediate medical treatment.
There are three kinds of retinal detachments. The most common form, described above, occurs when fluid leaks into the retina; people who are nearsighted or who have had an injury or eye surgery are most susceptible. Less frequently, friction between the retina and vitreous or scar tissue pulls the retina loose, something that occurs most often in patients with diabetes. Third, disease-related swelling or bleeding under the retina can push it away from the eye wall.
Signs of retinal tear or detachment include flashes of light, a group or web of floaters, wavy vision, a sense that there is a veil or curtain obstructing peripheral vision, or a sudden drop in vision acuity. If you experience any of these symptoms, call your doctor immediately. Early treatment is essential to preserve your vision and is usually done through laser or intraoperative procedures.
If liquid seeps through the tear and collects behind the retina or between its nerve layers, the retinal tear can become a retinal detachment. Retinal detachment can cause significant, permanent vision loss and requires immediate medical treatment.
There are three kinds of retinal detachments. The most common form, described above, occurs when fluid leaks into the retina; people who are nearsighted or who have had an injury or eye surgery are most susceptible. Less frequently, friction between the retina and vitreous or scar tissue pulls the retina loose, something that occurs most often in patients with diabetes. Third, disease-related swelling or bleeding under the retina can push it away from the eye wall.
Signs of retinal tear or detachment include flashes of light, a group or web of floaters, wavy vision, a sense that there is a veil or curtain obstructing peripheral vision, or a sudden drop in vision acuity. If you experience any of these symptoms, call your doctor immediately. Early treatment is essential to preserve your vision and is usually done through laser or intraoperative procedures.
Vitreous Floaters
Small specks or clouds moving in your field of vision as you look at a blank wall or a clear blue sky are known as floaters. Most people have some floaters normally but do not notice them until they become numerous or more prominent. In most cases, floaters are part of the natural aging process.
The appearance of flashing lights comes from the traction of the vitreous gel on the retina at the time of vitreous separation. Flashes look like twinkles or lightning streaks. You may have experienced the same sensation if you have ever been hit in the eye and seen stars.
Floaters and flashes are sometimes associated with retinal tears and thorough retinal exam is indicated.
The appearance of flashing lights comes from the traction of the vitreous gel on the retina at the time of vitreous separation. Flashes look like twinkles or lightning streaks. You may have experienced the same sensation if you have ever been hit in the eye and seen stars.
Floaters and flashes are sometimes associated with retinal tears and thorough retinal exam is indicated.
Epiretinal Membrane
Epiretinal membranes, also known as cellophane maculopathy, retinal wrinkling, and macular pucker, is a condition where a fine growth of fibrous tissue occurs on the surface of the macula causing surface wrinkling and distortion of the macula. Patients with epiretinal membranes usually complain that they see wavy lines and images where they should be straight.
Treatment involves removing the vitreous gel and gently peeling the membrane from the surface of the retina. This usually results in a significant improvement in the distortion seen by the patient as well as some improvement in visual acuity.
Treatment involves removing the vitreous gel and gently peeling the membrane from the surface of the retina. This usually results in a significant improvement in the distortion seen by the patient as well as some improvement in visual acuity.
Macular Hole
The macula is the part of the retina responsible for acute central vision, the vision one uses for reading, watching television, and recognizing faces. A macular hole is a small round opening in the macula. The hole causes a blind spot or blurred area directly in the center of your vision.
Vitrectomy surgery is the main treatment for a macular hole. With treatment, most macular holes close and some of the lost central vision returns. The amount of visual improvement typically depends on the length of time the hole was present.
Vitrectomy surgery is the main treatment for a macular hole. With treatment, most macular holes close and some of the lost central vision returns. The amount of visual improvement typically depends on the length of time the hole was present.
Additional Information:
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Diseases and Conditions
Diseases and Conditions