Retinal Diseases

Retinal Detachment

Retinal detachment is a serious eye condition that occurs when the retina becomes separated from the wall of the eye and its supportive underlying tissue. The retina cannot function when these two layers are detached, and without prompt treatment, permanent vision loss may occur. Retinal detachment can occur from injury to the eye or face, or from very high levels of nearsightedness.

Patients with retinal detachment may experience a blind spot, blurred vision or shadows forming in their peripheral vision. Other symptoms may include an increase in flashes and floaters. It is important to see Dr.Brown at the first sign of symptoms in order to minimize the damage caused by this condition.

To prevent permanent vision loss, the retina must be quickly reattached. Treatment for retinal detachment can be done through surgery or laser photocoagulation. Laser photocoagulation provides a barrier to prevent progression of the retinal detachment. Pneumatic retinopexy is a procedure that places a gas bubble within the vitreous gel. The bubble expands to seal the retinal tear and enables the retina to reattach. A freezing treatment or laser photocoagulation is also placed, in order to form a permanent adhesion.

Many retinal detachments require surgery to put the retina back into the proper position. During the surgery, the vitreous traction on the retina is relieved, laser treatment is performed, and a gas bubble is placed into the eye. After the surgery, the bubble holds the retina in place while the laser spots develop a firm adhesion. In some cases, a thin band is placed on the outside of the eye to help relieve traction and enable the retina to reattach (for more information, see section on eye procedures).

These procedures can preserve vision and may also allow lost vision to return in some patients. The sooner the retina is attached, the more effective treatment tends to be. If you are experiencing signs of retinal detachment, please call us immediately.

Macular Hole

The macula is a small spot in the center of the retina that focuses light at a sharp point and allows us to see objects in detail. This is especially useful for reading, driving and other everyday activities that require clear vision. A macular hole often develops as part of the natural aging process, when the vitreous gel thins and separates from the macula. This can pull on the macula and cause a hole to form. Macular holes can also develop from injury, inflammation, retinal detachment or other eye diseases.

In its early stages, a macular hole may cause a small blurry or distorted area in the center of vision. As the hole grows over time, central vision progressively worsens, and peripheral vision may also be affected. There are three different stages of macular holes, including foveal detachments, partial-thickness holes and full-thickness holes. Each stage can progress to the next if left untreated.

Most macular holes can be successfully treated through vitrectomy, a surgical procedure to remove the vitreous gel and stop it from pulling on the retina. Dr. Brown then inserts a mixture of air and gas into the area to keep its shape. This procedure is performed on an outpatient basis under local anesthesia and is considered a safe and effective treatment for a macular hole.

Epiretinal Membrane

An epiretinal membrane, also known as a macular pucker, is a thin layer of scar tissue that forms over the macula, the area of the retina that gives us clear central vision. An epiretinal membrane often develops with age, as the vitreous gel that makes up most of the eye’s volume thins and pulls away from the retina. The damage caused to the retina leads to the formation of scar tissue on the retina. When the scar tissue contracts, the retina wrinkles, or puckers, causing blurry or distorted central vision.

Patients with an epiretinal membrane may experience difficulty seeing fine details and reading small print, and may also see straight lines appearing as wavy. There may also be a gray area or blind spot in the center of your vision. Although the cause of the conditions is similar, an epiretinal membrane is different from a macular hole. A macular hole is usually a much more serious condition that can progressively worsen.

Most cases of epiretinal membranes do not progress and do not require treatment. The symptoms of distortion and blurriness are usually mild and patients are able to adjust to the vision changes without much impact on their daily lives. Noninvasive treatments such as eye drops or medications will not improve vision that is distorted from an epiretinal membrane. If vision distortion is severe enough, a vitrectomy may be performed to repair this condition.

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