What Is RETINA DISEASES?

Retinal diseases can be related to aging, diabetes or other diseases, trauma to the eye, or family history. To make a diagnosis, your ophthalmologist conducts a thorough eye exam and looks for abnormalities anywhere in the eye.

The following tests may be done to determine the location and extent of the disease:

Amsler Grid Test: Your doctor may use an Amsler grid to test the clarity of your central vision. He or she will ask you if the lines of the grid seem faded, broken or distorted and will note where the distortion occurs on the grid to better understand the extent of retinal damage. If you have macular degeneration, he or she might also ask you to use this test to self-monitor your condition at home.

Optical Coherence Tomography (OCT): This test is an excellent technique for capturing precise images of the retina to diagnose epiretinal membranes, macular holes and macular swelling (oedema), to monitor the extent of age-related wet macular degeneration, and to monitor responses to treatment.

Fluorescein Angiography: This test uses a dye that causes blood vessels in the retina to stand out under a special light. This helps to exactly identify closed blood vessels, leaking blood vessels, new abnormal blood vessels and subtle changes in the back of the eye.

Ultrasound: This test uses high-frequency sound waves (ultrasonography) to help view the retina and other structures in the eye. It can also identify certain tissue characteristics that can help in the diagnosis and treatment of eye tumours.

CT and MRI: In rare instances, these imaging methods can be used to help evaluate eye injuries or tumours.

The treatment of Retinal disease may be complex and sometimes urgent. Options include:

Using a laser: Laser surgery can repair a retinal tear or hole. Your surgeon uses a laser to heat small pinpoints on the retina. This creates scarring that usually binds (welds) the retina to the underlying tissue. Immediate laser treatment of a new retinal tear can decrease the chance of it causing a retinal detachment.

Shrinking abnormal blood vessels:Your doctor may use a technique called scatter laser photocoagulation to shrink abnormal new blood vessels that are bleeding or threatening to bleed into the eye. This treatment may help people with diabetic retinopathy. Extensive use of this treatment may cause the loss of some side (peripheral) or night vision.

Freezing: In this process, called cryopexy, your surgeon applies a freezing probe to the external wall of the eye to treat a retinal tear. Intense cold reaches the inside of the eye and freezes the retina. The treated area will later scar and secure the retina to the eye wall.

Injecting air or gas into your eye: This technique, called pneumatic retinopexy, is used to help repair certain types of retinal detachment. It can be used in combination with cryopexy or laser photocoagulation.

Indenting the surface of your eye: This surgery, called scleral buckling, is used to repair a retinal detachment. Your surgeon sews a small piece of silicone material to the outside eye surface (sclera). This indents the sclera and relieves some of the force caused by the vitreous tugging on the retina. This technique may be used with other treatments.

Evacuating and replacing the fluid in the eye: In this procedure, called vitrectomy , your surgeon removes the gel-like fluid that fills the inside of your eye (vitreous). He or she then injects air, gas or liquid into the space.

Vitrectomy:May be used if bleeding or inflammation clouds the vitreous and obstructs the surgeon’s view of the retina. This technique may be part of the treatment for people with a retinal tear, diabetic retinopathy, a macular hole, an infection, eye trauma or a retinal detachment.

Injecting medicine into the eye:Your doctor may suggest injecting medication into the vitreous in the eye. This technique may be effective in treating people with wet macular degeneration, diabetic retinopathy or broken blood vessels within the eye. Various kinds of medications can be used such as Anti VEGF injections, Steroids or Antibiotics, depending upon the condition of the patient.

Implanting a retinal prosthesis: People who have severe vision loss or blindness owing to retinal disease may be a candidate for surgery. One surgical option not widely available is called retinal prosthesis.

Diabetic Retinopathy is the “disease of the retina” caused by microangiopathy due to long term effects of diabetes leading to progressive damage of the retina & blindness. The most common cause of severe bilateral visual loss in the working age group.

What are the common symptoms of Diabetic Retinopathy?

Diabetic Retinopathy is asymptomatic in early stages of the disease. As the disease progresses, symptoms may include

What are the Signs of Diabetic Retinopathy?

The signs are:

Retinal detachment is separation of the neurosensory retina from the underlying retinal pigment epithelium. The most common cause is a retinal break (a tear or, less commonly, a hole) (rhegmatogenous detachment).

What are the types of Retinal Detachment?

Rhegmatogenous detachment is the most common. Risk factors include the following: Myopia, Previous cataract surgery, Ocular trauma, Lattice retinal degeneration, a family history of retinal detachmentTraction retinal detachment can be caused by vitreoretinal traction due to preretinal fibrous membranes as may occur in proliferative diabetic or sickle cell retinopathy.Serous detachment results from transudation of fluid into the subretinal space. Causes include severe uveitis, especially in Vogt-Koyanagi-Harada disease, choroidal hemangiomas, and primary or metastatic choroidal cancer.

AMRD is a condition in which there is a slow breakdown of cells in the center of the retina (the light-sensitive layers of nerve tissue at the back of the eye). This blocks vision in the center of the eye and can cause problems with activities such as reading and driving. ARMD is most often seen in people who are over the age of 50.

What are the two types of AMRD?

Dry (nonexudative or atrophic): All age-related macular degeneration (AMD) starts as the dry form. About 85% of people with AMD have only dry AMD. The loss of central vision occurs over years and is painless, and most patients retain enough vision to read and drive. Central blind spots (scotomas) usually occur late in the disease and can sometimes become severe. Symptoms are usually bilateral.

Wet (exudative or neovascular): Wet AMD occurs in about 15% of people. Rapid vision loss, usually over days to weeks, is more typical of wet AMD. The first symptom is usually visual distortion, such as a central blind spot (scotoma) or curving of straight lines (metamorphopsia). Peripheral vision and color vision are generally unaffected; however, the patient may become legally blind (< 20/200 vision) in the affected eye, particularly if AMD is not treated. Wet AMD usually affects one eye at a time; thus, symptoms of wet AMD are often unilateral.

Although only 15% of patients with AMD have the wet form, 80 to 90% of the severe vision loss caused by AMD results from wet AMD.

What is the treatment for AMRD?

The following are the various treatment modalities for AMRD:

Dietary supplements for high-risk dry or unilateral wet age-related macular degenerationIntravitreal anti vascular endothelial growth factor drugs or laser treatments for wet AMD Supportive measures such as Vitamins