Retina Treatment

Retina is like the film in a camera. Retina is the inner most coat of the eye. When the focused light hits the retina, a picture is created and sent to the brain through the optic nerve, thus giving us vision. Sometimes part of the retina either tears, pulls away or detaches from the back of the eye; when this occurs that part of the retina cannot gather light ans results in vision loss.

Common diseases and conditions of the retina

• Age-Related Macular Degeneration
• Diabetic Retinopathy
• Retinal tear
• Retinal Detachment

1) Age-Related Macular Degeneration

• Symptoms
• Risk factors
• Diagnosis
• Treatment

During normal aging, yellowish deposits, called drusen, forms under the retina, which is the light-sensitive layer of the eye which provides clear, sharp images. As drusen increase in size and number, they can interfere with proper functioning of the retina, damaging or killing the light-sensitive cells on the retina. Because the macula’s light-sensitive cells provide the ability to have sharp, detailed vision, the results can be blurring of central vision and a devastating impact on the ability to enjoy activities of daily life, such as reading, driving, or even recognizing the face of a friend or family member.
This form of age-related macular degeneration is called dry ARMD. Dry ARMD can be a precursor to wet ARMD.Wet AMD occurs when abnormal blood vessels behind the retina start to grow. These blood vessels often leak blood and fluid, damaging or killing light-sensitive cells—loss of vision occurs quickly. AMD when diagnosed early can be treated to restore further loss in vision. It is important to learn about the disease and work with a retina specialist, who will put a treatment plan in place. These physicians have the ability, training, and experience to treat all medical and surgical aspects of AMD.

Symptoms

DRY ARMD

• Need for brighter light when reading
• Difficulty adapting to low light levels
• Increased blurriness of printed words
• Decrease in brightness of colors
• Blurred spot in the center of the field of vision
• Blank or black spot in the field of vision

Wet ARMD

• Sudden painless decline in central vision
• Visual distortions, such as straight lines appearing -wavy, or objects appearing larger or smaller than they are
• Well-defined blind spot in the center of vision

Risk factors

The primary risk factor for AMD is age—the older you are, the greater your risk. Also, people with a family history are at higher risk. Some lifestyle factors are also known to increase your risk for AMD:

• Cigarette smoking
• Obesity
• Hypertension (high blood pressure)
• Excessive sun exposure
• Diet deficient in fruits and vegetables

Diagnostic tests

Dilated eye exam

If you are over age of 50, it is a good idea to schedule an periodic eye examination to look for the earliest signs of AMD before any vision loss has occurred.

Ocular coherence tomography

This test provides cross-sectional images of the retina that show its thickness, helping determine whether fluid has leaked into retinal tissue and other changes that happen with ARMD.

Amsler grid test

In this test, the patient covers one eye at a time and stares at the black dot at the center of the grid. If the straight lines appear broken, crooked, wavy, bent, or distorted, the patient may have ARMD.

Treatment

There is no known cure for ARMD, but early detection and proper treatment can protect vision from further deterioration.

Dry AMD treatment

Currently, no medical treatments exist for dry AMD, but some strategies to slow its progression—taking vitamin or mineral supplements, for example can help.

Wet AMD treatment

There is a variety of medical treatments that can help stop further vision loss caused by wet ARMD:

Retinal Laser – These procedure can eliminate abnormal blood vessels and prevent additional leakage, bleeding, or growth.

Anti VEGF injections – This destroys abnormal blood vessels in the eye and prevent them from leaking.

2) Diabetic Retinopathy

• Symptoms
• Risk factors
• Types
• Prevention
• Investigations
• Treatment

Diabetic retinopathy is a complication of diabetes that affects the eyes. It’s caused by damage to the blood vessels of the retina due to high blood sugars. It can lead to vision loss or blindness if not treated in time.

Symptoms

• Spots or dark strings floating in your vision (floaters)
• Blurred vision
• Fluctuating vision
• Impaired color vision
• Dark or empty areas in your vision
• Vision loss

Risk factors

• Duration of diabetes — the longer you have diabetes, the greater your risk of developing diabetic retinopathy
• Poor control of your blood sugar level
• High blood pressure
• High cholesterol
• Pregnancy
• Tobacco use

Types

Diabetes damages the blood vessels of the Retina & as a result, they may leak fluid, proteins or fats or they may rupture & cause haemorrhage (bleeding) or they may get blocked. This is seen in Background Diabetic Retinopathy. In the more severe cases, as the blood vessels get blocked, the subsequent loss of nutrition & oxygen to the retina promotes the growth, i.e. proliferation of new, fragile abnormal vessels which easily rupture & use cause large haemorrhage & severe visual loss or blindness. This is seen in Proliferative Diabetic Retinopathy. When there is involvement of the central vision with difficulty in near vision affecting the most part of the retina called Macula it is known as Diabetic maculopathy.

Prevention

• Diabetic patients should get their eyes checked periodically
• Control of blood pressure (hypertension) and cholestrol
• Stop smoking & alcohol intake.

Investigations

• Dilated retinal examination helps detect diabetic retinopathy
• Fundus Photograph : This involves taking images of retina using a specialized non contact fundus camera.
• Fundus Fluorescein Angiography (FFA): By injecting dye into one of the peripheral veins, severity of retinopathy can be picked up for treatment depending on the pattern of dye leakage.
• Optical Coherence Tomography (OCT): is non-invasive test which provides accurate screening for diabetic retinopathy severity.

Treatment

• Laser photo-coagulation: Diabetic retinopathy is a treatable condition by laser photocoagulation at early stages. The Laser beam energy is absorbed by the ocular tissues/retina where it is directed & it is then changed to heat energy which coagulates the tissue by burning. Thus the Laser is used to spot weld the leaking point in the retina. We can prevent the complications of retinopathy such as haemorrhage, fibrous scar tissue formation & retinal detachment.
• Intravitreal injections : these are the more recent means of treating diabetic retinopathy. Like Lasers they are not particularly painful, can be more effective than laser itself in most cases.
• Surgery : with Microincisional (keyhole) Stitchless Vitrectomy surgery, diabetic retinopathy complications like bleeding & retinal detachment can be easily treated without opening up tissues of the eye or taking stitches.

3-4)Retinal Tear/Detachment

• Symptoms
• Risk factors
• Diagnosis
• Treatment

Retinal tears or detachment results from aging, an eye-injury, or another eye problem. A retinal detachment occurs when fluid leaks through the tear and separates the retina from the back of the eye. This may lead to gradual loss of a field of vision depending upon the area the detachment has occurred or sudden complete vision loss when the central portion of the retina is involved. Retina tears and detachment warrants an urgent intervention to have a good prognosis.

Symptoms

• Floaters (specks or threads in your vision).
• Flashes (lights, stars or streaks in your vision).
• Sudden blurry or loss in vision.

Risk factors

• Eye injury.
• Family history.
• High power glasses.

Diagnosis

Retinal examination using dilating drops can help detect weak areas in the eye and identify the tear or a detachment.

Treatment

Retinal Tear:

• Retinal Laser is usually performed to treat the tears and seal the week area. It helps decrease the leakage in the retina, treat abnormal blood vessel growth, or create a beneficial scarring effect that can help prevent a retinal detachment. It is a non invasive out patient procedure not requiring any injection or hospital stay.
• Some patients may require retinal laser in absence of a tear when only a weak area is noted in the retina to prevent it from further stretching the retina and causing a tear.

Retinal Detachment :

Retinal detachment requires an urgent retina surgery to prevent further loss in vision and to have a good prognosis. There are many treatment options for repairing a detachment based on the individual case the decision as to which treatment option is better will be selected.

• Vitrectomy : A sophisticated microsurgical technique in which the vitreous gel is removed from inside the eye with a small, specialized cutting device, an operating microscope to look into the eye, and microsurgical instruments.
• Scleral Buckle : This treatment for retinal detachment involves surgically sewing a silicone band (buckle) around the white of the eye (called the sclera) to push the sclera toward the tear until the tear heals. This band is not visible and remains permanently attached.
• Depending on the complexity of the retinal detachment, various combinations of vitrectomy, buckle, laser and gas bubble may be used to repair the retina.

Why chose us?

At Sanjeevani Eye Hospital we have an expert team of talented and skilled doctors who have an access to the latest diagnostic and surgical modalities. These doctors have been trained from the top notch institutes of India namely Sankara Nethralaya & Arvind Eye hospital to give deliver the best outcomes. We have the facilty of sutureless, 25 gauge vitrectomy surgeries. Please feel free to contact us for any further querries or doubts. We are always glad to help you.