Retinal disorders can affect vision and are caused by damage to the retina. Common retinal diseases include retinal tears, detachments, diabetic retinopathy, and macular degeneration. Symptoms include blurred or distorted vision. Diagnosis involves tests like optical coherence tomography and fluorescein angiography. Treatment aims to stop progression and may include laser therapy, freezing, injecting gas or medication, or surgery like vitrectomy. Coping strategies include magnifiers, assistive technology, brighter lighting, transportation alternatives, and support groups.
2. Retinal diseases vary widely, but most of
them cause visual symptoms. Retinal diseases
can affect any part of your retina, a thin layer
of tissue on the inside back wall of your eye.
3. SYMPTOMS
๏ถ Many retinal diseases share some common
signs and symptoms. These may include:
โข Seeing floating specks or cobwebs
โข Blurred or distorted (straight lines look wavy)
vision
โข Defects in the side vision
โข Lost vision
4. TYPES
๏ถCommon retinal diseases and conditions include:
โข Retinal tear :- A retinal tear occurs when the
clear, gel-like substance in the center of your eye
(vitreous) shrinks and tugs on the thin layer of
tissue lining the back of your eye (retina) with
enough traction to cause a break in the tissue. It's
often accompanied by the sudden onset of
symptoms such as floaters and flashing lights.
5. โข Retinal detachment:- A retinal detachment is
defined by the presence of fluid under the
retina. This usually occurs when fluid passes
through a retinal tear, causing the retina to lift
away from the underlying tissue layers.
6. โข Diabetic retinopathy :-If you have diabetes, the
tiny blood vessels (capillaries) in the back of your
eye can deteriorate and leak fluid into and under
the retina. This causes the retina to swell, which
may blur or distort your vision. Or you may
develop new, abnormal capillaries that break and
bleed. This also worsens your vision.
โข Epiretinal membrane:- Epiretinal membrane is a
delicate tissue-like scar or membrane that looks
like crinkled cellophane lying on top of the retina.
This membrane pulls up on the retina, which
distorts your vision. Objects may appear blurred
or crooked.
7. โข Epiretinal membrane:- Epiretinal membrane is
a delicate tissue-like scar or membrane that
looks like crinkled cellophane lying on top of
the retina. This membrane pulls up on the
retina, which distorts your vision. Objects may
appear blurred or crooked.
8. โข Macular hole. A macular hole is a small defect in the
center of the retina at the back of your eye (macula).
The hole may develop from abnormal traction between
the retina and the vitreous, or it may follow an injury
to the eye.
โข Macular degeneration. In macular degeneration, the
center of your retina begins to deteriorate. This causes
symptoms such as blurred central vision or a blind spot
in the center of the visual field. There are two types โ
wet macular degeneration and dry macular
degeneration. Many people will first have the dry form,
which can progress to the wet form in one or both
eyes.
โข Retinitis pigmentosa. Retinitis pigmentosa is a
degenerative disease that affects the retina.
9. Risk factors
โข Risk factors for retinal diseases might include
aging, having diabetes or other diseases, eye
trauma, and a family history of retinal
diseases.
10. Diagnosis
โข The following tests may be done to determine the
location and extent of the disease:
โข 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.
11. โข 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
(edema), to monitor the extent of age-related
wet macular degeneration, and to monitor
responses to treatment.
โข 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.
12. โข Indocyanine green angiography. This test uses a
dye that lights up when exposed to infrared light.
The resulting images show retinal blood vessels
and the deeper, harder-to-see blood vessels
behind the retina in a tissue called the choroid.
โข 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
tumors.
โข CT and MRI. In rare instances, these imaging
methods can be used to help evaluate eye
injuries or tumors
13. Treatment
๏ถ The main goals of treatment are to stop or slow disease
progression and preserve, improve or restore your vision. In
many cases, damage that has already occurred can't be
reversed, making early detection important. Your doctor
will work with you to determine the best treatment.
โข Treatment of retinal disease may be complex and
sometimes urgent. Options include:
โข 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.
14. โข 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.
15. โข Freezing. In this process, called cryopexy (KRY-o-pek-see),
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.
โข Injecting air or gas into your eye. This technique, called
pneumatic retinopexy (RET-ih-no-pek-see), is used to help
repair certain types of retinal detachment. It can be used in
combination with cryopexy or laser photocoagulation.
โข Indenting the surface of your eye. This surgery, called
scleral (SKLEER-ul) 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
16. โข Evacuating and replacing the fluid in the eye. In
this procedure, called vitrectomy (vih-TREK-tuh-
me), 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.
โข 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.
17. โข 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.
โข 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
18. Coping and support
โข Vision loss from retinal disease can affect your ability to do
things such as read, recognize faces and drive. These tips
may help you cope with your changing vision:
โข Ask your eye doctor to check your eyeglasses. If you wear
contacts or glasses, be sure your prescription is up to date.
โข Use magnifiers. A variety of magnifying devices can help
you with reading and close-up work, such as sewing. Such
devices include hand-held lenses or magnifying lenses you
wear like glasses. You may also use a closed-circuit
television system that uses a video camera to magnify
reading material and project it on a video screen.
โข Change your computer display and add audio
systems. Adjust the font size and monitor contrast in your
computer's settings. Consider adding speech-output
systems or other technologies to your computer.
19. โข Use electronic reading aids and voice interface. Try
talking watches, clocks and calculators, large-print
books, tablet computers, and audio books. Some tablet
and smartphone apps are designed to help people with
low vision. And many of these devices now come with
a voice recognition feature.
โข Select special appliances made for low vision. Some
clocks, radios, telephones and other appliances have
extra-large numbers. You may find it easier to watch a
television with a larger high definition screen, or you
may want to sit closer to the screen.
โข Use brighter lights in your home. Better lighting helps
with reading and other daily activities, and it may also
reduce the risk of falling.
20. โข Consider your transportation options. If you drive,
check with your doctor to see if it's safe to continue
doing so. Be extra cautious in certain situations, such
as driving at night, in heavy traffic or in bad weather.
Use public transportation or ask a friend or family
member to help. Make arrangements to use local van
or shuttle services, volunteer driving networks, or
rideshares.
โข Get support. Having macular degeneration can be
difficult, and you may need to make changes in your
life. You may go through many emotions as you adjust.
Consider talking to a counselor or joining a support
group. Spend time with supportive family members
and friends.
