Retinal Disorders &
Retinal Procedures
Vitreous Detachment and Retinal Tears
Between the lens and the retina a clear jelly, known as the vitreous
body, maintains the shape of the eyeball. As a person ages, the vitreous
gradually becomes more watery and may pull away from the retina. As many
as half of all people experience this condition by the age of 50, although
most are unaware of it. A tear in the retina can occur during vitreous
detachment and is characterized by light flashes in the field of vision
at the onset of the condition, possibly progressing to spots and webs
which may gradually clear with a remaining ring-shaped floater as a continuing
annoyance.
Preventive measures are 95 percent effective; however, retinal tears
may be successfully treated by laser or cryosurgery which are both done
on an outpatient basis. Following surgery, the majority of people can
resume their normal life style with restrictions on only extreme activities.
For more information, visit the Lucentis website here.
Retinal Detachment
If you were to load film incorrectly into a camera, you would be unable
to get a good photograph. In a similar way, if the retina is not properly
positioned in the back of the eye, vision is lost. This problem occurs
with retinal detachment, in which the retina is pulled away from the back
of the eye by trauma, or more commonly, vitreous detachment. When the
retina is pulled away from the choroid, the system of blood vessels covering
the outer surface of the retina, it is deprived of nourishment and loss
of vision results.
The warning signs of retinal detachment are the appearance of flashes
of white light at the perimeter of the field of vision and the onset of
tiny floaters. Laser treatment or cryotherapy may be done at these initial
signs to avoid the more serious effects of retinal detachment. As retinal
detachment progresses, a curtain starts in the peripheral viewing field
and spreads toward the center of vision. By this time, laser or cryotherapy
treatment is no longer effective and major surgery must be performed.
The type of surgery employed depends upon the number, location
and extent of the retinal tears:
The goal of each of these, in combination with laser treatment or cryotherapy,
is to close the retinal tears, which if done, will restore the retina
to its proper position.
The recovery period usually consists of a hospital stay of a day or two
beyond surgery followed by a rapid return to normal lifestyle with some
restrictions on activity within the first couple of weeks. Eye glasses
may need to be changed; however, this is postponed for six to eight weeks
following surgery to allow the retina and vitreous body to settle in for
accurate testing.
Surgery is successful for more than 90 percent of all retinal detachment
cases. However, on a rare occasion a condition called "proliferative
vitreoretinopathy" may call for additional surgery. Retinal detachment
was once an incurable problem, but thanks to the vast improvement in surgical
procedures over the past 20 years, it may be successfully treated in the
majority of cases.
Macular Holes
The macula is the small central area of the retina responsible for our
clear direct vision, while the remainder of the retina is used for side
or peripheral vision. The vitreous body is a transparent jelly which fills
the space between the lens and the retina and maintains the shape of the
eyeball. A macular hole is frequently caused when the vitreous gel separates
from the retina, a condition which occurs most commonly as a person ages,
although, in some cases, persistent vitreous forces upon the retina can
cause a macular hole without the actual separation of the two.
Among the symptoms of a macular hole, or an impending macular hole, is
distorted vision. A straight line will look bent or wavy; signs may appear
to have letters missing. The center of an image may appear to be blurry
while the perimeter is clear. A fully developed macular hole can result
in "legal blindness."
The presence of a macular hole may be determined during a complete eye
exam along with the use of a fluorescein angiography, a test using yellow
dye so that macular holes may be revealed photographically. Once diagnosed,
they may be surgically treated. Depending upon the patient's general physical
condition, medical history and the condition of the eye, the vitrectomy
surgery may be performed under general or local anesthesia. For most patients,
some activity is restricted for the first few days after surgery, with
approximately a two-week period before returning to work.
What is Macular Degeneration?
Macular degeneration is a deterioration or breakdown of the macula. The
macula is a small area in the retina at the back of the eye that allows
you to see fine details clearly and perform activities such as reading
and driving. When the macula does not function correctly, your central
vision can be affected by blurriness, dark areas or distortion. Macular
degeneration affects your ability to see near or far, and can make some
activities - like threading a needle or reading - difficult or impossible.
Although macular degeneration reduces vision in the central part of the
retina, it does not affect the eye's side, or peripheral, vision. For
example, you could see the outline of a clock but not be able to tell
what time it is.
Macular degeneration alone does not result in total blindness. Even in
more advanced cases, people continue to have some useful vision and are
often able to take care of themselves. In many cases, macular degeneration's
impact on your vision can be minimal.
What Causes Macular Degeneration?
Many older people develop macular degeneration as part of the body's
natural aging process. There are different kinds of macular problems,
but the most common is age-related macular degeneration (AMD). Exactly
why it develops is not known, and no treatment has been uniformly effective.
Macular degeneration is the leading cause of severe vision loss in Caucasians
over 65.
The two most common types of AMD are "dry" (atrophic) and
"wet" (exudative):
"Dry" Macular Degeneration (Atrophic) - Most
people have the "dry" form of AMD. It is caused by aging and
thinning of the tissues of the macula. Vision loss is usually gradual.
"Wet" Macular Degeneration (Exudative) - The
"wet" form of macular degeneration accounts for about 10% of
all AMD cases. It results when abnormal blood vessels form underneath
the retina at the back of the eye. These new blood vessels leak fluid
or blood and blur central vision. Vision loss may be rapid and severe.
Although not as common, it accounts for 90% of all blindness. Some cases
are treatable with laser surgery, which is done in the doctor's office
after which the patient would return for follow-up exams.
What Are The Symptoms Of Macular Degeneration?
Macular degeneration can cause different symptoms in different people.
The condition may be hardly noticeable in its early stages. Sometimes
only one eye loses vision while the other eye continues to see well for
many years.
But when both eyes are affected, the loss of central vision may be noticed
more quickly. Following are some common ways vision loss is detected:
-
Words on a page look blurred;
-
A dark or empty area appears in the center of vision;
-
-Straight lines look distorted.
How Is Macular Degeneration Diagnosed?
Many people do not realize that they have a macular problem until blurred
vision becomes obvious. Your ophthalmologist (eye M.D.) can detect early
stages of AMD during a medical examination that includes the following:
-
A simple vision test in which you look at a chart (Amsler grid);
-
Viewing the macula with an ophthalmoscope;
-
Taking special photographs of the eye called fluorescein angiographs
to find abnormal blood vessels under the retina.
Age is the greatest risk factor, but the following groups of people have
been found to be more likely to get AMD: women, whites, smokers and those
whose immediate family members have had AMD.
The most important thing you can do to protect your vision is to have
your eyes examined by an eye care professional at least once a year, particularly
if you are age 60 or older.
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For Post-op Instructions
To Learn More About Our Vitreo-Retinal Disorder Specialist:
Jaime Jiménez, M.D.
If you are considering a Retinal Procedure
in Hattiesburg or the surrounding Mississippi
area, please call 601-264-EYES or email
us today.
(601)264-3937
1420 S. 28th Ave
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