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RETINA

Retina is the light-sensitive tissue lining the back of our eye, light rays are focussed onto the retina through the cornea, pupil and Lens then the light rays are converted into impulses that travel through the optic nerve to the brain, where they are interpreted as images we see. A healthy, intact retina is important for clear vision.There are different problems that are related to Retina and patients are recommended to get them treated at the earliest as delaying treatment will reduce their vision. If treatment is delayed for a very long time vision restoring is tough and sometimes not possible.

retina

Common Retinal problems

Diabetic Retinopathy

Macular Degeneration

Retinal tears/holes

Retinal Detachment

Retinal Vein Occlusion(CRVO/BRVO)

1. Diabetic Retinopathy

Diabetes Microvascular and macrovascular complications affect up to 72% of total population. Diabetic Retinopathy is a leading cause of new cases of blindness in adults of working age (20 to 74 yrs.) with, poor glycemic control, poor BP control. Other complications are early cataract and glaucoma. Diabetic retinopathy often has no early warning signs. The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy. Diabetic retinopathy is damage to the retinal blood vessels which can eventually lead to blindness without treatment.

retina

How does DR affect your vision?

Initially, DR is symptomless I.e. patients will have no complaints and they will have perfect vision. Due to this patients will not come for regular eye check-ups. But at the same time, there can be minimal bleeding or swelling which is treatable if identified in the early stages.

Frequency of Retinal examination to be done for Diabetics

If you have diabetes, you should have a detailed eye examination by a retina specialist at least once in a year.

With No Diabetic Retinopathy - Yearly check up

Early stages of DR – once in 6 month

Severe DR – once in 3 months

Tests that can be undertaken for Diabetic Retinopathy screening?

If you have diabetes, you should have a detailed eye examination by a retina specialist at least once in a year.

Indirect Ophthalmoscopy

Fundus fluorescein angiography(FFA)

Optical Coherence Tomography (OCT)

Diabetic Retinopathy Treatments

Please note that:

Early stages need no intervention and patient have to control his blood sugars/BP/cholesterol strictly with frequent, regular follow-ups are advised.

Late stages will need FFA, OCT to confirm the diagnosis followed by following treatment options.

Some of the common treatments that are done to handle DR are:

Laser photocoagulation

Anti VEGF (Vascular endothelial growth factors)

Intra Vitreal steroids injections/implants

Pars plana Vitrectomy +Silicon oil or gas+endolaser


2. Macular degeneration (ARMD DRY/WET)

Treatment includes monthly injections of intravitreal Anti VEGF (Bevacizumab/Ranibizumab). The treatment may require multiple injections till the bleeding subsides.


3. Retinal tear/Breaks

These are small areas of the retina that are torn. Symptoms include a sudden or gradual increase in a number of floaters (cobwebs or specks that float in your field of vision), FLASHES (experiencing sudden lightening)

Treatment
Holes and Breaks can be treated with barrage laser which will prevent further retinal detachment


4. Retinal Detachment

Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a medical emergency.

Signs and Symptoms
A retinal detachment is commonly preceded by a posterior vitreous detachment which gives rise to these symptoms:

flashes of light (photopsia) – very brief in the extreme peripheral (outside of center) part of vision.

A sudden dramatic increase in the number of floaters.

A ring of floaters or hairs just to the temporal side of the central vision.

A slight feeling of heaviness in the eye.

The impression that a veil or curtain was drawn over the field of vision.

Straight lines (scale, edge of the wall, road, etc.) that suddenly appear curved (positive Amsler grid test) central visual loss.

There are few more and it is recommended for patients to approach eye specialist on any minor difference in their vision.

Risk Factors:
Risk factors for retinal detachment include severe myopia, retinal tears, trauma, family history, as well as complications from cataract surgery.

TYPES OF RETINAL DETACHMENTS:


   5. Central Retina vein occlusion(CRVO/BRVO)

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