Age-related Macular Degeneration (AMD)
Age-related macular degeneration is the leading cause of blindness in people of retirement age in industrialized nations. The macula is the part of the retina that corresponds to your central vision and is preferentially affected in this condition. AMD is typically split into two forms referred to as Non-exudative (“Dry”) and Exudative (“Wet”) Some of the risk factors for developing AMD include increasing age, a family history of AMD, and smoking. The “dry” form of AMD is characterized by the formation of structures called drusen in the back of the eye as well as atrophic changes within the retina and associated structures. Although the “dry” form can affect your central vision, it tends be less severe and more slowly progressive then the “wet” form of AMD. Exudative or “wet” AMD is characterized by abnormal blood vessels that grow underneath the retina and cause leakage, bleeding and scarring. This form of AMD, although affecting only a minority of AMD patients, can rapidly decrease your vision. Fortunately the treatments for AMD, such as vitamin supplements, injections and lasers, are expanding rapidly and can often restore vision in this formerly untreatable condition. Your doctor will have a full discussion with you concerning your type of AMD and which treatment option is the most beneficial for your vision. (see photo: The yellow spots seen within the retina are referred to as drusen, and are a sign of “dry” AMD).
Central Serous Chorioretinopathy
Central Serous Chorioretinopathy (CSCR) is a condition where fluid builds up underneath the retina due to a dysfunction in the layers underlying the retina itself. This buildup of fluid causes blurring and distortion of the vision. CSCR is often associated with “Type A” personalities or the use of steroid medications. In the vast majority of patients this condition self-resolves and the vision recovers, although in rare circumstances your doctor may recommend a laser treatment to hasten recovery. (see photo: The large white dot indicates an area of leakage of dye under the retina secondary to CSCR.)
Both Type 1 and Type 2 Diabetes have the ability to damage the blood vessels within the retina leading to diabetic retinopathy. This condition can cause blurring of your vision through swelling, bleeding, interruption of blood flow, and in its most severe form a specific type of retinal detachment. If early in the course of diabetic retinopathy your doctor may recommend only better control of your blood sugars, as well as blood pressure and cholesterol control. However if your retinopathy has progressed to the point that it is affecting your vision your doctor may recommend any number of treatments including lasers, injections or surgery. Your doctor will have a detailed conversation with you concerning your diabetic retinopathy and which of the numerous treatment options is most appropriate for your eyes. (see photo illustrating bleeding and exudation (yellow spots) into the retina from Diabetic Retinopathy)
A Macular hole is a full thickness defect in your retina that forms in the area that controls your central vision. The result is a blind spot in your central vision and a decrease in your visual acuity. The majority of macular holes form with out any identifiable cause, although they sometimes may be related to events such as trauma, or other ocular condition such as High Myopia. Early stages of macular holes may resolve spontaneously, however once the macular hole reaches a certain stage surgery is often required to attempt to close the hole and restore vision. Your doctor will have a full discussion with you concerning the characteristics of your macular hole as well as what surgical options are most appropriate to repair it. (see photo: The macular hole is present in the center of the photograph and appears brown in color with a faint yellow ring.)
Macular Pucker (Epiretinal Membrane)
A small proliferation of scar tissue on the surface of the retina is referred to as an epiretinal membrane, or a macular pucker. This scar tissue can contract and distort the retinal anatomy, cause retinal swelling, and result in blurring and distortion of your vision. (i.e.: objects that should appear straight no longer appear so) These membranes may form secondary to other conditions in your eye, or occur on their own. Treatment options include observation, eye drops or surgical removal of the membrane. (see photo: The white glistening on the retina corresponds to an area of epiretinal membrane formation)
A retinal detachment refers to the formation of a separation between the retina and the underlying eye wall. Most commonly this is due to a hole forming within the retina itself, which then allows fluid to build up underneath the retina causing the separation. Patients often notice floaters, flashing lights, or the perception of a black curtain coming across their vision when experiencing a detachment. Depending on the exact type of your detachment the doctor may recommend an office based treatment (laser or freezing perhaps with a gas injection) or he may recommend a trip to the operating room for repair. After performing a thorough examination your doctor will discuss all the treatment options available for your detachment. (see photos illustrating a total retinal detachment with scar tissue formation (top) and a retinal tear (bottom).)
Strokes of the Retina (Retinal Vein or Artery Occlusions)
Similar to any other tissue in your body, the retina can suffer from an interruption in its blood flow involving either the arteries or veins. The causes of these blockages of blood flow are diverse and often related to systemic conditions you may have including high blood pressure or Diabetes. Based on your exam your doctor may recommend treatment with lasers or injectable medications. (see photos: Left: occlusion of artery, Right: occlusion of vein)
Uveitis (Intraocular Inflammation)
Uveitis refers to inflammation of specific parts of the internal anatomy of your eye. (see photo where white particles indicate active inflammation) There are many conditions that can lead to this inflammation including infections and autoimmune conditions. After thoroughly examining your eyes your doctor may recommend further blood work or other testing, possibly with the assistance of your primary MD or another medical specialist, in order to help find a cause for your inflammation. Common treatments include anti-inflammatory eye drops, as well as oral or injectable steroids.
Other retinal conditions we treat:
• Macular Diseases
• Cystoid Macular Edema
• Hereditary Retinal Diseases
• Intraocular tumors
Important Eye Related Websites
American Academy of Ophthalmology- the premier organization of eye M.D.s in North America.
Eye Care America- a public service foundation for eye care in America.
MedlinePlus- a service of the U.S. National Library of Medicine covering information on health related topics.
National Eye Institute- one of the centers of research in ophthalmology, part of the National Institutes of Health.
Ophsource - a central place for the important journals in ophthalmology online.