Retina Care
The Retina is the light sensitive layer of tissue in the back of the eye that converts light and images into electrical signals that are sent to the brain to be processed into vision. Damage or conditions affecting the retina are often serious and can cause significant vision loss. Early detection and management of retina conditions can be sight saving. Being aware of concerning symptoms and getting prompt evaluation and care for these is important for your eye health and vision. Ohio Eye offers comprehensive eye care for screening, monitoring and managing retina conditions, including access to several fellowship trained retina specialists. Below are some common symptoms and conditions to be aware of that may impact your eye health.
Flashes and Floaters
Flashes and floaters are symptoms of the eye that commonly occur as a result of age-related changes to the vitreous gel. When we are born, the vitreous is firmly attached to the retina and is a thick, firm substance without much movement. But as we age, the vitreous becomes thinner and more watery, and tissue debris that was once secure in the firm gel can now move around inside the eye, casting shadows on the retina.
Flashes in vision occur as a result of pressure on the retina in the back of the eye and causes patients to see flashing lights or lightning streaks. Floaters occur when fibers move across the vitreous and into your field of vision, causing patients to see specks, strands, webs or other shapes as the fibers cast shadows on the retina. These spots are most visible when looking at a plain, light background.
Although flashes and floaters are common, especially as we age, it is important to see your doctor if you experience them, as they may indicate a retinal tear or detachment, which is a serious, sight threatening condition. Your doctor can distinguish between harmless flashes and floaters, and those that may require treatment for an underlying condition. Most flashes and floaters will become less noticeable with time as patients adjust their vision.
Retinal Tear & Detachment
Retinal tears and detachments are serious, sight threatening conditions. A torn retina describes a tear or hole in the thin retina tissue located in the back of your eye. People often note blurred vision, new flashes and floaters if the retina tears, and if not promptly treated, it can lead to a retinal detachment. A detachment is where the retina is lifted away from the back of the eye. This results in significant and potentially permanent changes in your vision. Prompt evaluation and treatment of a retinal tear or detachment, often with a Retina Specialist, is required to preserve vision.
Call us immediately if you have any of these symptoms:
Seeing flashing lights in your vision.
Noticing many new floaters. These can look like specks, lines or cobwebs in your field of vision.
A shadow appearing in your peripheral (side) vision.
A gray curtain covering part of your field of vision.
Macular Degeneration
The macula is a part of the retina in the back of the eye that ensures that our central vision is clear and sharp. Age-related macular degeneration (AMD) is a complex condition that results in damage to the macula. As its name implies, it is more common with age but can have a variety of causes. Patients suffering from AMD experience anything from a blurry, gray or distorted area to a blind spot in the center of vision.
AMD is the number one cause of vision loss in the U.S. Macular degeneration doesn’t cause total blindness because it doesn’t affect the peripheral vision. Possible risk factors include genetics, age, diet, smoking and sunlight exposure. Regular eye exams are highly recommended to detect macular degeneration early and prevent permanent vision loss.
Symptoms of macular degeneration include:
A gradual loss of ability to see objects clearly
A gradual loss of color vision
Distorted or blurry vision
A dark or empty area appearing in the center of vision
There are two kinds of AMD: wet (neovascular / exudative) and dry (non-neovascular). About 10-15% of people with AMD have the wet form. “Neovascular” means “new vessels.” Accordingly, wet AMD occurs when new blood vessels grow into the macula. These new vessels are very fragile and often leak blood and fluid between the layers of the retina. Not only does this leakage distort vision, scar tissue can form resulting in a dark spot in the patient’s central vision.
Dry AMD is much more common than wet AMD. Patients with this type of macular degeneration do not experience new vessel growth. Instead, thinning of the retina, loss of retinal pigment and the formation of small, round particles inside the retina called drusen can be found.
Vision loss with dry AMD is slower & often less severe than with wet AMD. We recommend patients with dry AMD or at high risk for developing AMD take over the counter vitamins (AREDS2 formulation) to reduce their risk for progressive vision loss or conversion to wet AMD. Patients with advanced dry AMD or wet AMD often require treatment with a Retina Specialist.
Amsler Grid
The Amsler Grid chart should be used to check the central part of your visual field, the area that can be damaged by Macular Degeneration.
Instructions for Use:
View the chart (with your reading glasses on) at normal reading distance.
Completely cover one eye and look at the central dot on the chart.
Notice if there are any areas within the grid that appear gray (or black), or if there are any areas where the straight lines appear bent, crooked, or missing.
Check the chart regularly (daily or weekly).
Call your doctor if new changes occur.
Macular Pucker (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, surgical treatment with a Retina Specialist may be required.
Macular Hole
A macular hole is an opening or defect which occurs in the central macula that can be caused by scar tissue forming on the surface of the retina or adhesions between the retina and the vitreous gel. Early symptoms of a macular hole are blurry, wavy and distorted central vision. If the hole worsens, a central dark or blind spot can develop.
Age is the most common cause of a macular hole, though many other eye conditions or eye trauma can contribute to development of this condition.
Treatment of a macular hole is typically surgical and requires the care with a Retina Specialist.