Treating your Retinal Conditions

MACULAR DEGENERATION & DIABETIC RETINOPATHY

Retinal conditions can affect the retina (including the macula) and the vitreous – some of the main conditions are mentioned below:

Retinal vein occlusion: This occurs when the veins in the retina are blocked and the build-up of pressure causes smaller downstream blood vessels to leak. The blockage can occur in a branch vein with vision loss restricted to part of the visual field (branch vein retinal occlusion) or a central vein with the entire visual field affected (central vein retinal occlusion).

Retinal detachment: A retinal detachment is a serious condition in which the retina lining the back of the eye separates from the wall of the eye. If not treated, it can lead to permanent blindness. Surgery under local anaesthesia is needed to reattach the retina.

Retinal tears: A retinal tear is not usually as serious as a retinal detachment, but it can develop into a retinal detachment if untreated. Retinal laser treatment is an effective treatment for retinal tears.

Macular hole: A macular hole is a small tear in the macula that usually forms gradually. The first sign is usually distortion of central vision. A vitrectomy may be recommended.

Retinitis pigmentosa: This is the name for a range of genetic diseases that damage the retinal rod and/or cone cells (photoreceptors), causing vision loss. Unfortunately, there is no known treatment. An ophthalmologist can give you advice on what to expect and how to manage the disease.

Epiretinal membrane: Also known as macular pucker, epiretinal membrane occurs when a thin sheet of scar-like tissue grows on the surface of the macula and interferes with central vision. Your doctor will monitor progression using an OCT scan and fluorescein angiogram. Vitrectomy may be recommended.

Eye floaters: Specks or smudges that float around your field of vision, caused by the degeneration of the clear, jelly-like fluid that fills your eye (the vitreous). Most floaters are harmless, but they may also be a sign of more serious retinal conditions. New floaters should always be checked by an eye specialist. Laser treatment or vitrectomy surgery can be performed for severe floaters if they are affecting your quality of life.

Symptoms

These will vary depending on the exact condition, for example:

  • Sudden loss of vision (retinal vein occlusion, diabetic retinopathy)
  • Flashing lights (retinal detachment, retinal tear)
  • Shadow-like objects in your field of view (retinal detachment, diabetic retinopathy)
  • Blurring or distortion of central vision (epiretinal membrane, macular degeneration)
  • Tunnel vision (retinitis pigmentosa)

WHY IS THE RETINA SO IMPORTANT? ASK YOUR EYE EXPERT AT SMARTVISION

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Diagnosing Retinal Conditions

The examination usually begins with an ophthalmoscope to look inside the eye and directly visualise the back of the eye. This requires your pupils to be dilated using eye drops. It’s important to note that your eyes will remain dilated for approximately 4 to 6 hours and your vision will be blurry, meaning that you may not be able to drive home – please make other arrangements.

After dilating your pupils, your ophthalmologist may use a special condensing lens and a bright light, usually mounted on their forehead, to evaluate the retina, the optic nerve and tiny blood vessels. A retinal tear or retinal detachment can often be detected during this type of examination.

Other tests may be necessary to assess the severity of your condition, diagnose other retinal conditions and guide treatment.

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DIABETIC RETINOPATHY IS ONE OF THE LEADING CAUSE OF BLINDNESS

TREATING RETINAL CONDITIONS

Retinal laser treatment

The two most common diseases treated with laser are retinal tears (to seal the retinal layers together) and diabetic retinopathy (to stop leakage from small blood vessels that cause swelling or stop new blood vessels from growing).

Laser treatment aims to lower the risk of further vision loss – it is unlikely that lost vision will be recovered.

Vitrectomy

A vitrectomy involves removing the vitreous gel (the clear, jelly-like fluid inside your eye) using keyhole surgery so that stitches are not needed. It is performed in the day surgery – the procedure itself usually takes around 30 to 45 minutes.

Eye injections

These injections are also called intravitreal injections. They are administered in the clinic or day surgery. The eye is numbed with a local anaesthetic to stop any pain. Ongoing treatment is often necessary for many of the disorders.

EARLY DIAGNOSIS AND TREATMENT CAN PREVENT VISION-LOSS