Retina Care at Tri-County Eye

The eye has many delicate parts that allow it to function like a camera. The retina is a thin and delicate layer inside the back of the eye. It transmits visual information to the brain. If the retina becomes diseased, poor vision may result. At Tri-County, we are committed to ensuring the health of your eye. Every full eye health exam includes detailed examination of the retina to ensure there is no significant problems.

Our comprehensive ophthalmologists closely monitor retinal problems when they arise, and when neccessary, refer you to a retinal specialist if specific treatment is needed.

Common problems that can involve the retina include:
Age Related Macular Degeneration

The macula is the most central part of the retina, the film like structure of the eye that transmits your vision from the eye to the brain. Macular degeneration is a multifactorial genetic process in which the macula of the retina degenerates and atrophies. This is the leading cause of functional blindness in America in people over the age of 60 years. Thankfully this is a slow process that can take years to develop. It occurs in two forms, the initial “dry” form and the late “wet” form.
In the dry form, waste material form the rods and cones in the retina pile up under the retina and accumulate. These collections, called drusen, eventually lead to retinal break down and atrophy in the areas overlying the drusen. Vitamin therapy, along with amsler grid testing, is recommended in most patients with early ARMD to prevent vision loss. Dry age related macular degeneration accounts for 90% of patients.

The wet form only occurs in 10% of patients with macular degeneration, but is much more devastating to the vision. In areas where the retina has degenerated, the underlying blood vessels that feed the outer retina grow up in these injured areas of retina. Biochemical signals are responsible for this growth. In the past, laser treatments alone were used destroy these vessels. Today a combination of laser treatments, photodynamic therapy and most recently, eye injections with anti-growth factor type medicines like Lucentis, Avastin and Macugen, slow down or halt the damage from these leaking and bleeding vessels.

The Amsler Grid

amslergrid2

INSTRUCTIONS

  • Test one eye at a time, covering the opposite eye
  • Wear regular reading correction, if any, and hold at normal reading distance
  • Focus upon the center dot
  • Note any irregularities in the linear grid or any blurred areas
  • Report results to your eye care specialist.
Flashes and Floaters

The retina is the thin layer that lines the inside of the eyeball and acts as the film that captures your vision and transmits it to the brain. No matter how you stimulate the retina (shine a light in the eye, push on the outside of the eye, or pull on the retina from within the eye) it only responds by “seeing light”. The inside cavity of the eye is filled with a clear jelly called the vitreous. As we get older, the vitreous tends to liquefy, and pull away from the retina. In doing so, this process temporarily places traction on the retina and thus you see a quick flash of light like a flash of a camera. This is most often noticed at night when it is dark out and the flash is seen in the periphery of your vision. After the vitreous pulls away from the retina, small bits of debris float inside the eye and cast a shadow onto the retina. Thus there is often the perception of a bug in front of your eye or a hair in front of the eye. This process is known as a vitreous detachment.

These “Flashes and Floaters” are typically transient. The flashes will last a few days to a couple of weeks, while the floaters never fully go away but do settle down. The major concern with a vitreous detachment is that this common and benign process can sometimes pull too hard on the retina and tear it, leading to a retinal detachment. A retinal detachment is a sight threatening process that typically progresses over several days and is most often associated with an area of distorted peripheral vision. This distortion progresses as more of the retina detaches.

Since vitreous detachments can sometimes lead to a retinal detachment, it is recommended that patients with flashes, floaters, and most importantly changes in their peripheral vision, be examined as soon as possible.

Diabetic Retinopathy

Diabetes is a chronic disease associated with high blood sugar. This can occur early in age from a lack of insulin production by the pancreas or later in life due to a change in sugar metabolism from resistance to insulin. Either way, high sugar levels circulating in the blood stream over time corrodes this inside of blood vessels. As a result the blood vessels get damaged and in turn the function of the organ containing these vessels is compromised. The eyes, along with the kidneys, heart and nerves, contain the highest concentration of blood vessels in the human body and thus become injured over time. In the eye in particular, injured blood vessels lead to bleeding, swelling and irregular blood vessel regeneration. All of these lead to decreased vision over time.

Diabetes, resulting in retinopathy or injury to the retina in the eye, is the most common cause of blindness in individuals under the age of 65 years in the USA. The duration of diabetes is the most important single risk factor with a 90% prevalence of diabetic retinopathy in those with the disease more than fifteen years. Strict control of blood sugar is the best way to avoid or diminish the possible side effects of diabetes. Early detection of diabetic retinopathy, and treatment when indicated, is currently the best hope of preserving vision.

Annual eye exams are recommended for patients with diabetes to ensure the health of their vision.