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Retina

Diabetic Retinopathy

Diabetes is a disease that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. When the blood vessels in the eyes are affected, this is called diabetic retinopathy.

The retina is in the back of the eye. It detects visual images and transmits them to the brain. Major blood vessels lie on the front portion of the retina. When these blood vessels are damaged due to diabetes, they may leak fluid or blood and grow scar tissue. This leakage affects the ability of the retina to detect and transmit images.

During the early stages of diabetic retinopathy, reading vision is typically not affected. However, when retinopathy becomes advanced, new blood vessels grow in the retina. These new vessels are the body’s attempt to overcome and replace the vessels that have been damaged by diabetes. However, these new vessels are not normal. They may bleed and cause the vision to become hazy, occasionally resulting in a complete loss of vision. The growth of abnormal blood vessels on the iris of the eye can lead to glaucoma. Diabetic retinopathy can also cause your body to form cataracts.

The new vessels also may damage the retina by forming scar tissue and pulling the retina away from its proper location. This is called retinal detachment and can lead to blindness if left untreated.

Symptoms Of Diabetic Retinopathy

  • There are usually no symptoms in the early stages of diabetic retinopathy
  • Floaters
  • Difficulty reading or doing close work
  • Double vision
  • If left untreated, severe vision loss can occur

Causes Of Diabetic Retinopathy

Diabetes

Everyone who has diabetes is at risk for developing diabetic retinopathy, but not everyone develops it. Changes in blood sugar levels increase the risk. Generally, diabetics don’t develop diabetic retinopathy until they’ve had diabetes for at least 10 years.

You Can Reduce Your Risk Of Developing Diabetic Retinopathy By

  • keeping your blood sugar under control.
  • monitoring your blood pressure.
  • maintaining a healthy diet.
  • exercising regularly.
  • getting an eye exam at least once a year.

Diagnosing Diabetic Retinopathy

There are usually no symptoms in the early stages of diabetic retinopathy. Vision may not change until the disease becomes severe. An exam is often the only way to diagnose changes in the vessels of your eyes. This is why regular examinations for people with diabetes are extremely important.

You eye doctor may perform a test called fluorescein angiography. During the test, a harmless orange-red dye called Fluorescein will be injected into a vein in your arm. The dye will travel through your body to the blood vessels in your retina. Your doctor will use a special camera with a green filter to flash a blue light into your eye and take multiple photographs. The pictures will be analyzed to identify any damage to the lining of the retina or atypical new blood vessels.

Treatment For Diabetic Retinopathy

Diabetic retinopathy does not usually impair sight until the development of long-term complications, including proliferative retinopathy (when abnormal new blood vessels bleed into the eye). When this advanced stage of retinopathy occurs, pan-retinal photocoagulation is performed. During this procedure, a laser is used to destroy all of the dead areas of retina where blood vessels have been closed. When these areas are treated with the laser, the retina stops manufacturing new blood vessels, and those that are already present tend to decrease or disappear.
If diabetic retinopathy has caused your body to form cataracts, they can be corrected with cataract surgery.

Flashes & Floaters

Flashes and floaters can be alarming. Usually, however, an eye examination will confirm that they are harmless and do not require any treatment.

Symptoms of flashes & vitreous floaters:

  • Seeing small, floating spots
  • Seeing bright flashes of light

Causes of flashes and floaters:

Aging of the eye: Most flashes and floaters are caused by age-related changes in the gel-like material, called vitreous, that fills the back of the

When you are born, the vitreous is firmly attached to the retina. In the very young, the vitreous is rather thick, like firm gelatin. Within the vitreous, there may be clumps of gel or tiny strands of tissue debris left over from the eye’s early development. These clumps or strands are firmly embedded in the thick, young vitreous and cannot move around much.

As you get older, the vitreous gradually becomes thinner or more watery. By the time you are in your twenties or thirties, the vitreous may be watery enough to allow some of the clumps and strands to move around inside the eye. This material floating inside the eye can cast shadows on the retina, which you see as small floating spots.

Vitreous Detachment

Sometime after about age 55, you may experience the onset of larger, more bothersome floaters or flashes of light. By this age, the vitreous gel has usually become much more watery. It jiggles around quite a bit when you move your eye, making flashes and floaters much more common.
Eventually, the aging vitreous can pull away from the retina and shrink into a dense mass of gel in the middle of the eyeball. Shadows cast onto the retina by the detached vitreous can cause you to see large floaters.

Who is at risk?

Flashes and floaters are very common. Almost everyone experiences them at one time or another. They become more frequent as we age. In rare cases, a doctor’s exam may reveal a more serious problem called a retinal tear or retinal hole, so it’s important to get regular eye exams and inform your doctor if you’re experiencing flashes or floaters.

Diagnosing flashes and floaters:

Using special instruments to look into your eyes, your doctor can distinguish between harmless floaters and flashes and more serious retinal problems such as holes, tears or detachment. The usual symptoms of these more serious problems include seeing hundreds of small floating spots, persistent flashing lights, or a veil-like blockage of a portion of the vision. If you experience any of these, you should contact your doctor immediately.

Treatment for flashes and floaters:

There is no way to eliminate the floater through surgery, laser treatment or medication. With time, the floater will become less noticeable as the brain adjusts to its presence and can “tune out” the floater. The floater will always be somewhat observable and present, particularly if one eye is covered and the patient looks at a light-colored background.

Anyone with flashes or the sudden onset of a new floater should be examined promptly by an ophthalmologist. The ophthalmologist will perform a dilated exam and look at the vitreous and retina with specialized equipment. Sudden flashes or floaters could be symptoms of a vitreous detachment, which is a benign condition that carries the risk of developing into a retinal tear and/or retinal detachment.

Retinal Detachment

Retinal detachment occurs when the retina is lifted or pulled from the wall of the eye. If not treated immediately, a retinal detachment can cause permanent vision loss. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should call the office immediately.

Symptoms of retinal detachment

  • The appearance of a curtain over the field of vision.
  • Seeing lght flashes
  • Wavy or watery vision
  • A sudden decrease in vision
  • A sudden increase in the number of floaters in the field of vision

Who is most at risk for retinal detachment?

  • Those who are very nearsighted
  • The elderly
  • People with a family history of retinal detachment
  • Those who have had cataract surgery
  • Patients with diabetes or other eye disorders

Treatment for retinal detachment

Retinal detachments are treated with surgery that may require a hospital stay. In some cases, a scleral buckle, a tiny synthetic band, is attached to the outside of the eyeball to gently push the wall of the eye against the detached retina. If necessary, a vitrectomy may also be performed. Vitrectomy is a procedure in which the vitreous humor is removed and replaced with a gas that pushes the retina back onto the wall of the eye. Over time the eye produces fluid that replaces the gas. In both of these procedures either a laser or a cryopexy (a freezing device) is used to “weld” the retina back in place.

Retinal Vein Occlusion

There are veins in the retina that drain blood out of the retina, back to the heart. If those veins become blocked, this can cause fluid leakage, which can lead to vision loss. If you experience sudden loss of your central vision or a blurry or missing area of vision, call our office at once.

Symptoms of retinal vein occlusion

  • Sudden, painless loss of vision
  • Sudden increase in floating spots or flashing lights
  • Blurred or missing area of vision

Causes of retinal vein occlusion

  • High blood pressure
  • High cholesterol
  • Obesity
  • Smoking
  • Glaucoma, diabetes and other conditions

Treatment for retinal vein occlusion

The type of treatment depends on the cause of the blockage and the extent of damage. A laser can be used to reduce leakage and the growth of abnormal new blood vessels

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