Retina
What is the retina?
The retina is the membrane that lines the inside of the eye. Think of it like film in a camera. Images are captured on the retina, encoded, and then sent to the brain via the optic nerve. Attached to certain areas of the retina is the vitreous, a gel-like substance that fills the inside of the eye, giving it shape and volume.
Why treatment?
Many retinal diseases share common symptoms and treatments, but each has unique characteristics. The goal of retinal disease treatments is to stop or slow disease progression and preserve, improve or restore vision.
We perform the following retinal tests
- Optical Coherence Tomography (OCT): Optical Coherence Tomography (OCT) is a non-invasive imaging technique that produces high resolution cross-sectional tomographs (or pictures) of the retina.
- Fluorescein Angiogram (FA): Fluorescein Angiogram (FA) is a diagnostic procedure that uses a special camera and a vegetable based dye to exam the blood flow in the Retina. This technique is used to expose any abnormal blood vessels or damage to the lining of the retina. A dye is injected into the arm/hand and images of the retina are quickly captured by our advanced imaging Optos technology.
- Indocyanine Green Angiography (ICG): Indocyanine Green Angiography (ICG) is a diagnostic procedure similar to a fluorescein angiogram, however, this procedure focuses on capturing images of the blood vessels that lie underneath the lining of the retina (called the Choroid). A dye is injected into the arm/hand and images of the Choroid are quickly captured by our advanced imaging Optos technology.
- Ocular Ultrasound: Ocular ultrasound is a non-invasive imaging technique that uses soundwaves to measure and produce images of the eye. This technique is often used to provide optimum images for the doctor to better access any possible trauma to the eye.
Retinal conditions that we treat
Macular Hole
A macular hole is a small break in the macula, located in the center of the eye’s light-sensitive tissue, called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail. A macular hole can cause blurry and distorted central vision. Macular holes occur more with aging, usually in people over age 60. As we get older, the vitreous shrinks in size and pulls away from the retina (and macula). We call this a posterior vitreous detachment. Sometimes, the vitreous pulls on the retina too hard and creates a hole in the macula.
Central Serous Retinopathy
In central serous retinopathy (CSR) (sometimes called central serous choroidopathy), fluid builds up under the retina and distorts vision. Fluid leakage is believed to come from a tissue layer with blood vessels under the retina, called the choroid. CSR commonly occurs in healthy young males between 30 and 50 years of age. Patients diagnosed with CSR generally have a good prognosis for recovery of vision, though the condition may take six months or more to resolve. Recurrence of leakage is quite common. Steroid use and stress can also contribute to CSR. We will often perform a fluorescein angiogram to confirm the diagnosis of CSR.
Uveitis
Uveitis is a broad term used to describe many problems with your eyes. What they all have in common is inflammation and swelling that can destroy eye tissues. That destruction can lead to poor vision or blindness. There are three important structures to the uvea, the iris, the ciliary body, and the choroid. Symptoms include eye redness, pain, decreased vision, and floaters. The word uveitis is used because the swelling or inflammation affects the part of the eye called the uvea. This inflammation can be caused by systemic disease (such as Sarcoidosis), infectious disease (such as Tuberculosis), or autoimmune diseases (such as Rheumatoid Arthritis and Multiple Sclerosis). Symptoms can include:
- Eye Redness
- Pain
- Decreased Vision
- Floaters
CMV Retinitis
Cytomegalovirus (CMV) retinitis is a virus that may infect the retina and potentially cause irreversible vision loss due to retinal detachment or destruction. It is most often diagnosed in patients with a severely compromised immune system, including those with AIDS or those on chronic immunosuppressive therapy following organ transplantation. Although a large percentage of the human population is infected with the virus, only those with significant compromise of the immune system develop retinitis. This CMV virus quickly eats away at the retina. The symptoms are flashes of light, floaters, and blurred vision. This virus can also lead to a retinal detachment.
Strokes of the Retina
Eye strokes occur when blockages (occlusions) occur in arteries or veins in the retina, causing vision loss. This “stroke” is called a retinal artery occlusion. Just as strokes occur in other parts of the body because blood flow is blocked, your eye also may suffer damage when vital parts such as the retina and optic nerve are cut off from nutrients and oxygen flowing through your blood. The severity of vision loss depends on the extent and location of the occlusion(s) and loss of blood flow. During a dilated eye exam your doctor may recommend a fluorescein angiogram. This test is often used to confirm the diagnosis in these cases.
Macular Pucker
The macula is the center-part of the retina that provides the best vision needed for reading and fine detail. Sometimes, scar tissue forms over the macula and causes wrinkling in the macula. These wrinkles cause both distortion and blurriness of the vision. The macula must lie flat against the back of your eye to work properly. When the macula wrinkles or bulges, your central vision is affected. With a macular pucker, things can look wavy, or you may have trouble seeing details. You might notice a gray or cloudy area in your central vision. You may even have a blank spot in your central vision. Macular pucker will not affect your peripheral (side) vision.
Macular Degneration
Macular degeneration is one of the leading causes of blindness in older Americans. There are two types: dry macular degeneration and wet macular degeneration. Dry macular degeneration is diagnosed when drusen (deposits) accumulate under the retina. This causes the vision to dim or be distorted. Most people notice this more when they read. In the advanced stages the loss of the central vision can occur. Sometimes, drusen can lead to the development of new blood vessels under the retina. These new blood vessels leak fluid and blood under the retina. If this leakage occurs in the center of the retina, or macula, our vision becomes blurry, this is known as wet macular degeneration.
Diabetic Retinopathy
Diabetic retinopathy occurs when the blood vessels in the back of the eye become weakened and damaged, causing swelling or leakage of blood in the eye. There are two types: nonproliferative and proliferative. Non-proliferative Diabetic Retinopathy is caused by fluid from the blood vessels in the Retina leaking into the macula, causing it to swell. This can lead to blurry or cloudy vision. In its more advanced stages, Proliferative Diabetic Retinopathy (PDR) sets in and new blood vessels can form in the Retina. These irregular blood vessels can cause damage by leaking blood into the vitreous. If untreated, PDR can possibly lead to retinal detachment and even glaucoma.
Floaters
The vitreous is a jelly-like substance that adheres to the retina. As we get older, the vitreous shrinks in size and pulls away from the retina. We call this a posterior vitreous detachment. This shrinkage of the vitreous can cause flashes of light and floaters. Sometimes, the vitreous pulls too hard on the retina and causes a tear in the retina. A retinal tear can lead to a retinal detachment.
Retinal Detachment
Retinal detachment describes an emergency situation in which a thin layer of tissue (the retina) at the back of the eye pulls away from its normal position. A retinal detachment, itself, is painless. But warning signs almost always appear before it occurs or has advanced, such as:
- The sudden appearance of many floaters — tiny specks that seem to drift through your field of vision
- Flashes of light in one or both eyes
- Blurred vision
- Gradually-reduced side (peripheral) vision
- A curtain-like shadow over your visual field
