Detached & Torn Retina
The retina is a delicate layer of light-sensitive tissue that lines the inner eye. Images focused by the lens are pictured on the retina, then transmitted by the optic nerve to the brain. When a retina tears or separates from its connection at the back of the eye, the result is a detached or torn retina, a very serious problem that can cause blindness unless treated.
As we age, the vitreous, a gel-like substance that fills the inner eye, can shrink or become watery, and the resulting pressure can tear or rip the retina. Fluid from a retinal tear can lift the retina and peel or detach it from the back of the eye.
Laser surgery or cryotherapy (freezing) are often used to seal retinal tears and prevent detachment. If the retina is detached, it must be reattached before sealing the retinal tear. There are three methods available to repair a detached retina:
- Pneumatic Retinopexy – A gas bubble is injected into the eye, pushing the retina back to seal the tear.
- Scleral Buckle – The fluid under the retina is drained and a silicone implant is sewn onto the outer eye wall to provide retinal support while the tear heals.
- Vitrectomy – The vitreous gel is surgically removed from the eye and replaced with a gas bubble that over time will be replaced naturally with fluid.
Symptoms of a torn or detached retina include flashing lights, floating objects, or a grayish curtain that moves across the field of vision. If you notice any of these visual changes, contact an ophthalmologist immediately.
Diabetic Retinopathy
If you have diabetes mellitus, your body does not use and store sugar properly. High blood-sugar levels can damage blood vessels in the retina; this damage is referred to as diabetic retinopathy.
It is important to know that today, with improved methods of diagnosis and treatment, a smaller percentage of people who develop retinopathy have serious vision problems. Early detection of diabetic retinopathy is the best protection against loss of vision.
People with diabetes should schedule examinations at least once a year. Pregnant women should schedule an examination in the first trimester, as retinopathy can progress quickly during pregnancy. Rapid changes in blood sugar can cause fluctuating vision in both eyes even if retinopathy is not present, but visit the retinal specialists at Center for Sight if you experience visual changes that:
- affect either or both eyes;
- last more than a few days;
- are not associated with a change in blood sugar.
A Center for Sight ophthalmologist will be able to diagnose diabetic retinopathy — in many cases before you are even aware of any vision problems — and can then determine the best course of treatment, which may include the following:
- Intravitreal injections: used primarily to treat macular edema associated with nonproliferative diabetic retinopathy (NPDR), these are special shots of steroids or other medications that shrink the swelling of the macula.
- Laser surgery: recommended for people with macular edema, neovascular glaucoma and proliferative diabetic retinopathy (PDR), this procedure helps to prevent further loss of vision and is not a cure for diabetic retinopathy.
- Vitrectomy: recommended in advanced PDR cases, this microsurgical procedure replaces the blood-filled vitreous with a clear solution.
If you are diagnosed with diabetic retinopathy, it is important to schedule frequent examinations. Combined with strict control of your blood sugar, you can significantly lower your risk of vision loss.
Macular Degeneration
Age-related macular degeneration (AMD) is a chronic condition of the eye that causes central vision loss. Central vision is the center area of what you see, and most of the things we do everyday require central vision. AMD is the result of damage to the center of the retina, known as the macula.
Wet AMD is the most serious form of AMD and can progress very quickly. It occurs with the abnormal growth of blood vessels in the back of the eye, specifically under your retina. As the blood vessels grow, they can leak blood and fluid, which can cause scarring on your retina and substantial damage to the macula. The earliest symptom of wet macular degeneration is vision change. If you notice that straight lines appear wavy, or that doorframes don't seem straight, it may be an early sign of wet AMD.
Who gets Macular Degeneration?
AMD is a major cause of severe central vision loss in Americans age 55 and older. It is more common in women than men. About 10% of people (1 out of 10) with dry AMD will get wet AMD. It is estimated that 1.2 million people in the US have wet AMD. Over the next few years, the number of people who will get macular degeneration is expected to grow. In fact, by 2020, approximately 3 million people may be diagnosed with advanced AMD.
Treatment
Today, retina specialists can prevent vision loss from getting worse or even help you get some of your vision back. But early diagnosis is critical. If you think you have symptoms of AMD, see a Center for Sight eye doctor immediately. If you have been diagnosed with wet AMD, a Center for Sight retina specialist will determine your treatment by looking at the growth of abnormal blood vessels and the damage to the macula. Injections given into the eye will target the growth of abnormal blood vessels in the eye. Avastin and Lucentis are the newest medications currently used by retina specialists to treat wet macular degeneration.
Small-Incision Vitrectomy
A 25-guage I sutureless vitrectomy involves removing the jellylike substance inside the eye. It is followed by other procedures depending on the underlying problem. 25-guage refers to the size of the incision. Many retinal problems can be fixed using these techniques, such as macular puckers (scar tissue on the retina), macular holes (holes in the center part of the retina), certain types of retinal detachments, and problems related to bleeding from diabetic eye disease.
With less tissue manipulation, this new technology has tremendous benefits for the patients:
- significantly less operating time
- faster visual recovery
- less risk of complication
- less post-operative discomfort
Most retinal surgeons have adopted this new technique of surgery due to the above benefits and the great feedback of patients who have had the surgery.
