Katia E. Taba, MD, PhD, Fellowship Trained Retina Specialist
Todd Berger, MD, Fellowship Trained Retina Specialist
Jeffrey Kasper, MD, Fellowship Trained Retina Specialist
The retina is a light sensitive tissue lining the back of the inner eye, and it contains photoreceptors that capture light images. It then converts them into signals that travel through the optic nerve to the brain.
The following are some of the most common retinal conditions:
Floaters are tiny clumps of gel found in the vitreous, the jelly-like fluid that fills the inside of the eye. They generally appear as small specks, shadows or even cobweb-like in your line of sight. They randomly move in and out of your field of vision, and can be seen most clearly when looking at a plain background, such as a blue sky.
Causes of Floaters
Floaters can be a normal part of aging, as the vitreous gel tends to thicken, often forming clumps or strands. Floaters can be annoying, but they are usually harmless. However, occasionally they are an indication of a more serious condition. If you are experiencing either a sudden increase in the number of floaters or sudden flashes of light, you should see your eye doctor immediately. By dilating your eyes, your eye doctor can evaluate the retina and vitreous. The procedure is painless and non-invasive, and it is the only way to rule out that a serious, sight-threatening condition exists.
It is most likely to occur in individuals who have the following risk factors: age, nearsightedness, have had YAG laser surgery, have undergone cataract surgery, and/or have experienced an inflammation inside the eye.
It’s possible that floaters will fade over time, but it’s also possible that they will not. Although the gel clumps will always remain in your eyes, most people say that they becomes less noticeable over time. This may be because people become used to them or the floaters may settle below the line of sight. Even if floaters become less noticeable, it’s important to have an eye examination when you experience any of the symptoms related to floaters to rule out retinal tears and detachments.
Back to Top
Causes of Flashes
It’s common to see flashing lights or lightning streaks when the vitreous gel is pulling on the retina. It can sometimes indicate a serious problem if the flashing lights begin appearing frequently or are associated with sudden changes in vision. Watch for a "curtain" or "veil" that blocks a portion of your peripheral vision. If you are experiencing any of these symptoms, you should contact your eye doctor immediately. The sooner the problem is discovered, the better the potential is for preventing vision loss.
Back to Top
Normally, your retina lies smoothly against the inside back wall of the eyeball and functions similar to the film in the back of a camera. The vitreous, the jelly-like fluid that fills the inside of the eye, sometimes pulls away from the retina causing a tear or detachment from the retina. When the retina is pulled away from the back wall of the eye, vision can become blurry or distorted, and may eventually be lost completely.
Your chances of suffering a retinal detachment are increased if you have any of the following risk factors: age, nearsightedness; a history of intraocular surgery, including cataract surgery; glaucoma; severe trauma to the eye; a history of a retinal detachment in your other eye; family history of retinal detachment or weak areas in your retina.
Warning signs of a possible retinal detachment include an increased amount of floaters, flashing lights, and/or a gray curtain moving across your field of vision.
It is important that you seek treatment as soon as possible upon noticing any symptoms. The sooner the treatment occurs, the better the chances are for visual recovery.
The type of treatment that a doctor chooses and the degree of success is directly related to the amount of time lapsed since the detachment is discovered, the type of detachment, the severity, and the location.
Small holes and tears are usually treated with laser surgery, or a freezing method, called cryopexy. Laser surgery fuses the retina back into place by making tiny burns around the hole. On the other hand, using cryopexy, the retina is reattached by freezing the area around the hole. Pneumatic retinopexy is another method used for retinal tears. In this procedure, a small gas bubble is injected into the middle of the eye. The head is positioned in a way that the bubble floats to the detached area, and the retinal tear is pushed back up against the wall of the eye so that no more fluid can seep under it. The bubble is harmless and will eventually be absorbed into your body. Each of these methods is typically an outpatient procedure, performed in your doctor’s office.
An actual retinal detachment requires treatment with a scleral buckle or a vitrectomy; both of which may require an overnight stay in the hospital. A scleral buckle is a tiny, flexible band that is wrapped around the outside of the eye to gently push the retina back against the wall of the eye. A vitrectomy is sometimes performed in addition to placing the scleral buckle. In a vitrectomy procedure, the gel-like vitreous, which is tugging on the retina, is removed through a tiny incision in the eye. Gas is often injected into the eye to replace the lost fluid and to push the retina against the wall. During the course of healing, the body gradually replaces the vitreous with new fluid.
The improvement in vision after treatment can vary, depending on the severity of the detachment. The earlier the intervention, the better the prognosis for visual recovery. In some cases, vision may never return to the level before the detachment. In other cases, complete vision can be returned. However, the larger the detachment is, the less likely it is that you will be able to recover vision. That's why it is very important to see your eye doctor at the first sign of trouble.
If you are seeing any warning signs of a torn or detached retina, immediately call The Eye Associates at 941-792-2020 or Toll-free 1-866-865-2020.
Back to Top
Click here to view an animation about Diabetic Retinopathy
(Expect a short delay in loading.)
Diabetes affects your entire body, including your eyes. According to The American Academy of Ophthalmology, diabetics are 25 times more likely to lose vision than those without this disease. The most common complication of diabetes is diabetic retinopathy, and the longer you have diabetes, the more likely it is that you'll develop diabetic retinopathy.
High blood sugar levels, as associated with diabetes, often affect blood vessels in the retina of the eye, causing diabetic retinopathy. There are 2 stages of classifications of diabetic retinopathy: nonproliferative or proliferative.
Non-proliferative retinopathy, sometimes known as background diabetic retinopathy, is the most common form of the disease. This condition is first diagnosed when small retinal blood vessels start to swell. As the disease progresses, these blood vessels break and leak blood.
Proliferative retinopathy is the more advanced stage of diabetic retinopathy. As the condition progresses, more and more blood vessels are blocked. Sensing the need for new blood vessels to supply nourishment, new blood vessels grow, but they are frail and abnormal, often hemorrhaging and scarring. Patients with this type of diabetic retinopathy can experience severe vision loss, and even blindness.
At both the early and advanced stage, fluid can leak into the macula, the center of the retina that allows you to see fine detail. Known as macula edema, it is another common cause of vision loss in diabetics.
It is worth noting that smoking does accelerate the damaging effect that diabetes has on the retina. Several other influencing factors include your genes, your blood pressure levels, how long you have had diabetes and of course, your blood sugar level.
In the early and most treatable stages of diabetic retinopathy, there are usually no visual symptoms or pain. In fact, many times the disease can even progress to an advanced stage without any noticeable change in your vision.
Symptoms of diabetic retinopathy may include:
- Abnormal patterns in the field of vision
- Dark streaks in your vision
- Sudden onset of decreased vision
- Distorted central vision
- Red film that blocks vision
- Blind spots
- Poor night vision
- Items may have a blue-yellow color tone, interfering with color perception
We strongly recommend that all diabetics have yearly comprehensive medical eye exams. Your eye doctor will dilate your eyes and check your retina, blood vessels and optic nerves for changes. They may also order a fluorescein angiogram to track and photograph dye as it flows through the retina and its blood vessels to look for leaking blood vessels.
We also commonly perform an Optical Coherence Tomography (OCT) to assess fluid accumulation (macular edema) in the retina of diabetics. The OCT can show areas of retinal thickening and is often a useful tool in assessing a patient’s response to a treatment.
The most important tool for treating diabetic retinopathy is good management of the underlying diabetic condition. Nevertheless, once diabetic retinopathy has presented itself, there are several methods of treatment. Lasers are the mainstay; often used to treat the early stages of diabetic retinopathy by sealing leaking blood vessels. More advanced cases may require a vitrectomy, a surgical procedure needed when the vitreous, the gel in the eye, contains a great amount of blood.
The optimal time for treatment is before the patient experiences visual symptoms so early detection and treatment is the best protection against significant vision loss. Diabetic retinopathy can progress into its advanced stages with no pain, no recognizable vision loss, or other symptoms. That’s the reason it is so important for all diabetics to get a yearly comprehensive medical eye examination.
Please take time to educate yourself, and any loved ones with diabetes, on how to preserve their vision.
If you are diabetic and would like to schedule an appointment for a comprehensive medical exam at The Eye Associates, please call 941-792-2020.
Back to Top
Age-related macular degeneration (AMD) affects approximately 13 million people in the United States and is a major cause of severe vision loss in people age 65 and older. AMD occurs when there is a breakdown in the macula, the very center of the retina, which allows the eyes to see fine details clearly. It does not affect the peripheral vision, but it does affect both distance and close vision. Macular degeneration alone does not result in total blindness, but it does make many activities, such as reading a book or driving a car, difficult or even impossible to do.
Despite ongoing medical research, neither the cause nor a cure for AMD is known. Nor do researchers know why it affects some people and not others.
For more information on the causes, symptoms, and treatment of this disease, please visit our Macular Degeneration page.
Back to Top
by Katia Taba