Retina

What is the Retina?

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 to provide us with vision.

The risk for flashes increases with age. Because some people just expect to have poor vision as part of the aging process, they just accept it. But at The Eye Associates, we have the latest technology to give you the best vision possible for your eye and eye conditions. Our well trained and experienced eye doctors will give you a comprehensive dilated eye exam that can detect eye diseases so that if any disease is found, it can be treated as soon as possible.

What are Flashes?

When the vitreous gel is pulling on the retina, it can cause you to see flashes of light or lightning streaks. Often people will think that they are just seeing a light to the side of their head and not realize that it is actually inside their eye. This can sometimes indicate a serious problem and should be checked out immediately. Take note 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 one of our eye doctors immediately. The sooner the problem is discovered, the better the potential is for preventing vision loss.

What are Floaters? 

Floaters are tiny clumps of liquefied gel found in the vitreous, the jelly‐like substance that fills the inside of the eye. They generally appear as small specks, shadows or even cobwebs‐like images 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 or white background.

Causes of Floaters

Floaters can be a normal part of aging, as the vitreous gel tends to naturally liquefy, it can often form clumps or strands. They 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.

Risk Factors

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.

Treatment

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, they can become less noticeable with the passage of time. This may be because people become used to them by the brain learning to ignore them, or they may settle below the line of sight. Even if your floaters do become less noticeable, it’s important to have an eye examination when you experience any symptoms to rule out retinal tears and detachments.

Worried about Retinal Conditions?

If you have or are worried you have a Retinal Condition, please schedule an appointment with our board certified Retinal Specialists. 

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, pulls away from the retina as a natural process of aging. In most cases, no damage is caused and the majority of people have no symptoms. However, sometimes in certain patients the vitreous gel is very adherent to the retina and can actually take off a piece of the retina during this process causing a tear or even retinal detachment. 

What is the difference between a Retinal Tear and Retinal Detachment? 

Imagine the retina as your “wallpaper” that lines the back wall of your eye. If you get a break (retinal tear) in the wallpaper and the vitreous fluid is able to get through the hole, it has the potential to take the whole wallpaper off the wall (retinal detachment). When this occurs, vision can become blurry or distorted, and may eventually be lost completely.

Risk Factors

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 (lattice degeneration).

Warning Signs

Warning signs of a possible retinal detachment include an increased amount of floaters, flashing lights, and/or a black gray curtain moving across your field of vision.

Treatment

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.

Treatment of Retinal Tears

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 to help seal the “wallpaper”. On the other hand, using cryopexy, the retina is reattached by freezing the area around the hole to form scar tissue that also seals the “wallpaper” and prevents progression to a retinal detachment.

Treatment of Retinal Detachments

A retinal detachment requires treatment that is either done in the office or in the operating room. Pneumatic retinopexy is another method used for retinal detachment repairs in certain cases. In this procedure, a small gas bubble is injected inside 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 to close it so that no more fluid can enter through the retinal tear. The bubble is harmless and will eventually be absorbed into your body. This procedure is combined with either cryopexy and/or laser retinopexy. Each of these methods is typically an outpatient procedure, performed in your doctor’s office.

The standard treatment to repair a retinal detachment requires treatment in the operating room with a scleral buckle and/or a vitrectomy; both of which can be performed as an outpatient surgery. A scleral buckle is a tiny, flexible silicone band that is wrapped around the outside of the eye to gently push the retina back against the wall of the eye and give it support. 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. A gas or silicone oil bubble 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.

What to expect after treatment?

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 it was 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.

A retinal vein occlusion occurs when there is an abrupt blockage of the small veins that carry blood away from the retina. This usually occurs due to atherosclerosis (thickening) of retinal arteries that subsequently compress the vein as both vessels are inside the same sheath and run together. This blockage of blood flow is like having a “stroke” inside the eye. Damage to the retina includes bleeding, macular edema (swelling), and possibly new leaky blood vessel formation that can lead to blindness.

Risk Factors include:

  • Age
  • High Blood Pressure
  • Atherosclerosis (High Cholesterol)
  • Diabetes, and Glaucoma

Treatments

Treatments include a combination of eye medications (intravitreal ANTI-VEGF injections/implants, steroids) and laser therapy to treat macular edema and new blood vessel growth.

“I will work with patients to provide the optimal treatment strategy for their vision needs. I enjoy working with all our patients in a team approach in order to provide the highest quality of eyecare. I strive everyday to ensure all my patients achieve their best visual potential to enjoy their lives.” explains fellowship trained retina specialist Dr. Joshua Mali.

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