“Our vision and eye health are of the utmost importance, and any symptom of retinal disease should be taken seriously. If you suffer from complete or partial vision loss, you should seek treatment immediately. Blurred or distorted vision or the appearance of frequent, severe or chronic floating spots are also causes. For eye examination. ” Dr. Avi Ohayon, an ophthalmologist who specializes in retinal, vitreous and cataract surgery, tells us.
Dr. Ohayon goes on to explain some of the most common conditions and diseases of the retina, their symptoms and possible treatments.
Retinal degeneration, also known as age-related macular degeneration (AMD), is a condition that commonly occurs in people over the age of 50. It reduces the ability to see in the macula (center of the retina), which is responsible for high resolution and color vision, by damaging light receptors. The condition can affect one or both eyes.
Symptoms of macular degeneration include a number of changes in vision. The patient may see a distorted image, for example straight lines that look curved. The patient may have difficulty reading due to blurring or difficulty adjusting to a change in light levels. A very distinct symptom is the presence of a blurred or blind spot in the patient’s visual center.
There are two types of AMD, dry and wet. In dry AMD there is no fluid below the retina, and vision deterioration is very slow. Wet AMD is the active form of the disease in which sub retinal fluids form, as well as hemorrhages that require intraocular injections for years to “dry out the fluids” and to maintain vision stability or prevent further deterioration.
Treatment of dry or final macular degeneration can include rehabilitation for impaired vision. Because the condition usually does not lead to complete blindness, patients can learn to live with it. In severe or cases with macular degeneration in both eyes, a telescopic lens can be implanted in the eye to increase the field of vision.
Diabetic retinopathy is a complication of diabetes that affects the blood vessels within the eye. These tiny blood vessels can be blocked by excess blood sugar, and cut off the blood supply. This eventually causes the growth of abnormal new blood vessels to compensate for the lack of oxygen, which can lead to vitreous hemorrhage, retinal detachment, stretching and increased pressure within the eye (neovascular glaucoma). Another complication in threatening vision can be macular edema that involves fluid accumulation in the macular area.
The condition affects vision to varying degrees. Patients may experience complete vision loss or lose vision only in certain areas. They may also experience blurred or altered vision. Floating spots or strings in your vision can be another symptom of the condition.
Patients with diabetes are advised to have an eye exam every year, even if there are no symptoms. Early cases will usually require close monitoring while strictly balancing the diabetes. In advanced cases, treatments can include injections into the eye to treat macular edema, a laser treatment called photocagulation PRP, or vitrectomy (vitreous resection), cleansing of vitreous hemorrhage and peeling of scar tissue from the retina.
Retinal detachment is a condition in which the retina, the thin layer of tissue in the back of the eye that is responsible for absorbing light, detaches from the wall of the eye. This condition disconnects the retina from the blood vessels that supply it, which can quickly lead to permanent vision loss. Anyone who has experienced retinal detachment symptoms should seek emergency medical attention.
Retinal detachment is not expected to occur suddenly, and symptoms usually appear early and worsen over time, however, patients are usually unaware of these symptoms because of the other eye functioning better, hence reaching the ophthalmologist when the retina is already separated. Symptoms may include flashes of light, blurred central vision, sudden appearance of multiple skimmers or blackheads, a gradual reduction in peripheral vision or shadow across the field of vision.
There are several treatments for reattaching the retina to its place. Injecting a gas bubble into the eye to pin the retina back in place with the addition of a cryo or laser treatment. Another treatment option is a girdle surgery in which a silicone belt is fastened around the eyeball in order to attach the retina by bringing the wall of the eye closer to the retina itself. Another surgical option is vitrectomy in which the vitreous is removed from the eye cavity to release the vitreous strokes that caused the rupture and then attach the retina and use laser to solder and strengthen the retina and at the end of the surgery fill the eye with another material (gas or silicone oil) to keep the retina tight.
An epiretinal membrane is a membrane formed on the surface of the retina, which shrinks and causes distortion and thickening of the center of the retina (the macula) and can cause blurring and distortion of vision. The condition is more common in people in old age, with most cases occurring in people over the age of 50.
Patients with an epiretinal membrane may experience distorted or blurred vision. They can have wavy vision, for example straight lines that look curved. Over time patients will have difficulty reading more and more, and decreased central vision may lead to difficulty in many daily activities.
The only effective treatment for the epiretinal membrane is surgical removal of the membrane. This involves vitrectomy surgery to remove the vitreous in the eye cavity, after which the surgeon carefully peels off and removes the epithelial membrane. It is important to know that there may be only a partial improvement in visual distortion and the improvement can take months and all this depends on various parameters on the part of the patient.
A macular hole is actually a hole formed in the center of the retina, the macula, the area responsible for visual acuity at the highest resolution. This condition causes a severe decrease in vision that can only be rehabilitated surgically.
The macular hole is caused by tension forces across the retina. The surgery involves vitrectomy surgery with removal of the vitreous and eliminating all tension forces over the macula and central hole by peeling membranes and eventually leaving gas inside the eye for several weeks.
After surgery, the patient should remain in the head position for about one week to increase the chances of the hole closing. Once the hole is closed, the healing process may take several months until vision improves. It is important to remember that sometimes it is not possible to achieve an improvement in vision for baseline vision or 6/6 vision after the hole is closed.
To maintain the health of your eye, it is important to perform periodic checkups. Your next eye exam can detect signs of retinal disease and allow for more proactive treatment. This reduces the chance of permanent vision loss or other complications. Even those without vision problems or risk metrics should seek eye examination at least once every two years.