Retinal diseases vary widely where some are common and easily remedied, while others are rare, more difficult to diagnose and require more complex treatment. A few common retinal diseases and conditions are listed below.
1. Retinal Detachment
A serious eye disease that requires prompt treatment, retinal detachment occurs when the gel-like substance that fills the eye cavity (vitreous) begins to sag and shrink with age. While this shifting occurs in most peoples' eyes as they age, it becomes dangerous quickly if the retina tears. When fluid from the vitreous begins to leak through the tear under the retina, the retina may begin to peel away from the back of the eye. The patient begins to lose vision in the areas where the retina is detached; if left untreated, this condition can lead to permanent and severe vision loss.
Floaters and flashes are common symptoms of degeneration in the eyeball and almost everyone begin to see some of these at forty years old and beyond. However, a sudden and dramatic increase in these symptoms may indicate a retinal tear and an examination by the ophthalmologist are needed. Untreated, these may progress to a retinal detachment, when the patient will notice a black shadow extending across the field of vision, like a curtain drawn across the window.
Retinal holes and tears can be treated with laser surgery. This is done as an outpatient procedure and takes a few minutes to complete. It is safe and non-invasive, and the patient can resume normal activity almost immediately.
By the time the retina detaches, surgery is necessary. The success rate of surgery is more than 90%, though some patients may still experience some degree of visual loss despite successful reattachment of the retina. More than one surgery may be needed to reattach the retina if it detaches again after the initial operation. The surgery is usually performed under general anaesthesia. The eye will appear red and puffy after surgery. Visual recovery can take a few months, though the patient may move about in his daily activity by the next day.
International patients should discuss travel plans with their ophthalmologist, as a gas bubble is sometime injected into the eye as part of the surgery, and after that the patient may not be able to travel by air for three to four weeks.
2. Diabetic Retinopathy
Diabetic retinopathy refers to damage to the tiny blood vessels that nourish the retina. These blood vessels are often affected by the high blood sugar levels associated with diabetes. For those on oral diabetic medication, nearly 60% will develop some form of blood and fat leakage at the back of the eye after 20 years of diabetes, while up to 99% of those requiring insulin injection for their diabetes will develop these damages over twenty years.
Early diagnosis and laser treatment is required to control the progression of the disease in the eye. Laser treatment is safe and non-invasive. It is done as an outpatient procedure and patients can resume normal daily activities on the same day. Further sessions of laser treatment may be scheduled by your ophthalmologist if necessary. Laser treatment can effectively prevent worsening of diabetic retinal disease in the early stages. Despite llser treatment, some patients, especially those with poorly controlled diabetes, experiences progressively worsening eye disease and other treatment may be needed.
Injections may be given into the eyeball to arrest the bleeding. In late stages of diabetic eye disease, advanced vitrectomy surgery can help to clear blood and scar tissue from the back of the eye to save vision.
Good general diabetic control with medication and regular review by your ophthalmologist are keys to maintaining healthy vision in those with diabetes disease.
3. Age Macular Degeneration
Age-related macular degeneration (AMD) is a chronic eye condition that affects age 50 and older. When a person has macular degeneration, the macula begins to deteriorate, causing anything from blurred or slightly distorted central vision to a blind spot in the center of the visual field.
Usually the symptoms of retinal diseases are painless, and some may be slight and difficult to notice. When the disease is present in only one eye, the healthy eye will compensate for the other; many people live with a disease for years without knowing.
Signs and symptoms of a retinal disease may include:
- Tiny specks and spots that appear to float in the field of vision
- A sensation of flashing lights in one or both eyes
- Blurred vision or vision loss
- A shadow over a portion of the visual field
- Poor night vision
- Difficulty adjusting from bright to dim light
The goal of many treatments is to stop further progression of the disease. In most cases, the damage that has already occurred cannot be reversed, making early detection very important for vision preservation. Treatment options include laser, injections of anti-angiogenic medication into the eye and vitreoretinal surgery. Treatment can limit or slow down the progression of the disease, but a complete cure is not available. Long term regular reviews by your ophthalmologist are necessary.