RETINA CONDITIONS

Macular Degeneration and Torn Retina

The retina is the light-sensitive tissue lining the back of our eye. Light rays are focused onto the retina through our cornea, pupil and lens. The retina converts the light rays into impulses that travel through the optic nerve to our brain, where they are interpreted as the images we see. A healthy, intact retina is key to clear vision.

The middle of our eye is filled with a clear gel called vitreous that is attached to the retina. Sometimes tiny clumps of gel or cells inside the vitreous will cast shadows on the retina, and you may sometimes see small dots, specks, strings or clouds moving in your field of vision.

These are called floaters. You can often see them when looking at a plain, light background, like a blank wall or blue sky.

As we get older, the vitreous may shrink and pull on the retina. When this happens, you may notice what look like flashing lights, lightning streaks or the sensation of seeing “stars.” These are called flashes.

Carolina Eyecare Physicians offers world-class expertise in diagnosing and treating all diseases and conditions related to the retina.

RETINA CONDITIONS

Who is at risk for a retinal detachment?

People with the following conditions have an increased risk for retinal detachment:

Nearsightedness;
Previous cataract, glaucoma or other eye surgery;
Glaucoma medications that make the pupil small (like pilocarpine)
Severe eye injury;
Previous retinal detachment in the other eye;
Family history of retinal detachment;
Weak areas in the retina that can be seen by an ophthalmologist during an eye exam.

Symptoms of a detached or torn retina

Symptoms of a retinal tear and a retinal detachment can include the following:

A sudden increase in size and number of floaters, indicating a retinal tear may be occurring;
A sudden appearance of flashes, which could be the first stage of a retinal tear or detachment;
Having a shadow appear in the periphery (side) of your field of vision;
Seeing a gray curtain moving across your field of vision;
A sudden decrease in your vision.

Floaters and flashes in themselves are quite common and do not always mean you have a retinal tear or detachment. However, if they are suddenly more severe and you notice you are losing vision, you should call your ophthalmologist right away.

Causes of retina conditions

As we get older, the vitreous may change shape, pulling away from the retina. If the vitreous pulls a piece of the retina with it, it causes a retinal tear. Once a retinal tear occurs, vitreous fluid may seep through and lift the retina off the back wall of the eye, causing the retina to detach or pull away.

Vitreous fluid normally shrinks as we age, and this usually doesn’t cause damage to the retina. However, inflammation (swelling) or nearsightedness (myopia) may cause the vitreous to pull away and result in retinal detachment.

Surgery for a torn retina

Most retinal tears need to be treated by sealing the retina to the back wall of the eye with laser surgery or cryotherapy (a freezing treatment). Both of these procedures create a scar that helps seal the retina to the back of the eye. This prevents fluid from traveling through the tear and under the retina, which usually prevents the retina from detaching. These treatments cause little or no discomfort and may be performed in your ophthalmologist’s office.

A detached retina diagnosis

Your ophthalmologist can diagnose retinal tear or retinal detachment during an eye examination where he or she dilates (widens) the pupils of your eyes. Only after careful examination can your ophthalmologist tell whether a retinal tear or early retinal detachment is present. Some retinal detachments are found during a routine eye examination. That is why it is so important to have regular eye exams.

After successful surgery for retinal detachment, vision may take many months to improve and, in some cases, may never return fully. Unfortunately, some patients do not recover any vision. The more severe the detachment, the less vision may return. For this reason, it is very important to see your ophthalmologist regularly or at the first sign of any trouble with your vision.

SCLERAL BUCKLE

This treatment involves placing a flexible band (scleral buckle) around the eye to counteract the force pulling the retina out of place. The ophthalmologist often drains the fluid under the detached retina, allowing the retina to settle back into its normal position against the back wall of the eye. This procedure is performed in an operating room.

PNEUMATIC RETINOPEXY

In this procedure, a gas bubble is injected into the vitreous space inside the eye in combination with laser surgery or cryotherapy. The gas bubble pushes the retinal tear into place against the back wall of the eye. Sometimes this procedure can be done in the ophthalmologist’s office. Your ophthalmologist will ask you to constantly maintain a certain head position for several days. The gas bubble will gradually disappear.

VITRECTOMY

This surgery is commonly used to fix a retinal detachment and is performed in an operating room. The vitreous gel, which is pulling on the retina, is removed from the eye and usually replaced with a gas bubble.

Sometimes an oil bubble is used (instead of a gas bubble) to keep the retina in place. Your body’s own fluids will gradually replace a gas bubble. An oil bubble will need to be removed from the eye at a later date with another surgical procedure. Sometimes vitrectomy is combined with a scleral buckle.

If a gas bubble was placed in your eye, your ophthalmologist may recommend that you keep your head in special positions for a time. Do not fly in an airplane or travel at high altitudes until you are told the gas bubble is gone. A rapid increase in altitude can cause a dangerous rise in eye pressure. With an oil bubble, it is safe to fly on an airplane.