Retina Consultants

Our practice focuses on the care and treatment of complex diseases of the retina, vitreous and uvea. The retina lines the back of the eye and receives images somewhat like the film on a camera. The macula is the central part of the retina and is responsible for high-resolution vision, such as that required for reading and driving. The vitreous is a transparent, jelly-like substance in front of the retina, filling the interior of the eye.

Many diseases involve the retina, from localized disorders to manifestations of systemic diseases, such as diabetes. We specialize in the medical and surgical management of all types of vitreo-retinal diseases, including:

Retinal tears and detachments
Diabetic retinopathy
Macular diseases, including age-related macular degeneration
Retinal-vascular diseases
Ocular trauma
Intraocular tumors
Uveitis (inflammation)
Systemic diseases with retinal manifestations

Common Reasons Why Patients Visit a Retina Specialist:

Floaters and Flashes: Small particles consisting of cells or pigment that move in the vitreous. Floaters have been described by patients as seeing bugs crawling on the walls or flies moving across their face or within their field of vision. They can be in the shape of dots or spider webs; even hair like. Floaters may be symptoms of inflammation in the eye, bleeding in the eye and a vitreous or retina detachment.
Flashing in the eye may be of different intensity as well as size and shape. A bright “arch shaped” light on the corner of the eye which last a split second each time and repeats in various intervals. This is usually more prominent in dark lighting and is typically caused by a pull on the retina by a vitreous tag and/or retina tear/detachment. With these symptoms a patient should see a retina specialist immediately to have their retina examined and treated to minimize further damage.

Retinal Detachment: The retina can detach from the back of the eye, leading to rapid visual loss. This is often seen as a curtain clouding part of the vision. Retinal detachments occur from retinal holes that develop during vitreous detachment or from diseases such as diabetes or viral infection within the eye. Patients should be examined by a retina specialist so that surgical treatment can be discussed and initiated.

Diabetic and Hypertensive Retinopathy: Both diseases (when not controlled properly) may perhaps cause damage to the smallest blood vessels in the brain, kidneys, heart as well as the eyes. Ophthalmologists are fortunate to see the blood vessel damage directly within the eyes and treat it accordingly. Various studies have proven that early detection and treatment of diabetic retinopathy prevents further loss of vision.

Uveitis: Inflammation of the uveal tract which is the vascular coat of the eyeball. Some of the symptoms include the following: light sensitivity, blurred vision, pain, floaters, and redness in the eye. There are many reasons why one may develop uveitis. Some of the causes include:

a viral infection, such as shingles, mumps, or herpes simplex;
a fungus, such as histoplasmosis;
a parasite, such as toxoplasmosis;
related disease in other parts of the body, such as gastrointestinal disease (Crohn’s disease, inflammatory bowel disease) arthritis (rheumatoid, psoriatic), vascular disease;
a result from an injury to an eye.

In most cases the cause of uveitis is unknown. Treatment for this disease includes eye drops (especially corticosteroids and pupil dilators). It is often important to coordinate the treatment of uveitis with other physicians since the management of these diseases can affect other parts of the body.

Age Related Macular Degeneration (ARMD): This disease affects the central (reading) visions by damaging the retina. There are two forms of ARMD. the dr form is an age related change beneath the retina that can cause slow loss of vision. The wet form is a more severe form of the disease that involves new blood vessel growth beneath the retina resulting in bleeding and swelling in the retina and visual distortion and impairment. A common symptom of ARMD is blurred reading vision or distortion of straight lines. There are several treatment options now available for ARMD, with more being developed each year.

Retinal Vein Occlusion: The blood vessels of the retina can become occluded. Vein occlusion is more common than artery occlusion and is more likely to occur in patients with hypertension or diabetes or in patients with an abnormal tendency to form blood clots. When the retinal veins become blocked, bleeding and swelling occur within the retina leading to distorted and blurred vision. Treatment for these problems depends on the location and severity of the occlusion.

Sudden Visual Loss: Sudden loss of vision can occur from a number of retinal diseases including retinal detachment, retinal blood vessel occlusion, bleeding within the eye. Other causes of sudden visual loss include a stroke, acute glaucoma and inflammation of the optic nerve.

Other Retinal Disease: These include macular hole, macular pucker, hypertensive retinopathy, cystoid macular edema, ocular tumors and inherited retinal degenerations.

Glaucoma: An optic nerve damage caused by high intraocular pressure. It does not cause any pain and takes place gradually. Therefore, it is considered a “silent blinder”. It may be related to one’s heredity or ethnicity. Early detection and treat can help with prevention of blindness.

Office Procedures
Using state-of-the-art technology and advanced surgical techniques, we can treat many retinal diseases-such as diabetic retinopathy, macular degeneration, some tumors, retinal tears, and selected retinal detachments-in our office.

The following procedures require no incision:

Retinal Laser photocoagulation
Intravitreal injections
Pneumatic reinopexy

Hospital Procedures
Some surgical procedures do require the specialized equipment available only in the operating room. Should this be necessary, our staff will work with you to schedule the procedure at the surgical facility most appropriate for you. Surgical cases are typically performed on an outpatient basis. Our physicians have privileges at many hospitals and ambulatory facilities in the area.

Diagnostic Tests Performed in our Offices:

Visual Field Test: This test evaluates the total area in which objects can be seen in the peripheral vision while the eye is focuses on a central point. The test will detect any loss of peripheral vision and provide a map of that loss which will be helpful in diagnosing the cause. A brain tumor, stroke in the brain, vascular diseases in the eye (such as retinal vein/artery occlusion) and optic nerve damage (due to glaucoma) retina damage (caused by detachment) and macular degeneration are some of the diseases that may be detected by the visual field test.

ICG or Fluorescein Angiography: These are diagnostic procedures in which a rapid sequence of photographs are taken by a high resolution camera and analyzed by a computer to document the blood circulation of the retina/choroids. The dye is typically injected into a vein in the arm, forearm or hand. Both procedures are very important tools retina doctors use to diagnosis and guide treatment of macular degeneration. Other than macular degeneration; fluorescein angiography is used to diagnosis and treat diabetic retinopathy, hypertensive retinopathy and other vascular and chorioretinal diseases.

Optical Coherence Tomography (OCT): This procedure combines with technology to measure the thickness of the retina at the micron level. With this machine it is possible for our physicians to identify and diagnose many types of retinal abnormalities by obtaining optical scans of a cross-section of the retina. This is useful in evaluating age-related macular edema, cystoid macular edema, diabetic macular edema, macular tension syndrome, macular holes and surface wrinkling retinopathy.

Ocular Ultrasound: Ultrasound imaging is useful when the view into the eye is obstructed by cataract, hemorrhage or other opacities. It is also useful in the diagnosis of ocular tumors.

Links

The following are links to sites you may find useful:

Organizations

American Academy of Ophthalmology

American Society of Cataract and Refractive Surgery

American Society of Retina Specialists

American Uveitis Society

Columbia Lighthouse for the Blind

Macula Vision Research Foundation

Prevent Blindness America

Prevention of Blindness

The Macula Society