The retina is the delicate, light-sensitive tissue that covers the interior wall of the eye. Like the film of a camera, it receives images projected through the lens of the eye and sends these images to your brain through the optic nerve. When the retina is damaged in any way your vision becomes impaired. Damage to the retina may be caused by injury, illness or as a result of aging.
If you are experiencing vitreo-retinal problems you should consult with a specialist that focuses on diseases in the back of the eye such as macular degeneration, diabetic disease, retinal detachment, trauma and intraocular infection. Our vitreo-retinal specialist at Center For Sight in Naples, FL, Tanuj P. Banker, M.D., uses the newest state-of-the-art technology to diagnose and treat vitreo-retinal problems.
Macular Degeneration (Age-Related Macular Degeneration-AMD) is the breakdown or damage of the macula, the area of the eye that allows you to see fine details clearly and perform activities such as reading and driving. AMD usually does not affect the eyes side or peripheral vision.
There are two forms of AMD:
- “Dry” macular degeneration involves degeneration of the pigment cells under the macula, these cells are vital to the retina so when the cells are lost the overlying retina stops functioning and blind spots may occur. Sometimes abnormal substances called drusen can accumulate under the macula in dry form of macular degeneration and can cause distortion and blind spots.
- “Wet” macular degeneration has abnormal blood vessel growth under the macula which can cause swelling and or bleeding. The vision loss with the wet form of macular degeneration is usually more rapid and severe then the dry form.
Symptoms: words on a page look blurred, a dark or empty area appears in the center of vision or straight lines look distorted
Causes: rarer forms of macular degeneration can occur in younger people and can be inherited or associated with trauma, infections or systemic disease
- Acuity test – Measures the accuracy of your central vision at specific distances
- Amsler Grid test – Checks for blind spots, loss of sight and distortion
- Color Testing – Determines the status of your cone cells which are the cells located in the macula and are the retinal cells that interpret color
- Fluorescein Angiogram test – Identifies new blood vessel growth and leakage from blood vessels
- The Thermal laser was the first treatment used to treat wet macular degeneration and is still occasionally used today.
- Photodynamic Therapy (PDT) uses a low intensity laser to stimulate a light sensitive drug that is injected intravenously to cause shrinking of abnormal blood vessels of the macula.
- Anti-VEGF Injections are the newest treatment involving a series of injections of a small quantity of drugs into the eye. These drugs block chemicals that allow the abnormal blood vessels to grow. Treatment for wet macular degeneration can involve combining these types of treatments and the treatments may take several months to complete.
Macula Pucker is when wrinkles, creases or bulges form in the macula.
Symptoms: Blurred central vision, distorted or “wavy” vision, difficulty reading or performing tasks that require detail vision, gray and/or cloudy area in the central vision.
Causes: As the vitreous begins to pull away from the retina, scar tissue may develop on the macula. The scar tissue may warp and contract, causing the retina to wrinkle or bulge.
- For mild symptoms, no treatment may be necessary but if there is significant vision loss, vitrectomy surgery is recommended to remove scar tissue.
Macula Hole occurs when the shrinking vitreous gel adheres to the macula. This causes the macular tissue to stretch and after several weeks or months the macula tears forming a hole.
Symptoms: in the early stages, your central vision becomes blurred and distorted. As the hole progresses, a blind spot develops in your central vision and impairs the ability to see at both distant and close ranges.
- Vitrectomy surgery is the most effective treatment to repair a macular hole and possibly improve vision; the surgery causes the macular hole to close, allowing the eye to slowly regain part of the lost sight.
Common Vitreo-Retinal Problems
Diabetic Retinopathy occurs when diabetes damages blood vessels inside your eye, which can lead to blurry, distorted vision and blindness.
Symptoms: Blurry, darkened or cloudy vision, seeing floaters or black lines
Risk factors: High blood pressure, smoking and high cholesterol
- Laser photocoagulation to control leaking capillaries and prevent growth of new capillaries, vitrectomy to remove cloudy vitreous and scar tissue and cryotherapy to shrink capillaries and repair the retina
- Regular eye exams, diet, medications, exercise regularly, control your blood sugar and pressure and avoid alcohol and cigarettes
Posterior Vitreous Detachment (PVD)
PVD occurs when the liquefaction continues until the vitreous separates from the retina to which it is loosely attached. The vast majority of PVDs do not cause problems except annoying floaters and sometimes flashes. Improvement is usually seen within a few months. There is a small chance that a PVD can cause a retinal tear. Retinal tears can lead to a detached retina if the retina tear is not treated. There is no way to tell if a PVD caused a retinal tear so if someone has symptoms of a PVD they need a prompt dilated retinal exam.
Anyone can have a tear or detachment but there are factors for those most at risk, which include family history of vitreo-retinal problems, age, cardiovascular disease or diabetes, nearsightedness, previous eye surgery or trauma to the eye.
Causes for Tears and Detachments: As you age, the vitreous gel in your eye liquefies and shrinks, causing the retina to tear or detach. Certain diseases or trauma to the eye can cause scar tissue to form and pull on the retina. If not treated promptly, retinal problems can lead to permanent vision loss.
- Flashing lights
- New floaters
- A shadow in the periphery of your field of vision
- A gray curtain moving across your field of vision