Retinal

 

Retinal Detachment laser surgery and treatment from one of Pittsburgh's most trusted retinal treatment centers.

The retina is the thin layer that lines the inside of the back of the eye that senses light and sends images to the brain. Common causes of retinal detachment include:

Tears or holes in the retina. These may lead to retinal detachment by allowing fluid from the middle of the eye (vitreous gel) to collect under the retina. A common cause of retinal tears is posterior vitreous detachment (PVD). An eye or head injury or other eye disorders, such as lattice degeneration, a condition in which the retina becomes very thin, may also cause tears or holes in the retina.

Traction on the retina. Traction pulls the retina away from the layers beneath it. The most common cause of this problem is proliferative diabetic retinopathy, a condition that leads to the growth of scar tissue that can pull on the retina.

Fluid buildup under the retina. Fluid buildup causes the layers of the retina to separate, resulting in retinal detachment. Fluid buildup may be caused by inflammation or disease in the retina, in the layer just beneath

 

If left untreated, a detached retina would cause complete loss of vision. However, if a tear is found before the detachment has started, it can be treated with retinal detachment laser surgery or freezing the area to create a seal around the tear,

If a retinal detachment occurs and fluid has leaked under the retina, retinal detachment surgery is usually necessary to seal the tear and push the retina back into its normal position.

Retinal detachments usually occur in one eye, not both eyes at a time. Warning signs of a detached retina include a gradual or sudden increase in floaters in one eye, a gradual or sudden increase in flashes of light in one eye, or the gradual or sudden appearance of a dark cloud or "curtain" over field of vision.

Back to Top


Macular Hole

A macular hole is a small break in the macula, located in the center of the eye's light-sensitive tissue called the retina. The eye contains a jelly-like substance called the vitreous. Shrinking of the vitreous usually causes the hole. As a person ages, the vitreous becomes watery and begins to pull away from the retina. If the vitreous is firmly attached to the retina when it pulls away, a hole can result. Once the vitreous has pulled away from the surface of the retina, some fibers can remain on the retinal surface and can contract. This increases tension on the retina and can lead to a macular hole. In either case, the fluid that has replaced the shrunken vitreous can then seep through the hole onto the macula, blurring and distorting central vision. In very rare instances, trauma or other conditions lead to the development of a macular hole. In the vast majority of cases, however, macular hole develop spontaneously. 

Treatment for a macular hole includes a surgical procedure called a victrectomy.

Back to Top


Macular Degeneration

Age-related Macular Degeneration Treatment (ARMD) from one of Pittsburgh's most trusted eye care and eye surgery centers.


Macular degeneration of the eye begins when the central portion of the retina, the macula, begins to deteriorate. There are two forms of age-related macular degeneration (ARMD). Each damages vision in its own way. The two forms are:

  • Dry ARMD: Dry ARMD causes most cases (about 90%) of ARMD. However, it only accounts for 10% of all blindness from ARMD.
  • Wet ARMD: The situation with wet ARMD is exactly the opposite: it causes only 10% of ARMD but accounts for 90% of all blindness from ARMD.

FAQs for Macular Degeneration

ARMD (age-related macular degeneration) is detected during a thorough eye examination performed by our macular degeneration doctors.
Dry ARMD does not cause pain. The most common symptom of dry ARMD is slightly blurred vision. The person may need more light for reading and other tasks. Also, the patient may find it hard to recognize faces until the person is very close to him or her. As dry age-related macular degeneration worsens, the individual may see a blurred spot in the center of his or her vision. This spot occurs because a group of cells in the macula have stopped working. Over time, the blurred spot may get bigger and denser, taking more of the patient’s central vision. People with dry ARMD in one eye often do not notice any changes in their vision. With one eye seeing clearly, they can still drive, read and see fine details. Some people may notice changes in their vision only if ARMD affects both of their eyes.
AIO uses several drugs to treat wet ARMD. These include: Eylea, Lucentis, Avastin, Macugen, and Visudyne.
In the dry form of macular degeneration, a yellow material begins to collect beneath the retina. This yellow material accumulates in tiny spots called drusen. At this point, patients may become aware of blurring of their central vision. Also, in dry ARMD, the light sensitive cells in the macula slowly break down. With less of the macula functioning, central vision diminishes. Dry ARMD often occurs in just one eye at first. Later, the other eye can be affected. Doctors have no way of knowing if or when both eyes may become involved. The cause of dry ARMD is unknown.
In the wet form of macular degeneration, abnormal blood vessels grow under the retina. These vessels bleed, which may cause central vision to be distorted or destroyed. Wet ARMD is a chronic condition of the eye that causes central vision loss. Many of the things we do each day, such as drive, read, or even watch TV, require central vision. This central vision loss from wet ARMD is caused by damage to the macula, which is the central part of the retina. For some people, wet ARMD progresses slowly. For others, it may progress faster. ARMD is a major cause of central vision loss in Americans ages 55 or older. When you have lived your life being able to do the things you want when you want, central vision loss can leave you missing more than just your sight. Macular degeneration treatment can take many forms, and numerous modalities continue to become available due to continuous research in this field. Our retina doctors who specialize in ARMD perform all of the state-of-the-art treatments for macular degeneration.
Factors that influence the risk for developing ARMD include:
  • Age: Age is the most powerful risk factor.. People in their 50’s have about a 2% chance of contracting ARMD. This likelihood rises to nearly 30% over age 75.
  • Gender: Women tend to be at greater risk than men.
  • Smoking: Smoking increases the risk of ARMD.
  • Family history of ARMD: People with ARMD in the family are at higher risk of developing the disease.
  • Cholesterol: People with elevated levels of blood cholesterol may be at higher risk for wet ARMD.


Additional Links related to Macular Degeneration

Back to Top


Vitreomacular Traction

Vitreomacular adhesion (VMA) is a human medical condition where the vitreous gel (or simply vitreous) of the human eye adheres to the retina in an abnormally strong manner. As the eye ages, it is common for the vitreous to separate from the retina. If this separation is not complete, i.e. there is still an adhesion, the can create pulling forces on the retina that may result in subsequent loss or distortion of vision. The adhesion in itself is not dangerous, but the resulting pathological vitreomacular traction (VMT) can cause severe ocular damage. VMA can also lead to the development of VMT/traction-related complications such as macular puckers and macular holes leading to distorted vision. 

Treatment for VMT includes a surgical procedure called a vitrectomy or the drug Jetrea.

Back to Top


Epiretinal Membrane

An Epiretinal membrane is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes. It is also called a macular pucker. Sometimes, as a result of immune system response to protect the retina, cells converge in the macular area as the vitreous ages and pulls away in a posterior vitreous detachment (PVD). PVD can create minor damage to the retina. These cells can gradually form a transparent layer and, like all scar tissue, tighten to create tension on the retina which may bulge and pucker (e.g. macular pucker), or even cause swelling or macular edema. Often this results in distortions of vision that are clearly visible as bowing and blurring when looking at lines on an Amlser grid. 

The treatment for an epiretinal membrane includes a surgical procedure called a victrectomy.

Back to Top