Our retina team is experienced in treating vitreoretinal diseases including diabetic retinopathy, macular degeneration, retinal detachment, macular hole and other vitreoretinal disorders.
Diabetes is a disease that occurs when the pancreas does not secrete enough insulin or the body is unable to process it properly. Insulin is the hormone that regulates the level of sugar (glucose) in the blood. Diabetes can affect children and adults.
Patients with diabetes are more likely to develop eye problems such as cataracts and glaucoma, but the effect of the disease on the retina is the main threat to vision. Most patients develop diabetic changes in the retina after approximately 10 years. The effect of diabetes on the eye is called diabetic retinopathy.
Over time, diabetes can cause damage to the blood vessels in the back of the eye. This damage is called diabetic retinopathy. The effect of diabetic retinopathy on vision varies widely, depending on the stage of the disease. Some common symptoms of diabetic retinopathy are: blurred vision (this is often linked to blood sugar levels), floaters and flashes, and sudden loss of vision.
The treatment for diabetic retinopathy depends on the stage of the disease and the specific problem that requires attention. The retina specialist monitors the progression of the disease based on diagnostic testing and observation in order to make decisions for the appropriate treatment. The most common treatments for diabetic retinopathy are anti-vascular endothelial growth factor inhibitors, or anti-VEGF medications. These medications are injected directly into the eye to stop the formation of abnormal blood vessels and leakage. Injectable steroids can also be effective in the treatment of diabetic retinopathy.
Macular degeneration (AMD) is a degenerative condition of the macula (the central retina). It is the most common cause of vision loss in the United States in those 50 or older, and its prevalence increases with age. AMD is caused by hardening of the arteries that nourish the retina. This deprives the sensitive retinal tissue of oxygen and nutrients that it needs to function and thrive. As a result, the central vision deteriorates.
Macular degeneration varies widely in severity. In the worst cases, it causes a complete loss of central vision, making reading or driving impossible. For others, it may only cause slight distortion. Fortunately, macular degeneration does not cause total blindness since it does not affect the peripheral vision.
AMD is classified as either wet (neovascular) or dry (non-neovascular). About 10% of patients who suffer from macular degeneration have wet AMD. This type occurs when new vessels form to improve the blood supply to oxygen-deprived retinal tissue. However, the new vessels are very delicate and break easily, causing bleeding and damage to surrounding tissue.
Anti-VEGF medications are the most widely used treatment for wet (bleeding) macular degeneration. These medicines are injected into the eye in order to help stop blood vessel growth and bleeding. Certain nutritional supplements have been shown to be beneficial for dry macular degeneration when other treatments are not appropriate.
A retinal detachment occurs when the retina’s sensory and pigment layers separate. Retinal detachment is considered an ocular emergency that requires immediate medical attention and surgery because it can cause devastating damage to the vision if left untreated. It is a problem that occurs most frequently in the middle-aged and elderly.
There are three types of retinal detachments. The most common type occurs when there is a break in the sensory layer of the retina, and fluid seeps underneath, causing the layers of the retina to separate. Those who are very nearsighted, have undergone eye surgery, or have experienced a serious eye injury are at greater risk for this type of detachment. Nearsighted people are more susceptible because their eyes are longer than average from front to back, causing the retina to be thinner and more fragile. The second most common type occurs when strands of vitreous or scar tissue create traction on the retina, pulling it loose. Patients with diabetes are more likely to experience this type. The third type happens when fluid collects underneath the layers of the retina, causing it to separate from the back wall of the eye. This type usually occurs in conjunction with another disease affecting the eye that causes swelling or bleeding.
Symptoms of retinal detachment include: a veil or curtain moving across the field of vision; shadowing in the peripheral vision; shower of floaters that resemble spots, bugs or spider webs; sudden decrease of vision; wavy or watery vision; and flashes of light.
There are a number of ways to treat retinal detachment. The appropriate treatment depends upon the type, severity and location of the detachment.
Early detection of retina conditions is crucial in successfully treating the problem. Awareness of the quality of your vision in each eye is extremely important, especially for those at an increased risk due to age or other health concerns.
Notify your doctor immediately if you notice any of the following:
Sudden or gradual loss of vision
An obstruction of your peripheral vision (veil, shadow, or curtain)
Sudden shower of floaters
Flashes of light
Distorted vision – straight lines such as a doorway or edge of a window appearing wavy or bent
The appearance of spots, bugs, or spider webs
Wavy or watery vision