Retina

Retina Disorders Saskatoon, Saskatchewan

Light has to travel through the eye before it reaches the retina. The retina is a clear, light-sensitive covering that lines the inside of the eye. One might think of it as the "film inside a camera" that takes the images you see and sends them along the optic nerve to the brain, where the "pictures" you see are interpreted as vision. Prompt detection of disease in the retina is important to begin treatment, stop its progress and/or avoid permanent damage to your vision.

A healthy retina is essential to maintaining clear vision and overall eye functioning. A diagnostic retinal exam may be recommended if any potential retinal abnormalities are detected during a general eye exam. Patients at a higher risk for developing retinal conditions may also be recommended for examination.

During a retinal exam and consultation, Dr. Conlon will perform a series of diagnostic procedures in order to evaluate the retina for any signs of disease or abnormality. These tests may include a visual field test, fluorescein angiography, fundus photography and more. ables an extended view of the retina with enhanced diagnostic capabilities.

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Common issues with the retina include:

Diabetic Retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina (the light-sensitive lining in the back of the eye where vision is focused). These weak vessels can leak, swell or develop thin branches, causing a loss of vision. Changes to your vision may not be noticeable at first. But in its advanced stages, the disease can cause blurred or cloudy vision, floaters and blind spots – and, eventually, blindness. This damage is irreversible. Diabetic retinopathy is the most common diabetic eye complication and a leading cause of blindness in American adults. Macular edema, which is leaking fluid that causes blurred vision, often occurs with diabetic retinopathy.

Diabetic macular edema (DME) is swelling of the macula, or central retina, in patients with diabetes mellitus. The retina is like the film in a camera, and the central part of the retina is the most important for detailed central vision. The retina is fed by a tree of blood vessels. Diabetes affects the blood vessels in the eye and may cause them to leak. When fluid leaks out of the retinal blood vessels, it collects in the retina and causes the retina to swell like a sponge. When the retina is swollen, central vision may be blurred or distorted.

Branch Retinal Vein Occlusion (BRVO) is vein blockage along a branch of the tree, usually at a point where an artery crosses over a vein and compresses it. This results in poor blood flow to a section of the retina. Since the retina is like film in a camera, a patient experiences branch retinal vein occlusion as painless vision loss. If the vein occlusion is away from the center or the retina, central vision may be unaffected. If the vein occlusion affects the central retina, vision may be severely limited.

A central retinal vein occlusion (CRVO) is blockage of the large vein in the trunk thereby reducing blood flow to the entire retina. Since the retina is like film in a camera, a patient experiences central retinal vein occlusion as painless vision loss. Vision may be affected to varying degrees, and patients who present with relatively good vision tend to maintain good vision long-term.

A central retinal artery occlusion (CRAO) is blockage of blood flow to the retina in the main trunk with sudden, severe vision loss throughout the visual field of one eye. A branch retinal artery occlusion (BRAO) is blockage along a branch of the tree. This results in poor blood flow to a section of the retina. A patient experiences branch retinal artery occlusion as sudden, painless loss of a portion of vision. If the artery occlusion is away from the center of the retina, central vision may be unaffected. If the artery occlusion affects the central retina, reading vision may be severely limited. The blockage or occlusion may last only a few seconds, or it may be permanent.

Cystoid macular edema (CME) refers to swelling of the central part of the retina (the macula). The retina is like the film in a camera, and the macula is responsible for detailed central vision. When the macula experiences swelling (edema), central vision is reduced.

A macular hole is a full thickness defect in the central retina (macula). Since the macula is responsible for reading vision, patients who develop a macular hole complain of distorted vision and loss of central vision in the affected eye. The incidence of macular hole is 3.3 cases per 1000 in the population. The risk for developing a macular hole in the fellow eye is 10% – 15%. Small macular holes occasionally resolve spontaneously but the majority will persist. Once a macular hole develops, vision usually stabilizes at 20/200 if left unrepaired. Changing eyeglasses will not correct the blur and distortion caused by the macular hole. Epiretinal membrane (ERM), also known as macular pucker or cellophane maculopathy, is a common disorder of the central retina (macula) which may cause a central blur or distortion in the vision. An ERM is a layer of scar-like tissue on the surface of the retina. Most eyes with ERM are asymptomatic, but ERMs may require intervention if the vision is significantly affected due to distortion or lack of clarity.

Central serous chorioretinopathy (CSCR) causes painless blurring of central vision, primarily in young men ages 20-45. Common symptoms include distortion, color vision changes, micropsia (objects look smaller), and a central blind or gray spot. These symptoms are caused by a blister of fluid that collects under the center of the retina. The retina is the"film" of the eye's camera and the symptoms are related to the size and duration of the fluid blister. The fluid collection usually resolves spontaneously but may recur in the same or fellow eye months or year later.

Posterior Vitreous Detachment Between the lens in the front and the retina in the back of the eye lies a clear gel called the vitreous. A posterior vitreous detachment (PVD) is a separation between the vitreous gel and the retina.At birth, the vitreous gel is clear and firm, and it is attached to the retina. With age, the vitreous gel becomes liquefied and some of the proteins in the gel clump together—these are the small floaters that most people see. Eventually the back surface of the gel may separate from the retina, beginning near the optic nerve and macula (central retina) and continuing towards the edges of the retina.

Hemorrhagic PVD is concerning because in the presence of blood there is a high likelihood of a retinal tear. If a tear is present, the blood may obscure it, and so frequent careful retinal examinations are appropriate in order to identify a retinal tear as early as possible and prevent a vision-threatening retinal detachment. In cases of dense hemorrhage that does not clear quickly on its own, surgery may be recommended to remove the blood and identify and treat the underlying source of bleeding.

Retinal tear. When a PVD occurs with flashes or floaters, there is about a 10% chance of developing a retinal tear. Most of these tears occur within 6 weeks of the initial symptoms. Tears occur because of the traction at the leading edge of the gel separating from the retina. An untreated retinal tear may lead to retinal detachment with severe vision loss.

A retinal detachment is when the retina pulls away from the wall of the eye. The retina cannot function normally when it is detached from the wall of the eye, which is why a retinal detachment can limit the vision.

Lattice degeneration is a common peripheral retinal degeneration, with oval or linear patches of retinal thinning. Lattice degeneration affects about 10% of the population and is bilateral in 30 to 50% of those patients. It may run in families and it is more common in near-sighted eyes. Patients with lattice degeneration are typically asymptomatic, and the lesions are usually an incidental finding of dilated eye exam. Lattice lesions usually develop during the teenage years and may continue to develop over many years. Lattice degeneration may predispose the retina to tears or atrophic holes which may lead to retinal detachment. For this reason, the acute onset of floaters, flashes of light, peripheral field loss, or central vision loss should be taken seriously and a detailed retinal examination is appropriate.

Evaluation

A healthy retina is essential to maintaining clear vision and overall eye functioning. A diagnostic retinal exam may be recommended if any potential retinal abnormalities are detected during a general eye exam. Patients at a higher risk for developing retinal conditions may also be recommended for examination.

During a retinal exam and consultation, Dr. Conlon will perform a series of diagnostic procedures in order to evaluate the retina for any signs of disease or abnormality. These tests may include a visual field test, fluorescein angiography, fundus photography and more. ables an extended view of the retina with enhanced diagnostic capabilities.

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