The retina is the lining in the back of the eye that contains millions of photoreceptors (light sensitive) cells. Light rays are focused by the rest of the ocular structures onto the retina to achieve clear vision. Various diseases and ocular conditions can affect the retina. The most common retinal problems are macular degeneration, diabetic retinopathy, broken or damaged blood vessels in the retina, retinal tears and holes, and retinal detachments. Although your eyes may look and feel normal with these conditions, they often lead to serious complications.
Retinal diseases are some of the most common causes of severe vision loss. However, a simple, painless eye exam can detect these conditions and allow us to begin appropriate treatment. At Chico Eye Center, we have the most technologically advanced equipment for diagnosing retinal diseases.
To detect retinal diseases, your physician with measure your vision, evaluate the blood vessels and circulation of the retina (fluorescein angiogram), and measure the thickness and contour of the retina and underlying structures (ocular computed tomography). Regular eye exams help monitor for possible changes to your vision and retina and determine whether you may develop any of these conditions.
Various treatment options are available to treat retinal conditions. They include:
- Oral medications – a large, multicenter trial has shown that certain combinations of vitamins, minerals and anti-oxidants are effective at slowing the progression of macular degeneration (AREDS study).
- Eye drops – swelling of the retina (edema) can frequently be resolved with one or a combination of eye drops.
- Intra-vitreal injections – injections placed in the back of the eye to deliver medication to the retina that reduces abnormal blood vessels. This is usually done as a series of injections over time.
- Focal and grid laser – a laser used to shrink retinal swelling and to seal leaking blood vessels that are interfering with proper retinal function. This is mostly used to treat diabetic retinopathy and small damaged retinal blood vessels. (see video)
- Pan retinal photocoagulation (PRP) laser – a more extensive laser therapy that treats large areas of the peripheral retina to reduce or eliminate the growth or abnormal blood vessels. (see video)
- Retinopexy laser – a laser treatment used to seal retinal tears and holes and prevent progression to a retinal detachment. (see video)
- Retinal surgery – several surgeries are available to treat severe retinal conditions. A referral to a retinal sub-specialist will be needed.
When retinal damage is too extensive or if retinal surgery is not successful, there are several resources to help patients with low vision. Many of these technologies can enable people to continue to live on their own and lead productive lifestyles.
Retinal Tear and 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 detachment. 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 or watery vision, a sense that there is a veil or curtain obstructing peripheral vision, or a sudden drop in vision quality. If you experience any of these symptoms, call your eye doctor immediately. Early treatment is essential to preserve your vision and is usually done through lasers, gas bubbles, and scleral band procedures.