Retinal Diseases

AGE RELATED MACULAR DEGENERATION

Age Related Macular Degeneration is an aging condition in the center of the retina. It is becoming a very common disease as people are living longer. This disease causes blurring, distortion, and “missing spots” in the center of the vision. It only rarely causes loss of all vision. There are two forms of the disease. There is a “wet” type and a “dry” type.

DRY MACULAR DEGENERATION

Approximately 90% of patients have the dry form. This typically leads to very gradual loss of some vision, but typically it does not lead to severe vision loss. There currently is no treatment for this form of the disease, however, due to the less severe vision loss it is considered the “better” form of the disease. Nutrition and vitamins may play a role in prevention or halting progression of this disease.

WET MACULAR DEGENERATION

The “wet” type occurs about 10% of the time. It can lead to very gradual or very rapid severe vision loss. Sometimes patients with this disease can be treated. Treatment with laser is possible in selected cases. There is a new treatment called Photodynamic Therapy that uses a laser and a medication called Visudyne. This treatment is useful in other selected cases. Other treatments including Transpupillary Thermotherapy and surgery are sometimes used and are currently under investigation.

AMSLER GRID

The Amsler Grid is a test pattern on a sheet of paper that patients can monitor in their own home. This test can discover discreet problems. Patients should report any Amsler grid changes or abnormalities to their eye doctor.

DIABETIC RETINOPATHY

If you have diabetes mellitus, you probably know that your body can’t use or store sugar properly. When your blood sugar gets too high, it can damage the blood vessels in your eyes. This damage may lead to diabetic retinopathy. (Your retina is the nerve layer that lines the inside of your eye and converts light into nerve signals that your brain can interpret.)

TYPES OF DIABETIC RETINOPATHY

When blood vessels in the retina are damaged, they can leak fluid or bleed. This causes the retina to swell and form deposits called exudates. 

This is an early form of diabetic retinopathy called nonproliferative or background retinopathy. You may not notice any change in your vision when you develop this early form of the disease, but it can lead to other more serious forms of retinopathy that affect your vision. When fluid collects in the macula (the part of the retina that allows us to see fine details), reading and other close work may become difficult. This is called macular edema. 

In proliferative retinopathy, new, fragile blood vessels grow on the surface of the retina.
These new blood vessels are called neovascularization, and can lead to serious vision problems, because the new vessels can break and bleed into the vitreous. (The vitreous is the clear, jelly-like substance that fills the center of the eye.) 

When the vitreous becomes clouded with blood, light is prevented from passing through the eye to the retina. This can blur or distort vision. 

The new blood vessels can also cause scar tissue to develop, which can pull the retina away from the back of the eye. This is known as retinal detachment, and can lead to blindness if untreated. In addition, abnormal blood vessels can grow on the iris (the colored part in the front of your eye, which can lead to glaucoma.

Dr. Stuart Burgess is the fellowship trained retinal specialist at the Fort Lauderdale Eye Institute.