The Retina akin to a film in a camera, the most vital tissue in the Eye, receives the images focused by the cornea and the lens and transmits the images along the optic Nerve, to the brain for processing and perception.
Retinal diseases vary widely, but most of them cause visual symptoms. Retinal diseases can affect any part of the retina.
The retina contains millions of light-sensitive cells (rods and cones) and other nerve cells that receive and organize visual information. The retina sends this information to the brain through the optic nerve, enabling one to see.
Treatment is available for some retinal diseases. Depending on the condition, treatment goals may be to stop or slow the disease and preserve, improve or restore vision. Untreated, some retinal diseases can cause severe vision loss or blindness.
Vitreoretinal surgery refers to any operation to treat eye problems involving the retina, macula, and vitreous fluid. These include retinal detachment, macular hole, epiretinal membrane and complications related to diabetic retinopathy. The purpose of vitreoretinal surgery is to restore, preserve and improve vision for a wide range of conditions.
Common Retinal Diseases
Retinal tear. A retinal tear occurs when the clear, gel-like substance in the center of the eye (vitreous) shrinks and tugs on the thin layer of tissue lining the back of the eye (retina) with enough traction to cause a break in the tissue. It’s often accompanied by the sudden onset of symptoms such as floaters and flashing lights.
Retinal detachment. A retinal detachment is defined by the presence of fluid under the retina. This usually occurs when fluid passes through a retinal tear, causing the retina to lift away from the underlying tissue layers.
Diabetic retinopathy. In the case of diabetics, the tiny blood vessels (capillaries) in the back of the eye can deteriorate and leak fluid into and under the retina. This causes the retina to swell, which may blur or distort vision. Additionally, new, abnormal capillaries may develop that break and bleed. This also worsens vision.
Epiretinal membrane. Epiretinal membrane is a delicate tissue-like scar or membrane that looks like crinkled cellophane lying on top of the retina. This membrane pulls up on the retina, which distorts vision. Objects may appear blurred or crooked.
Macular hole. A macular hole is a small defect in the center of the retina at the back of the eye (macula). The hole may develop from abnormal traction between the retina and the vitreous, or it may follow an injury to the eye.
Macular degeneration. In macular degeneration, the center of the retina begins to deteriorate. This causes symptoms such as blurred central vision or a blind spot in the center of the visual field. There are two types — wet macular degeneration and dry macular degeneration. Many people will first have the dry form, which can progress to the wet form in one or both eyes.
Retinitis pigmentosa. Retinitis pigmentosa is an inherited degenerative disease. It slowly affects the retina and causes loss of night and side vision.
Symptoms
Many retinal diseases share some common signs and symptoms. These may include:
- Seeing floating specks or cobwebs
- Blurred or distorted (straight lines look wavy) vision
- Defects in the side vision
- Lost vision
Risk factors
Risk factors for retinal diseases might include:
- Aging
- Smoking
- Being obese
- Having diabetes or other diseases
- Eye trauma
- A family history of retinal diseases
Diagnosis
The following tests may be done to determine the location and extent of the disease:
Amsler grid test. The Amsler grid to test is done to get clarity of the central vision. Patients with macular degenerationmay be asked to use this test to self-monitor the condition at home.
Optical coherence tomography (OCT). This test is an excellent technique for capturing precise images of the retina to diagnose epiretinal membranes, macular holes and macular swelling (edema), to monitor the extent of age-related wet macular degeneration, and to monitor responses to treatment.
Fundus autofluorescence (FAF). FAF may be used to determine the advancement of retinal diseases, including macular degeneration. FAF highlights a retinal pigment (lipofuscin) that increases with retinal damage or dysfunction
Fluorescein angiography.This test uses a dye that causes blood vessels in the retina to stand out under a special light. This helps to exactly identify closed blood vessels, leaking blood vessels, new abnormal blood vessels and subtle changes in the back of the eye. The new generation equipment does away with the dye thus reducing the risk of contrast induced complications
B-Scan (Ultrasound).This test uses high-frequency sound waves (ultrasonography) to help view the retina and other structures in the eye. It can also identify certain tissue characteristics that can help in the diagnosis and treatment of eye tumors.
Treatment
The main goals of treatment are to stop or slow disease progression and preserve, improve or restore vision. In many cases, damage that has already occurred can’t be reversed, making early detection important..
Treatment of retinal disease may be complex and sometimes urgent. Options include:
Using a laser. Laser surgery can repair a retinal tear or hole. The surgeon uses a laser to heat small pinpoints on the retina. This creates scarring that usually binds (welds) the retina to the underlying tissue. Immediate laser treatment of a new retinal tear can decrease the chance of it causing a retinal detachment.
Shrinking abnormal blood vessels. The Ophthalmologist may use a technique called scatter laser photocoagulation to shrink abnormal new blood vessels that are bleeding or threatening to bleed into the eye. This treatment may help people with diabetic retinopathy. Extensive use of this treatment may cause the loss of some side (peripheral) or night vision.
Freezing. In this process, called cryopexy (KRY-o-pek-see), the surgeon applies a freezing probe to the external wall of the eye to treat a retinal tear. Intense cold reaches the inside of the eye and freezes the retina. The treated area will later scar and secure the retina to the eye wall.
Injecting air or gas into the eye. This technique, called pneumatic retinopexy (RET-ih-no-pek-see), is used to help repair certain types of retinal detachment. It can be used in combination with cryopexy or laser photocoagulation.
Indenting the surface of your eye. This surgery, called scleral (SKLAIR-ul) buckling, is used to repair a retinal detachment. The surgeon sews a small piece of silicone material to the outside eye surface (sclera). This indents the sclera and relieves some of the force caused by the vitreous tugging on the retina and reattaches the retina. This technique may be used with other treatments.
Evacuating and replacing the fluid in the eye. In this procedure, called vitrectomy, the surgeon removes the gel-like fluid that fills the inside of the eye (vitreous). He or she then injects air, gas or liquid into the space.
Vitrectomy may be used if bleeding or inflammation clouds the vitreous and obstructs the surgeon’s view of the retina. This technique may be part of the treatment for people with a retinal tear, diabetic retinopathy, a macular hole, epiretinal membrane, an infection, eye trauma or a retinal detachment.
Injecting medicine into the eye. The doctor may suggest injecting medication into the vitreous in the eye. This technique may be effective in treating people with wet macular degeneration, diabetic retinopathy or broken blood vessels within the eye.
Treatment available at Sankara
Following Retinal procedures are available at Sankara:
- Intravitreal Injections
- Vitrectomy
- Retinal Cryopexy
- Scteral Buckle
- Vitrectomy+removal of dislocated lenses/IOL
- Vitrectomy + Gas/Silicon oil
- Vitrectomy+Lensectomy
- Vitrectomy+Membrane peel+Endolaser+Silicon Oil/Gas
- Silicon Oil removal
- Intravireal Antobiotics
- Combinations of some of the above