| Felipe de Alba, MD
|Mark J. Daily, MD||Daniel Owens, MD||Nehali Saraiya, MD||Shivan Tekwani, MD|
|Susan Vierling, MD|
Detached and Torn Retina
Retinal detachments affect about one in 10,000 people. It typically happens to patients who are nearsighted, have a family history of retinal detachments, and after cataract surgery. Retinal detachments can lead to visual impairment and even loss of vision. Early diagnosis and treatment can help to decrease the chance of visual loss. Tears or holes in the retina cause most retinal detachments. As we age, there is often shrinkage of the vitreous body or the gel-like substance, which is in the center part of the eye. The vitreous is attached to the retina in several places around the back wall of the eye. As the vitreous shrinks, in some cases it can pull a piece of retina away with it, causing a hole or tear in the retina. Once this hole or tear occurs, fluid from the vitreous jelly can pass through the hole, in between the retina and the back of the eye. This separates the retina from the back of the eye and causes the retina to detach. Some of the common symptoms include loss of peripheral and/or central vision, along with flashing lights and floaters. If symptoms of a retinal detachment are noticed, a thorough retinal evaluation is necessary.
Most of the time retinal tears can be treated with laser and/or freezing. A retinal detachment typically requires surgery, which may include a procedure called a pneumatic retinopexy, a scleral buckle and/or a vitrectomy.
In pneumatic retinopexy, a gas bubble is injected into the eye vitreous cavity. In scleral buckling, a silicone band is wrapped around the eye. In some complex retinal detachments a vitrectomy can be done, which cuts the vitreous away from the retina and removes the shrunken vitreous. About 80% to 85% of all retinal detachments can be reattached by modern surgical techniques.
Diabetes and Diabetic Retinopathy
Diabetes mellitus is a condition which impairs the body’s ability to use and store sugar. Diabetes can cause serious changes in the blood vessels throughout the body, including the eye. It can start without symptoms and it can get worse over time. All diabetics should keep their blood sugar under control, learn about your eyes, have eye exams regularly, and follow their doctor’s treatment plan.
Diabetic retinopathy is one of the eye complications that diabetics can have. If you have diabetic retinopathy, the blood vessels in the eye go through a series of changes. The blood vessels can leak, close or bleed causing loss of vision. Swelling of the retina, bleeding in the vitreous jelly, and retinal detachment can also occur and cause loss of vision. Blurred vision can be a symptom of diabetic retinopathy, but sometimes patient have no symptoms of diabetic retinopathy. Diagnosing diabetic retinopathy is typically done with a dilated eye examination by your eye doctor.
Treatment of diabetic retinopathy can include laser surgery. The laser spots reduce abnormal blood vessel growth and help attach the retina to the back of the eye. Some patients may end up needing surgery. This treatment is used for bleeding into the vitreous or retinal detachments. If you are diabetic the best way to protect your eyesight from diabetic retinopathy is to detect the disease early on. Even when patients are asymptomatic, you should have eye examinations by your eye doctor once a year. Once you are diagnosed with diabetic retinopathy your follow up exams might be more frequent.
Macular degeneration is the leading cause of loss of vision among people over 65 in the United States. Macular degeneration can also affect younger patients. It is a process of wear and tear in the macula, which is the central part of the retina that gives us the fine detail vision. There are two types of macular degeneration – the dry type that causes a gradual loss of vision, and the wet type that causes a sudden of vision.
The diagnosis of macular degeneration is made with a full dilated eye examination.
The dry type of macular degeneration has no treatment, but vitamin supplements have shown in certain groups to slow the rate of visual loss. Also self-screening with a grid chart is helpful to detect subtle changes. For the wet type of macular degeneration, laser treatment is used to dry up leaking blood vessels and to prevent them from continuing to grow. Visual rehabilitation, low vision aids and/or magnifiers are very important to compensate for vision loss in some cases.
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