What is Retina
The retina is a thin layer of nervous tissue that covers the inside of the back of the eye. It is light-sensitive and contains cells called rods and cones. The retina converts light into electrical signals that are sent to the brain through the optic nerve. The brain then creates the image you see. The retina i an extension of the brain and is formed embryonically from neural tissue.
Treatment for Retinal Pathologies
Age Related Macular Degeneration
This is the most common cause of central visual loss in almost every country on earth. It is, as the name suggests, related to increasing age. In addition to getting older, there are some genetics and possibly some lifestyle factors.
It is noted though that macular degeneration is worse in those people who smoke, and for this as well as many other reasons, smoking should be avoided.
There are 2 types of AMD: dry and wet.
Most people with AMD have dry AMD (also called atrophic AMD). This is when the macula gets thinner with age. Dry AMD happens in 3 stages: early, intermediate, and late. It usually progresses slowly over several years. There’s no treatment for late dry AMD, but you can find ways to make the most of your remaining vision. And if you have late dry AMD in only 1 eye, you can take steps to protect your other eye.
Wet AMD (also called advanced neovascular AMD), is a less common type of late AMD that usually causes faster vision loss. Any stage of dry AMD can turn into wet AMD — but wet AMD is always late stage. It happens when abnormal blood vessels grow in the back of the eye and damage the macula. The good news is that treatment options are available for wet AMD.
How will my doctor check for AMD?
Eye doctors can check for AMD as part of a comprehensive dilated eye exam. The exam is simple and painless — your doctor will give you some eye drops to dilate (widen) your pupil and then check your eyes for AMD and other eye problems.
Your doctor may also recommend doing a test called optical coherence tomography (OCT). In an OCT test, your eye doctor will take pictures of the inside of your eye with a special machine.
What’s the treatment for AMD?
Treatment for AMD depends on the stage and type. There’s currently no treatment for early AMD, so your eye doctor will probably just keep track of how your eyes are doing with regular eye exams. Eating healthy, getting regular exercise, and quitting smoking can also help.
If you have intermediate AMD in 1 or both eyes, special dietary supplements (vitamins and minerals) may be able to stop it from turning into late AMD. If you have late AMD in only 1 eye, these supplements may slow down AMD in your other eye.
If you have wet AMD, there are other treatments that may be able to stop further vision loss:
- Medicines called anti-VEGF drugs that the doctor injects in your eye
- Photodynamic therapy (PDT), a combination of injections and laser treatment
There’s currently no treatment for late dry AMD — but researchers are hard at work looking for treatment options. And you can get support to help you live with vision loss from AMD.
Diabetic Retinopathy
Diabetic retinopathy means changes in the retina secondary to diabetes. Diabetes causes problems with blood vessels, partly due to sugar making some of the layers of blood vessels more brittle. Microvasculopathy, or blood vessel disease in small blood vessels, occurs in the retina, the kidneys and in the feet. The condition can develop in anyone who has type 1 or type 2 diabetes.
The longer you have diabetes and the less controlled your blood sugar is, the more likely you are to develop this eye complication.
Diabetic retinopathy is a significant cause of visual loss and occurs over time. Diabetic retinopathy is more common the higher the HbA1c is (the longer term sugar control index), the length of time of diabetes, how high the blood pressure is, and how high the cholesterol is. Diabetic retinopathy can get worse in pregnancy.
There are a lot of treatment strategies for diabetic retinopathy. Vision loss from diabetic retinopathy is hard to recover.
The treatment options for diabetic retinopathy include laser, injections of steroids and anti-vascular endothelial growth factors, and sometimes surgery.
Remember, diabetes doesn’t necessarily lead to vision loss. Taking an active role in diabetes management can go a long way toward preventing complications
Retinal Tears
Tears in the retina can occur because of a normal event known as “posterior vitreous detachment”. The vitreous generally fills the cavity in the back of the eye, but tends to shrink and detach from its back surface, that which is next to the retina, with age. Shrinking and detachment of the vitreous is normal, but can cause the development of floaters and on occasion flashes of light in the periphery.
The sudden onset of floaters and flashes are things that should be checked out and they can be associated with a tear in the retina. A tear in the retina is unusual but much more important than the “posterior vitreous detachment”.
If a retinal tear is diagnosed promptly before it progresses to retinal detachment, the prognosis is extremely good. Retinal tears are typically treated with laser or a freezing procedure (cryotherapy). Treatment is performed in an office setting and is very effective and quite safe.
Topical or local anesthesia is utilized, and the procedure is only mildly uncomfortable. The treatment creates spot-welding around the edges of the tear that nearly eliminates the risk of the tear progressing to retinal detachment. After a tear has been treated, there remains a future risk of developing additional, separate retinal tears; therefore, continued monitoring is important.
Not all retinal tears require treatment. When low-risk tears are identified in patients who have no symptoms, these tears can be observed without treatment. Some tears “treat themselves,” meaning they develop adhesion around the tear without treatment, and these situations can be followed without treatment as well.
More extensive detachment of the retina will require more complicated procedures.