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RETINAL DISEASES
Diabetic Retinopathy
Early stage diabetic retinopathy is characterized by damaged blood vessels that allow leakage into the retina. Though patients may not notice a change in vision, the leakage could potentially be causing permanent damage to the retina. The advanced phase described as proliferative retinopathy is characterized by new, abnormal blood vessels within the retina. The new vessels have a tendency to bleed, which may lead to blurred vision, scarring and retinal detachment.
Signs/Symptoms
- At first, there may be no signs or symptoms
- Blurred vision
- Extreme loss of vision
Treatment
A person with diabetes should have a comprehensive dilated eye exam at least once a year. Treatment will depend on the severity of the disease but may include laser surgery or vitrectomy surgery to remove some or all the vitreous (thick transparent substance) from within the eye.
Macular Degeneration
Age-related macular degeneration (AMD) causes damage to the macula (the central portion of the retina) resulting in impaired central vision. Patients often report difficulty with various daily activities such as reading and driving. AMD is more common in the elderly. There are two categories of macular degeneration. Aging and thinning of the macula cause the more common "dry" form. It tends to progress slowly. In contrast, the "wet" form carries a greater risk for significant vision loss. It is the direct result of abnormal blood vessel growth behind the retina. The vessels tend to leak fluid and blood that damages the macula.
Signs/Symptoms
- Blurred vision
- Distortion of straight lines
- Words appear to crowd together, declining reading ability
- Eyeglasses do not improve vision
Treatment
Treatment depends upon the severity of the disease. An ophthalmologist will discuss the various options that may include ultraviolet protection, dietary supplements or intravitreal injections.
Macular Hole
A macular hole may be caused by eye injury, certain eye diseases and eye inflammation, but generally results from the normal aging process. The vitreous (thick transparent substance within the eye) is firmly attached to the central portion of the retina (the macula). As the vitreous shrinks with normal aging, it may pull away from the retina. As it moves, a hole can be formed at the macula.
Signs/Symptoms
- Decreased central vision for distance and reading activities
- Distortion in central vision where small letters may disappear
- Distorted "wavy" or blurred central vision
- Central gray area or blind spot in more severe cases
- Spontaneous, partial or total loss of sharp, central vision
Treatment
Vitrectomy surgery is needed to remove some or all the vitreous (thick transparent substance) from within the eye.
Melanoma
Choroidal melanoma is the most common primary malignant intraocular tumor in adults. It is composed of melanocytes and arises from the blood-vessel layer (choroid) beneath the retina. Most patients have no symptoms so early detection and treatment is vital. Untreated, the melanoma can spread to other parts of the body such as the liver. Such spread can be fatal.
Signs/Symptoms
- Asymptomatic
- Distorted vision
- Floaters
Treatment
Treatment depends on diagnosis of the tumor and the size and is directed toward reducing risk of recurrence. Standard treatment options include external beam radiation therapy, iodine plaque therapy or removal of the eye (enucleation).
Retinal Detachment
A retinal detachment occurs when the retina pulls away from the underlying tissue. The retina is a light sensitive layer of tissue that sends visual images to the brain. Detachment of the tissue can lead to severe vision loss. There are a variety of causes for a detachment. Often there are retinal tears that occur with aging. The vitreous gel inside the eye may also shrink and pull on the retina resulting in a tear or hole. Nearsightedness, previous intraocular surgery, previous retinal detachment in the other eye and family history of retinal detachment all increase the risk.
Signs/Symptoms
- Sudden flashes of light
- Floaters
- Sensation of a dark shadow or curtain covering the visual field
- Vision loss
Treatment
Treatments based on the severity of the disease include laser surgery, cryotherapy (freezing), scleral buckle placement and vitrectomy (removal of vitreous substance from within the eye).