Retinal Diseases

Age-related macular degeneration (AMD) is the leading cause of vision loss in older adults. It happens when a part of the retina called the macula is damaged. The macula is the central part of the retina responsible for detailed vision tasks. There are two types of ARMD.

DRY ARMD: 

This is the most common form. Dry AMD is characterized by accumulation of yellow deposits called drusen, thinning of the macula, and gradual deterioration of central vision. Dry ARMD is monitored and treatment is not necessary. 

WET ARMD: 

Wet AMD is less common but more serious. With wet AMD, abnormal blood vessels grow under the retina and may leak, causing accumulation of blood or other fluid. This can cause scarring of the macula and you may experience blurred or loss of your central vision.

Our physicians will use a variety of tests and perform a dilated exam to make an accurate diagnosis and decide which treatment method is best for the patient. During the exam for macular degeneration, patients typically undergo two tests:

Fluorescein Angiography (FA)

The FA involves the injection of a small amount of a yellow, vegetable-based dye through a patient’s peripheral vein – usually the arm or hand. An ophthalmic photographer will take a series of time related retinal photographs. The injected dye lights up the retina’s vascular network. This will show our retina specialists the areas of leakage in those patients with wet macular degeneration.

Optical Coherence Tomography (OCT)

OCT is a non-invasive test that scans the retina and provides very detailed images of the retina and macula.

Self-Monitoring With Amsler Grid

Patients also play a part in self-monitoring with an Amsler Grid. An Amsler grid is a simple graph paper-like patchwork of straight vertical and horizontal lines.

Patients with subtle progression of macular disease will report new “waviness” or “missing areas” when monitoring their grid daily. Contact us promptly should you or a family member notice new changes on an Amsler grid.

*Click to see an example of the Amsler Grid*

Diabetic retinopathy is the leading cause of blindness in the United States. Diabetes damages the body’s normal circulation which is why people with diabetes may have problems with circulation to their legs, kidneys, heart, brain, and eyes.

In diabetic retinopathy, high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell or leak, or they can close, preventing blood from circulating through them. In some cases, abnormal blood vessels grow on the retina. All of these changes can cause loss of vision.

The sudden onset of floaters or flashes can be a warning signal of possible retinal problems. Fortunately, the majority of people who experience floaters or light flashes do not develop serious retinal problems. In most cases, the floaters and flashes gradually subside over a period of time with no permanent loss of vision. Since flashes and floaters can, however, be an important warning of a retinal tear or impending retinal detachment. Please contact your ophthalmologist for evaluation if you notice any of the following:

Significant increase in new floaters

A lot of flashes

A shadow in your peripheral (side) vision

A gray curtain covering part of your vision

Macular edema is the build-up of fluid in the macula, an area in the center of the retina. The macula is the part of the retina responsible for sharp, straight-ahead vision. Fluid build-up causes the macula to swell and thicken, which distorts vision. It may cause blurriness, wavy vision or sometimes colors appear ‘faded’ out.

A common cause of macular edema is diabetic retinopathy, a disease that can happen to people with diabetes. Macular edema can also occur after eye surgery, in association with age-related macular degeneration, or as a consequence of inflammatory diseases that affect the eye. Any disease that damages blood vessels in the retina can cause macular edema.

Clear gel that fills the inside of our eye is called vitreous.  As we age, the vitreous jelly in our eye turns to liquid. The vitreous can pull away from the retina as it liquefies. In a small percentage of people.it exerts traction on the macula which is responsible for our sharp, central vision functions like reading small print, threading a needle, or identifying small objects with fine detail. This tugging can ultimately lead to a hole forming in the center of the macula – a macular hole.

The macula is the small, central part of the retina that allows you to read and see fine details. Damage to the macula can significantly affect central vision.

A macular pucker occurs when a clear membrane, like cellophane grows and covers the surface of the macula. This condition can occur at any age, but more often occurs in patients over the age of 40. Often these membranes remain completely flat and cause no vision problems. However, in some cases, the membrane will start to contract on the surface of the macula which leads to wrinkling or puckering of the retina beneath. This puckering can impair central vision.

Retinal Artery Occlusion (RAO)

A retinal artery occlusion (RAO) is a blockage in one or more of the arteries of your retina, a layer at the back of the eye where visual images are formed.

The blockage is caused by a clot or occlusion in an artery or a build-up of cholesterol in an artery. It is similar to a stroke. An occlusion causes damage to the retina due to lack of blood flow. Patients should go to the closest STROKE CENTER/ER for evaluation and treatment before seeing a retina specialists.

There are two types of retinal artery occlusions:

Central retinal artery occlusion (CRAO)

Branch retinal artery occlusion (BRAO)

A retinal vein occlusion occurs when one of the veins of the retina becomes blocked and cannot drain blood from the retina normally. This blockage leads to a backup of blood and fluid into the retina and can be seen in the retina as hemorrhages. The amount of swelling in the retina varies and depends on the degree of blockage of the retinal vein.

There are two types of retinal vein occlusions:

CRVO-Central Retinal Vein Occlusion

BRVO-Branch Retinal Vein Occlusion

The middle of our eye is filled with a clear gel called vitreous that is attached to the retina, the inner lining of the back of the eye.

As we get older, the vitreous may shrink or change shape usually without any damage. However, the vitreous can pull away from the retina, especially if you have nearsightedness (myopia) or inflammation. If the vitreous pulls a piece of the retina with it, it causes a retinal tear. Persistent pull on the tear can lead to a retinal detachment, a condition in which fluid gets under the retina and lifts the retina away from the back of the eye.

Once detached, the retina no longer works properly, causing vision to become blurry. If not treated surgically, a retinal detachment can cause blindness.

Fresh retinal tears and detachments should be treated urgently since rapid loss of vision can occur. The success rate is much higher with prompt surgical repair.

(RP) is the most common inherited retinal disorder. It is actually a group of problems that affect the retina, changing how it responds to light and making it hard to see. RP causes some photoreceptor cells to gradually fade and die, losing the ability to transmit visual messages to the brain. It typically begins to affect people in their teenage years.

Symptoms of RP are typically painless and bilateral (affecting both eyes) and may include:

• Gradual loss of peripheral (side) vision (also
known as tunnel vision)

• Loss of central vision

• Loss of night vision

• Problems with color vision

Retinopathy of prematurity (ROP) is a potentially blinding eye disease that occurs in some premature babies (those born before 31 weeks). The blood vessels in the retina, which is in the back of the eye, do not completely develop until the ninth month of pregnancy. In many premature babies, retinal blood vessels will continue to develop after birth, causing no problems, but with ROP, abnormal blood vessels develop on the baby’s retina which can cause serious eye and vision problems. All premature infants should be checked for ROP by retina specialists soon after birth. An initial exam can take place in the hospital and decisions for treatment if necessary.

Uveitis is a term used to describe inflammation of the internal structures of the eye.  Uveitis can be divided into anterior or posterior. Uveitis can be caused by injury, ocular surgery, infection, or systemic.  There is no underlying illness that cause the uveitis. The inflammation of the eyes is considered the primary disease.