Learn More About Retinal Disease

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Learn More About Retinal Disease

The vitreous is normally a clear, jelly-like fluid that fills the inside of the eye. Various disease states can cause the vitreous to fill with blood so that light entering the eye will not reach the retina properly.

Vitreous hemorrhage, or bleeding, results in a sudden change in vision as it blocks light moving through the vitreous to the retina. This hemorrhage specifically occurs in front of the retina in the posterior section of the eye. The vitreous hemorrhage may be the result of an aneurysm of a blood vessel in the eye, trauma to the eye, a retinal tear, a retinal detachment, a new blood vessel (neo-vascularization) or as a result of another underlying disease. These diseases include diabetes, hypertension, and carotid artery disease. Diabetics are particularly susceptible because the disease triggers the growth of new blood vessels within the eye. The vessels are weak and bleed easily.

There are many types of changes that can affect your vision, and you should always seek medical attention if changes in your vision occur. Vision changes can include blurriness, halos, blind spots, floaters, the inability to see at certain distances, and even blindness. If any of these symptoms are occurring, it could be a sign of an eye disease, aging, an eye injury, or another condition. Vision changes should never be ignored, as they can get worse, and sometimes lead to irreversible blindness.

Vision changes affect your ability to focus on objects, see fine detail, and live life as you see fit. Of the five senses, vision is the most crucial to our overall health and well-being. Although vision changes can occur at any age, most people begin to experience significant vision changes after the age of 60.

The conjunctiva is the thin, moist, transparent membrane that covers the white part of the eye (called the sclera) and the inside of the eyelids. The conjunctiva is the outermost protective coating of the eyeball.

The conjunctiva contains nerves and many small blood vessels. These blood vessels are usually barely visible but become larger and more visible if the eye is inflamed. These blood vessels are somewhat fragile and their walls may break easily, resulting in a subconjunctival hemorrhage (bleeding under the conjunctiva). A subconjunctival hemorrhage appears as a bright red or dark red patch on the sclera. This does not require treatment and will resolve spontaneously in 3-6 weeks.

Posterior Capsule Opacification (PCO) is a common condition that develops in approximately 35% of patients who have undergone cataract surgery. It can occur within weeks or years after surgery. When cataract surgery is performed, the natural lens is removed, but the clear membranous covering of the cataract (the posterior capsule) is left behind. This capsule provides protection for and keeps the new IOL in place. Over time, the capsule can become clouded by various proteins within the eye. Posterior Capsule Opacification symptoms are very similar to cataract symptoms. These include: blurring of vision, glare in daytime or when driving and difficulty seeing near objects that were clear after cataract surgery.

Age-Related Macular Degeneration (AMD) is an acquired ocular disorder and a leading cause of legal blindness in persons over sixty. AMD affects the macula, the central part of the retina, which is responsible for providing clear, sharp vision needed for reading, writing, driving and other visually-demanding activities.

The nature and severity of this condition varies with individual patients, with many experiencing some degree of loss of central vision in one or both eyes. Approximately 90% of patients with AMD have a non-exudative (or dry) form of the disease, which results in the development of dry, atrophic scars in the macular area. Non-exudative AMD patients typically experience slower, more gradual loss of vision. Only 10% of patients develop an exudative (or wet) form, which results in the leaking of fluid beneath the retina, and a greater and more rapid loss of central vision. Effective laser photocoagulation treatment for the disease is limited to small numbers of patients with exudative AMD who are identified early in the disease process.

In central serous chorio-retinopathy (CSCR), some fluid collects within the central retina (macula). Because of the fluid, you may see a relatively black patch or blurred vision and/or distortion of images. Straight lines will appear bent and objects may appear smaller or larger than they are. Some vision loss can occur.

A choroidal nevus is a freckle or mole that appears inside the eye or on the eye's surface. Sometimes detected during a dilated eye examination, these pigmented spots are usually flat and brown in color. Choroidal nevi are commonly found in the choroid, a blood vessel-rich layer lying between the retina and the sclera. Although they are not necessarily a "normal" finding in our eyes, they are quite common and usually benign. Nevi vary from patient to patient but most look very similar and have certain traits that eye doctors are very familiar with. Your doctor will document this finding in your chart if it is detected during a routine eye exam.

Inflammation of the choroid (thin pigmented vascular tissue of the eye) and retina of the eye. It can be caused by various pathogens such as bacteria, viruses, fungus or protozoa. Other noninfectious diseases such as sarcoidosis can cause abnormal deposits in the eye which can also result in inflammation.

cataracts

A cataract means a cloudy or opacified lens. The lens is the middle window which separates the front (anterior) and back (posterior) segments of the eye. In a normal eye, it focuses the image entering the eye onto the retina. The retina is the innermost layer of the eye which converts the images into biochemical signals which are subsequently transmitted to the brain.

As you age, your lens becomes gradually more opaque. This affects the amount of light that enters the eye and the ability for images to be focused onto the retina. Your eyesight gradually becomes more blurry and your visual acuity decreases. The more severe the lens opacity, the less light enters the eye and the less the eye sees. Another disabling effect is glare, especially at night. An increase in myopia may occur when the lens becomes denser and thicker. Sometimes, it may also cause the perception of double vision even with the other eye closed.

The back cavity of the inner eye is filled with clear jelly called vitreous. When the vitreous jelly undergoes the natural aging process it deteriorates and becomes liquid. As the eyeball moves, small pockets of liquid vitreous can move around as well inside the vitreous cavity. This movement causes the vitreous to pull on the retina.

A retinal detachment is a separation of the retina from its attachments to the underlying tissue within the eye. Most retinal detachments are a result of a retinal break, hole, or tear. These retinal breaks may occur when the vitreous gel pulls loose or separates from its attachment to the retina, usually in the peripheral parts of the retina. The vitreous is a clear gel that fills two-thirds of the inside of the eye and occupies the space in front of the retina. As the vitreous gel pulls loose, it will sometimes exert traction on the retina, and if the retina is weak, the retina will tear. Most retinal breaks are not a result of injury. Retinal tears are sometimes accompanied by bleeding if a retinal blood vessel is included in the tear. Many people develop separation of the vitreous from the retina as they get older. However, only a small percentage of these vitreous separations result in retinal tears.

The vitreous is a transparent, gel-like substance that occupies the entire back portion of the eyeball. This portion of the eye is called the vitreous cavity. At birth, the vitreous humor fills up the entire space in the cavity. With age, the vitreous degenerates and is no longer able to keep its original consistency and shape. When this happens, the vitreous shrinks and pulls away from the retina at the back wall of the eye. This separation of vitreous from retina is called posterior vitreous detachment.

A Macular Hole is a small central break in the macula tissue of the retina at the back of the eye. The macula is the region of the retina responsible for sharp, central vision. It is dense with light-sensing cells which help us fine tune our vision for reading, recognizing faces, and driving. The size of the hole and its location determine its affect on a person’s vision. If left untreated, a Macular Hole can lead to severe vision loss, including a possible retinal detachment.

lattice degeneration

Lattice degeneration is a process which affects the peripheral retina of the eye, causing that part of the retina to atrophy and become thinner. Although this is not usually a progressive disease, in some cases, the degeneration may lead to retinal detachment, holes, and/or tear and temporary or permanent loss of vision. This eye disease is often associated with myopia, and the two conditions can appear together.

Hypertensive retinopathy is damage to the retinal vessels from high blood pressure. The higher the blood pressure and the longer it has been high, the more severe the damage is likely to be. When you have diabetes, high cholesterol levels, or you smoke, you have a higher risk of damage and vision loss. Most people with hypertensive retinopathy do not have symptoms until late in the disease. Malignant hypertension may cause the following sudden symptoms, and should be considered a medical emergency. The symptoms include double vision or dim vision, headaches, and/or visual disturbances and sometimes sudden vision loss

New onset of floaters or new change in floaters should always be evaluated with a dilated exam to rule out the risk of Retinal tears, retinal detachment, or bleeding in the eye. When not associated with other, more serious problems, "Floaters" are generally benign tiny gray or black spots that seem to weave in and out of your line of vision. Floaters can look like strings, circles, “O” shapes, or even cobwebs. Although they rarely interfere with your vision, floaters can be annoying or distracting, especially if they appear in front of an expanse of light color like a white wall or computer screen.

Eye Flashes are experienced in the form of light streaks or flashing lights. Symptoms of eye flashes can include sudden flashes of lights or 'stars'. In some cases, flashes can be in the form of jagged lines. Light flashes may be associated with an ocular migraine and tend to have shapes, colors and will last longer (typically 10-20 minutes). On the other hand, the flashes associated with vitreous separation, retinal detachment, or retinal tear are shorter and without any kind of shapes. If eye flashes are accompanied by a headache, then it's most probably a migraine headache. Eye flashes are the brain's way to alert you of stimulation of the retina (you can't experience the sensation of pain in your retina).

Age-related macular degeneration (ARMD) is a deterioration or breakdown of the eye's macula. The macula is a small area in the retina — the light-sensitive tissue lining the back of the eye. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly. The macula allows you to thread a needle, read small print, and read street signs. The peripheral retina is responsible for side (or peripheral) vision. If someone is standing off to one side of your vision, your peripheral retina helps you know that person is there by allowing you to see their general shape.  

Diabetic retinopathy occurs when blood vessels in the retina are damaged from elevated blood sugar in diabetes. Vascular damage causes fluid leakage or closure of small blood vessels. In other cases, abnormal blood vessels grow on the surface of the retina.

People who have diabetic retinopathy often don't notice changes in their vision in the disease's early stages. But as it progresses, diabetic retinopathy usually causes vision loss that in many cases cannot be reversed.

Cystoid macular edema, commonly called CME, is a painless disorder which affects the central retina or macula. The eye is often compared to a camera, with the front of the eye containing the lens that focuses images on the inside back layer of the eye; this back layer is called the retina, and it is covered with special nerve cells that react to light. When CME is present, multiple cyst-like (cystoid) areas of fluid appear in the macula and cause retinal swelling or edema. This swelling in the retina in turn can cause decreased vision.

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