Retinal disorders

The retina is the light-sensitive layer deep inside the eyeball, lining the back of the eye. It is a piece of neural tissue that creates a focused two-dimensional image that is translated into a neural electrical impulse that translates the image to create visual perception.

What symptoms do you experience in case of retinal disorders?

Many retinal diseases have some common signs and symptoms. These may include:

  • Seeing floating particles or cobwebs
  • Blurred or distorted vision (straight lines appear wavy)
  • Side vision errors
  • Vision loss
  • The appearance of a “veil” before the eyes. It is important to be clear from which side the “veil” has appeared, as over time it can expand and take up the whole field of vision
  • Noticing bright spots like sparks or lightning
  • Distortion of the image of the letters seen, of the objects, indicating that the detachment has reached the center of the retina
  • Sometimes the patient notices that in the horizontal position of the body the vision improves because the retina is repositioned, and in the vertical position the vision errors reappear, because the retina detaches again from the vascular membrane.
  • It is important to note that retinal detachment is not painful.

You may have to try looking with each eye individually to notice these issues.

What are the risk factors for retinal disorders?

It’s important to be aware of any changes in your vision and to see an ophthalmologist quickly. Immediate medical attention is needed if you suddenly see many floating particles, flashes or reduced vision. These are warning signs of a potentially serious retinal disease.

Risk factors for retinal diseases might include:

  • Ageing
  • Smoking
  • Obesity
  • Diabetes or other diseases
  • Eye trauma, large pressure variations, intense physical effort
  • A family history of retinal diseases
  • High myopia
  • Diabetic retinopathy
  • Intraocular tumors
  • Retinal dystrophy, retinopathy of prematurity (in preterm and especially babies with a low birth weight)

How can diabetic retinopathy be prevented?

Most cases of retinal disorders are related to ageing or related vitreous detachment. These are difficult to predict or prevent. However, prevention of retinal disorders starts with regular annual eye examination. Regular examination helps us detect any changes, such as inflammation, thinning or breaks in the retina, that could progress to retinal detachment.

What types of retinal disorders are there?

Common retinal diseases and disorders include:

Retinal detachment. Occurs when the two membranes of which the retina is composed detach from each other (the light capturing retinal membrane detaches from the nourishing vascular membrane). Retinal detachment can be primitive and occurs due to ageing and can occur in people over 50-60 years of age. A retinal detachment is defined by the presence of fluid under the retina. It is often accompanied by the sudden appearance of symptoms such as floating particles and flashing lights.

Diabetic retinopathy. If you have diabetes, the small blood vessels (capillaries) at the back of the eye can become damaged and bleed into and under the retina. This causes the retina to swell, which can blur or distort your vision. Or you may develop new, abnormal capillaries that rupture and bleed. This also makes your vision worse.

Epiretinal membrane. The epiretinal membrane is a scar or delicate tissue-like membrane that looks like a wrinkled cellophane that lies over the retina. This membrane can pull on the retina, which distorts your vision. Objects may appear blurry or twisted.

Macular hole. A macular hole is a small defect in the center of the retina (macula). The hole may develop from abnormal traction between the retina and vitreous or it may be caused by an injury to the eye.

Macular degeneration. In macular degeneration, the center of the retina begins to deteriorate. This causes symptoms such as central blurred vision or a blind spot in the center of the visual field. There are two types – 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.

Retinitis pigmentosa. Retinitis pigmentosa is an inherited degenerative disease. It affects the retina and causes loss of night and side vision.

What treatment methods exist for retinal disorders?

The main goals of treatment are to stop or slow the progression of the disease and to preserve, improve or restore vision. In many cases, damage that has already occurred cannot be reversed, making early detection important. Each case is unique, and the therapeutic approach can take place after examination and thorough investigation. Treatment of retinal disease can be complex and sometimes urgent.

Options include:

Laser surgery – can repair a tear or hole in the retina. The doctor uses a laser on small spots on the retina. This creates scars that connect (weld) the retina to the underlying tissue. Immediate laser treatment of a new retinal tear can reduce the risks of it causing a retinal detachment.

Reduction of abnormal blood vessels. We can use a technique called laser photocoagulation to shrink abnormal new blood vessels that are bleeding or threatening to bleed into the eye. This treatment can help people with diabetic retinopathy.

Vitrectomy. In this procedure, the doctor removes the gel-like fluid that fills the inside of your eye (vitreous). Air, gas or liquid is then injected into the remaining space. Vitrectomy may be used if bleeding or inflammation covers the vitreous and obstructs the surgeon’s view of the retina. This technique may be part of the treatment of people with retinal rupture, diabetic retinopathy, macular hole, epiretinal membrane, infection, eye trauma or retinal detachment.

Intravitreal injections. Your doctor may recommend intravitreal injections. This technique can be effective in treating people with wet macular degeneration, diabetic retinopathy or broken blood vessels in the eye.

Text medically reviewed by Dr. Teodor Holhoș, Ophthalmic Surgeon
Written by Dr. Holhos Team

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A patient who cancels a consultation or surgery appointment once, at least one day prior to the scheduled appointment, has the right to a second appointment under the same conditions.
If the patient cancels the second consultation and/or surgery appointment, a new appointment can be made only if the patient accepts to pay for both the consultation and the surgery in advance. This can be done either by payment order or in cash at the clinic reception.
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