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Information
Detached and Torn Retina
What is the retina?
The retina is a nerve layer at the back of your eye that senses light and sends images to your brain.
An eye is like a camera. The lens in the front of the eye focuses light onto the retina. You can think of the retina as the film that lines the back of a camera.
What is a retinal detachment?
A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred, just as a photographic image would be blurry if the film were loose inside the camera.
A retinal detachment is a very serious problem that almost always causes blindness unless it is treated.
What causes retinal detachment?
A clear gel called vitreous (vit-ree-us) fills the middle of the eye. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye.
Usually the vitreous separates from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through the retinal tear, lifting the retina off the back of the eye, much as wallpaper can peel off a wall.
The following conditions increase the chance of having a retinal detachment:
- Nearsightedness
- Previous cataract surgery
- Glaucoma
- Severe injury
- Previous retinal detachment in your other eye
- Family history of retinal detachment
- Weak areas in your retina that can be seen by your ophthalmologist (Eye M.D.).
What are the warning symptoms of retinal detachment?
These early symptoms may indicate the presence of a retinal detachment:
- Flashing lights
- New floaters
- A shadow in the periphery of your field of vision
- A gray curtain moving across your field of vision
These symptoms do not always mean a retinal detachment is present; however, you should see your ophthalmologist as soon as possible.
Your ophthalmologist can diagnose retinal detachment during an eye examination in which he or she dilates (enlarges) the pupils of your eyes. Some retinal detachments are found during a routine eye examination.
Only after careful examination can your ophthalmologist tell whether a retinal tear or early retinal detachment is present.
Treatment
The repair of retinal detachment is very successful in most cases. Some retinal detachments can be repaired in an office setting and other more severe cases are treated in the operating room as outpatient. The surgical procedure is very successful and most patients regain most of their vision.
Floaters and Flashes
What are floaters?
You may sometimes see small specks or clouds moving in your field of vision. These are called floaters. You can often see them when looking at a plain background, like a blank wall or blue sky.
Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear gel-like fluid that fills the inside of your eye.
Although the floaters appear to be in front of the eye, they are actually floating in the vitreous fluid inside the eye.
While these objects look like they are in front of your eye, they are actually floating inside it. What you see are the shadows they cast on the retina, the layer of cells lining the back of the eye that senses light and allows you to see.
Floaters can appear as different shapes such as little dots, circles, lines, clouds, or cobwebs.
What causes floaters?
When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye. The vitreous gel pulls away from the back wall of the eye, causing a posterior vitreous detachment. This is a common cause of floaters.
Posterior vitreous detachment is more common in people who:
- Are nearsighted
- Have undergone cataract operations
- Have had YAG laser surgery of the eye
- Have had inflammation inside the eye
The appearance of floaters may be alarming, especially if they develop very suddenly. You should contact your ophthalmologist (Eye M.D.) right away if you develop new floaters, especially if you are over 45 years of age.
Are floaters ever serious?
The retina can tear if the shrinking vitreous gel pulls away from the wall of the eye. This sometimes causes a small amount of bleeding in the eye that may appear as new floaters.
A torn retina is always a serious problem, since it can lead to a retinal detachment. You should see your ophthalmologist as soon as possible if:
- Even one new floater appears suddenly
- You see sudden flashes of light
If you notice other symptoms, like the loss of side vision, you should see your ophthalmologist.
Can floaters be removed?
Floaters may be a symptom of a tear in the retina, which is a serious problem, if a retinal tear is not treated, the retina may detach from the back of the eye. The only treatment for a detached retina is surgery.
Other floaters are harmless and fade over time or become less bothersome, requiring no treatment. Surgery to remove floaters is almost never required; vitamin therapy will not cause floaters to disappear.
Even if you have had floaters for years, you should schedule an eye examination with your ophthalmologist if you suddenly notice new ones.
What causes flashing lights?
When the vitreous gel rubs or pulls on the retina, you may see what look like flashing lights or lightning streaks. You may have experienced this same sensation if you have ever been hit in the eye and seen "stars."
The flashes of light can appear off and on for several weeks or months. As we grow older, it is more common to experience flashes, if you notice the sudden appearance of light flashes, you should contact your ophthalmologist immediately in case the retina has been torn.
Retinal Vein Occlusions
What is a retinal vein occlusion?
A retinal vein occlusion means that a vein in the retina of the eye has become blocked. The retina is the light-sensing tissue at the back of our eye. The veins drain blood out of the retina and return it to the heart.
Blockage or occlusion in the vein prevents adequate blood flow in the affected area. The walls of the vein leak blood and excess fluid into the retina.
What are the types of retinal vein occlusion?
There are two types of retinal vein occlusion:
- Central retinal vein occlusion (CRVO)
- Branch retinal vein occlusion (BRVO)
Who is at risk for a retinal vein occlusion?
Retinal vein occlusions are more common in people who have:
- Glaucoma (abnormal eye pressure)
- Diabetes
- Age-related vascular (blood vessel) disease
- High blood pressure disorders
What are the symptoms of retinal vein occlusion?
Blurred vision is the main symptom of retinal vein occlusion. It occurs when the excess fluid leaking from the vein collects in the macula.
The macula is the central area of the retina which is responsible for our central, detailed vision. If the macula swells with excess fluid (macular edema), vision blurs.
Treatment
Vein occlusions can successfully be treated with laser and intraocular injections of anti-VEGF drugs. We care currently involved in several studies comparing the results of patients treated with both laser and injections.