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Retina/Vitreous and Diabetic Eye Care

The retina is a structure inside of your eye that functions like the film of a camera. The retina receives images and transmits them to the optic nerve and then to your brain. The retina is a layer that can be affected by multiple diseases but the most common are described below.

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 have had cataract surgery.

Retinal detachments can lead to visual impairment and even loss of vision. Early diagnosis and treatment can help you to decrease the chance of visual loss. Tears or holes in your retina cause most retinal detachments.

As we age, there often is 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 your 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 your eye and causes the retina to detach.

Some of the common symptoms include:

  • Loss of peripheral and/or central vision
  • Flashing lights and floaters

If you notice symptoms of a retinal detachment, you need to have a thorough retinal evaluation.

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. About 80 percent to 85 percent of all retinal detachments can be reattached by modern surgical techniques.

Definitions of retinal detachment correction procedures:

Pneumatic retinopexy: a gas bubble is injected into the eye vitreous cavity

Scleral buckling: a silicone band is wrapped around the eye

Vitrectomy: cuts the vitreous away from the retina and removes the shrunken vitreous

Diabetes and Diabetic Retinopathy

Diabetes is a condition which impairs your body’s ability to use and store sugar. Diabetes can cause serious changes in the blood vessels throughout your body, including the eye. It can start without symptoms and it can get worse over time. If you are diabetic, you should keep your blood sugar under control, learn about your eyes, have eye exams regularly and follow your doctor’s treatment plan.

What is diabetic retinopathy?
Diabetic retinopathy is when the blood vessels in your eye go through a series of changes. They can leak, close or bleed causing loss of vision. Swelling of your retina, bleeding in the vitreous jelly and retinal detachment also can occur and cause loss of vision.

Blurred vision can be a symptom of diabetic retinopathy, but sometimes you may 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 your eye. 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 if you 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

Macular degeneration is the leading cause of loss of vision among people over 65 in the United States and 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 loss of vision.

How is macular degeneration diagnosed?
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 your vision loss in some cases.