Lets understand what is retina and various diseases which can affect retina

What is Retina?

The retina is the innermost layer of the eye, and it features many light-sensitive photoreceptor cells.

These cells detect light and convert it into electrical signals

Retinal tear

A retinal tear happens when there is a tear or hole in the retina. This typically occurs when the vitreous,

which is a jelly-like substance in the eye, attaches to the retina and pulls hard enough to tear it. This can

happen when the vitreous detaches as part of the aging process, or it can result from trauma.

Retinal tears can cause blurry vision, the sudden onset of floaters, or flashes of light.

It is important for people to receive treatment for a retinal tear, as it may result in retinal detachment.

This is a more serious condition that affects vision.

Retinal detachment

Retinal detachment occurs when a buildup of fluid, which usually enters through a retinal tear, causes

the retina to detach from the choroid, which is the eye layer that provides it with oxygen and nutrients.

Retinal detachment is a medical emergency that, without treatment, may lead to permanent vision loss.

Retinopathy

Retinopathy results from damage to the blood vessels at the back of the eye, which causes fluid to leak. This accumulation of fluid can affect the retina and result in changes to vision. Conditions that can cause retinopathy include diabetes, high blood pressure, anemia etc

Diabetic retinopathy i.e diabetic eye disease is a common complication of diabetes, with evidence suggesting that it is a leading cause of blindness among adults in the India

Epiretinal membranes

Epiretinal membranes (ERMs), also called macular puckers or cellophane maculopathy, make up a thin layer that forms on the retina’s inner surface. It is usually scar tissue from a medical condition or injury. ERMs often do not cause symptoms, except when they affect the macula or the center of the retina, which is important in perceiving visual details and features. A person may notice distortion of their central vision.

Macular hole

Similar to retinal tears, macular holes are small breaks in the macula that occur due to an unusual pulling between the vitreous and the retina. Aging is the most common cause of macular holes. Eye injuries may also result in macular holes.

Macular degeneration

Because macular degeneration is more common among older adults, eye doctors usually call it age-related macular degeneration (AMD). With this condition, the macula deteriorates and causes distorted central vision, which may worsen over time and cause permanent vision loss. It is a common cause of loss of vision in elderly

Retinitis

Retinitis refers to the inflammation of the retina. It usually results from viruses and bacteria. For example, Lyme disease, syphilis, and Dengue fever may cause retinitis. Autoimmune conditions, such as  Behçet’s disease  and lupus, may also cause this condition.

Retinitis pigmentosa

Retinitis pigmentosa is a rare genetic degenerative condition that causes a breakdown and loss of cells in the retina. This can cause a progressive loss of vision.

Macular edema

Macular edema is a condition that occurs due to fluids building up in the macula, causing it to swell. Several conditions can cause macular edema, including AMD, diabetes, and retinal vein occlusion.

Retinal vein occlusion

Retinal vein occlusion, or eye stroke, is a blood vessel disorder wherein branches of the retinal vein become occluded, causing fluid and blood to spill onto the retina. The blockage cuts off circulation, which can cause nerve cells to die, leading to vision loss.

Diagnosis

To examine and diagnose eye conditions such as retinal disorders, ophthalmologists will typically first ask about the person’s medical history. This allows them to look for factors that may affect their vision, such as underlying conditions. They will then perform a comprehensive eye exam with a particular focus on the retina and the macula. They will use a special instrument called an ophthalmoscope to investigate the inside of the eye.

The ophthalmologist may use eye drops to widen (dilate) the pupil to see the inner eye better. They may also request an eye ultrasound and give numbing eye drops to prevent discomfort as they scan the eye. Ophthalmologists may also take images of the retina using optical coherence tomography (OCT). They may also request dye tests such as fluorescein angiography to look for leakage in the blood vessels.

Treatment

The goals of treatment will be to preserve and restore vision or to prevent and slow down the damage in the retina.

Treatment for retinal disorders varies depending on the type and extent of the condition. Options may range from medications and vitamins to injections, surgery, and laser treatments.

An individual’s eye specialist will discuss the most suitable treatment options for their condition.

Glaucoma : the silent thief of vision

 

Glaucoma is a disease that causes loss of sight by damaging a part of the eye called the optic nerve. This nerve carries information from eyes to brain.

Glaucoma is an eye disease which causes loss of sight by damaging the optic nerve. This nerve carries information from your eyes to your brain.

When glaucoma damages your optic nerve, one first loses patches of vision, usually side vision . Over a period of time, glaucoma may also damage central vision. You may not notice a loss of vision until you

have lost a great deal of your sight. When checking for glaucoma, eye specialist usually look for damage to the optic nerve and any loss of vision. They will also check your eye pressure. Glaucoma is called the ‘silent killer of vision’ because people usually do not notice any signs of the disease until too late. Once lost, vision cant be recovered

Who is at Risk for Glaucoma?

These risk factors may increase your chance of having glaucoma:

 Age: The older you are, the greater your risk

 Race: Certain races have higher risk for glaucoma

 Family history : If your first degree relative has glaucoma, you have increased risk

 Systemic history: Diabetes mellitus, previous eye injuries, eye surgery or long-term steroid use anywhere in the body can increase your risk of glaucoma

Investigations:

 Tonometry: the pressure of the eye is measured 

Pachymetry: Thickness of the cornea (the front window of the eye) may affect the pressure reading and the risk of glaucoma progression, pachymetry is The medical terminology for measurement of central corneal thickness.

 Ophthalmoscopy: To examine the Optic nerve

 Gonioscopy: To examine the area in the front of the eye known as the drainage angle.

 Perimetry: Evaluates your visual field.

 Photography: This is a documentary proof of the existing appearance of your nerve in color and black and white. It can be used as a visual record of the nerve appearance over a period of time.

All the above tests will be done at the time of diagnosis and a systematic document would be made that would help the doctor treat you in the best possible way. Some of the above tests need periodic repetition that has a specific scientific logic. Please ask your doctor and understand the details and the logic behind such a routine. This will greatly enhance the way you understand your disease.

 Treatments: Glaucoma can usually be treated and controlled using medicine(s), laser surgery, glaucoma surgery or a combination of these treatments. Medicines (eye drops) are typically the first step in treatment, but laser surgery may be just as effective as a first choice. Your treatment is up to you and your doctor

 Treating Glaucoma with Medicines: Doctors prescribe many types of medication to treat glaucoma. These drugs lower the pressure inside the eye. Often, people with glaucoma have to take these medicines for life to control the pressure and limit vision loss. Remember, you and your doctor must work together to determine the best medicines for you.

Treating Glaucoma with Laser Surgery

Some people may need eye surgery to control their glaucoma. Lasers are very useful for treating glaucoma because they avoid cutting and have a lower chance of complications (compared to glaucoma surgery).

There are three common laser procedures:

 Laser trabeculoplasty

 Peripheral iridotomy

 Laser cyclophotocoagulation.

Treating Glaucoma with Glaucoma Surgery

 Filtering surgery

 Drainage implant surgery