Retinal Conditions & Treatments
Diabetic Eye Care
Diabetes can affect eyesight, and if you have diabetes mellitus, your body does not use or store sugar properly. High blood sugar levels can damage blood vessels in the retina, the nerve layer at the back of your eye that senses light and helps to send images to the brain. The damage to retinal vessels is referred to as diabetic retinopathy. There are two types of diabetic retinopathy:
Non-proliferative Diabetic Retinopathy (NPDR)
NPDR is commonly known as background retinopathy and is an early stage of diabetic retinopathy. In this stage, tiny blood vessels within the retina leak blood or fluid. The leaking fluid causes the retina to swell or to form deposits called exudates.
Many people with diabetes have mild NPDR, which usually does not affect their vision. When vision is affected, it is a result of macular edema and/or macular ischemia. Macular edema is swelling or thickening of the macula (small area in the center of the retina that allows us to see fine details clearly). The swelling is caused by fluid leaking from retinal blood vessels. It is the most common cause of visual loss in diabetes and may be mild to severe. Even with mild cases, however, the peripheral vision continues to function. Macular Ischemia occurs when small vessels close. Vision blurs because the macula no longer receives sufficient blood supply to work properly.
Proliferative Diabetic Retinopathy (PDR)
PDR is present when abnormal new vessels (neovascularization) begin growing on the surface of the retina or optic nerve. The main cause of PDR is widespread closure of retinal blood vessels, preventing adequate blood flow. The retina responds by growing new blood vessels in an attempt to supply blood to the area where original vessels closed.
The new vessels are normally accompanied by scar tissue that may cause wrinkling or detachment of the retina. PDR may cause more severe visual loss than NPDR and affects both central and peripheral vision.
Your risk of vision loss is minimal when problems are detected at an early stage and patients maintain strict control of their blood sugar. Regular visits to your ophthalmologist are extremely important.
There are various forms of treatment depending on the severity and extent of the patient's diabetic eye condition. Our retinal specialist can help you understand these conditions and decide on possible plans of treatment.
The retina is a nerve layer at the back of your eye that senses light and sends images to your brain. You can think of the retina as the film that lines the back of a camera.
This disease occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred, like a camera picture would be if the film were loose inside a camera. If this is left untreated, blindness could occur.
The middle of the eye is filled with a clear gel, called the vitreous. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye. Normally, the vitreous separates from the retina without causing problems. At times, however, the vitreous pulls hard enough to tear the retina in one or more places.
Fluid may pass through the retinal tear, lifting the retina off the back of the eye, like wallpaper can pull off a wall.
The following conditions increase risk of retinal detachment.
- Previous cataract surgery
- Severe injury
- Previous retinal detachment in you other eye
- Family history of retinal detachment
- Weak areas in your retina that can be seen by your ophthalmologist
The following symptoms may indicate the presence of a retinal detachment:
- Flashing lights
- New floaters
- Gray curtain moving across your field of vision
These symptoms do not always mean a retinal detachment, but your ophthalmologist should see you as soon as possible.
Retinal tears need to be treated with laser surgery or cryotherapy (freezing), which seals the retina to the back wall of the eye. In some cases it can be observed without treatment. Almost all patients with retinal detachments require surgery to put the retina back in its proper position.
Our retinal specialist comes down from Wills Eye Hospital. He can help explain the various conditions, treatments, surgical procedures, benefits and risks involved. Call our office to schedule an appointment.
Some retinal conditions include retinal detachment, diabetic retinopathy and macular degeneration.
The macula is a part of the retina in the back of the eye that ensures that our central vision is clear and sharp. Age-related macular degeneration (AMD) occurs when the arteries that nourish the retina harden. Deprived of nutrients, the retinal tissues begin to weaken and die, causing vision loss. Patients may experience anything from a blurry, gray or distorted area to a blind spot in the center of vision.
Age-Related Macular Degeneration develops as a part of the body's natural aging process. There are two types of macular degeneration; Dry AMD (non-exudative, atrophic), which accounts for 90% of all cases and Wet AMD (exudative, neovascular disciform), which accounts for the remaining 10%. Wet AMD is an irreversible eye disorder that can lead to blindness. Early detection and close observation by a qualified ophthalmologist can offer some hope.
AMD is the number-one cause of vision loss in the U.S. Macular degeneration doesn't cause total blindness because it doesn't affect the peripheral vision. Possible risk factors include genetics, age, diet, smoking and sunlight exposure. Many people do not realize they have a macular problem until blurred vision becomes obvious. Your ophthalmologist can detect early stages of macular degeneration during a medical eye exam. Regular eye exams are highly recommended to detect macular degeneration early and prevent permanent vision loss.
Treatment varies depending on severity and many other factors. Treatments include but are not limited to laser therapy, photodynamic therapy and injections.