Retina

Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes that affects the eyes. It is caused by damage to the blood vessels in the retina, the light-sensitive tissue at the back of the eye that is essential for vision.

In the early stages of diabetic retinopathy, there may be no noticeable symptoms. As the condition progresses, however, symptoms can include blurred vision, dark or empty areas in the field of vision, difficulty seeing at night, and sudden vision loss.  If not treated in a timely fashion, diabetic retinopathy may result in permanent visual damage.

Diabetic retinopathy can be classified into two main types: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). NPDR is an early stage of the disease, where the blood vessels in the retina become damaged and leak fluid or blood, leading to swelling or deposits of material in the retina. PDR is a more advanced stage, where new blood vessels grow abnormally on the surface of the retina, which can lead to bleeding, scarring, and ultimately, vision loss.
In some people with diabetic retinopathy, retinal blood vessels may leak fluid and cause swelling of the retina in the macular region, resulting in Diabetic Macular Edema (DME) which is a leading cause of vision loss.

 Treatment for diabetic retinopathy may include the injection of medications, laser therapy or surgery, depending on the severity of the condition. Early detection and management of diabetes is important in preventing diabetic retinopathy and other complications associated with the disease. Regular eye exams are recommended for people with diabetes to detect and manage any eye-related complications early.

The Arlington Eye Physicians retina specialists have extensive experience diagnosing and treating diabetic retinopathy and will discuss with you the best approach in the management of your particular disease.  

Retinal Vein Occlusion

Retinal vein occlusion (RVO) is a blockage of the retinal veins, which are the blood vessels that carry blood away from the retina and back to the heart. RVO occurs when there is a clot or blockage in the retinal vein, which can cause a backup of blood and fluid in the retina and may lead to severe vision loss.

There are two main types of RVO: branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). BRVO occurs when one of the branches of the retinal vein is blocked, while CRVO occurs when the main retinal vein is blocked.

Symptoms of RVO can include sudden, painless vision loss or blurry vision in one eye, distorted vision, and blind spots in the visual field. The severity of the symptoms depends on the location and extent of the blockage.

RVO is mostly caused by age-related changes to the blood vessels, but other risk factors include high blood pressure, diabetes, high cholesterol, smoking, and certain medical conditions or medications. RVO is more common in older adults, and the risk increases with age.

Treatment for RVO may include the injection of medications to reduce swelling and inflammation in the eye, laser therapy to reduce the risk of vision loss, or surgery to remove blood or fluid from the eye. In addition, lifestyle changes such as quitting smoking, managing blood pressure and cholesterol, and maintaining a healthy weight may help reduce the risk of developing RVO or slow its progression. 

Age-Related Macular Degeneration

Macular degeneration, also known as age-related macular degeneration (AMD), is a progressive eye disease that affects the macula, the central part of the retina responsible for sharp, detailed vision.

There are two main types of AMD: dry AMD and wet AMD. Dry AMD is the most common type and is characterized by the gradual thinning and breakdown of the macula over time, leading to a loss of central vision. Wet AMD, on the other hand, is less common but more severe. It occurs when abnormal blood vessels grow under the retina and leak fluid or blood, which can cause rapid and severe vision loss if left untreated.

Symptoms of AMD can include blurred or distorted vision, difficulty seeing fine details, and dark or empty areas in the center of the visual field. AMD typically affects people over the age of 50, and certain risk factors such as smoking, a family history of AMD, and cardiovascular disease can increase the likelihood of developing the disease.

There is no cure for AMD, but treatments such as intravitreal injections can improve damaged vision due to leakage or bleeding and slow the progression of the disease. In addition, lifestyle changes such as quitting smoking, maintaining a healthy weight, and eating a diet rich in fruits, vegetables, and omega-3 fatty acids may help reduce the risk of developing AMD or slow its progression. Regular eye exams with an ophthalmologist are important in detecting and managing the disease early, especially in those with a family history of this disease.

The Arlington Eye Physicians retina specialists have extensive experience diagnosing and treating macular degeneration and will discuss with you the best approach in the management of your disease.  

Retinal Detachment

Retinal detachment is a serious eye condition that occurs when the retina, the light-sensitive tissue at the back of the eye, becomes detached from the underlying layer of blood vessels and support tissues. This can result in a loss of vision or permanent blindness if left untreated.

There are several causes of retinal detachment, including trauma to the eye, nearsightedness, aging, and certain medical conditions such as diabetes. In some cases, the cause may be unknown.

Symptoms of retinal detachment can include the sudden appearance of floaters (tiny specks or cobwebs that seem to float across the visual field), flashes of light, and a curtain-like shadow or blur in the visual field. These symptoms may appear suddenly and may worsen over time.

 Treatment for retinal detachment typically involves surgery to reattach the retina to its underlying support tissues. There are several types of surgical procedures that may be used, including vitrectomy, laser surgery, cryopexy (freezing), and scleral buckling (placing a band around the eye to push the retina back into place). In some cases, a gas or silicone oil bubble may be injected into the eye to hold the retina in place during healing. Many of the procedures are done in the operating room but some may be performed in the clinic.

A retinal detachment is a medical emergency and prompt treatment is essential in preserving vision and preventing future complications.

The Arlington Eye Physician surgeons have extensive experience diagnosing and treating retinal detachments using all of the techniques listed above. Your surgeon will discuss with you which surgical procedure is the most appropriate in your case.

Epiretinal Membrane

Macular pucker, also known as epiretinal membrane, is a condition in which a thin layer of scar tissue forms over the macula, the central area of the retina responsible for sharp, detailed vision. This scar tissue can cause the macula to wrinkle or pucker, distorting vision and making it difficult to read, drive, or recognize faces.

The cause of macular pucker is not always clear, but it is often associated with aging and other eye conditions such as retinal detachments, tears, inflammation, or trauma. Other risk factors may include diabetes, and a history of prior eye surgery.

Symptoms of macular pucker can include blurred or distorted vision, difficulty seeing fine details or reading small print, and a gray or hazy area in the central vision. In some cases, people with macular pucker may also experience double vision or a blind spot in the center of their visual field.

Treatment for macular pucker may involve observation, as some cases may not require treatment if the symptoms are mild. However, if the vision impairment is significant, surgery may be necessary to remove the scar tissue and smooth out the macula. Surgery may be performed using microsurgical techniques and involves removing the vitreous gel in the eye and peeling the scar tissue away from the macula.The outcome of surgery for macular pucker can vary depending on the severity of the condition, the age of the patient, and other factors.  

The Arlington Eye Physician surgeons have extensive experience diagnosing and treating macular puckers using the most advanced and up to date techniques. Your surgeon will discuss with you whether observation or a surgical procedure is the most appropriate in your case.

Macular Hole

A macular hole is a small break in the macula, the central area of the retina responsible for sharp, detailed vision. The hole can interfere with the light-sensitive cells in the retina and can cause blurred and distorted central vision.

Macular holes typically occur in people over the age of 60 and are more common in women. They can also occur in people with certain medical conditions such as high myopia (nearsightedness), diabetes, or a history of eye injury.

Symptoms of a macular hole can include blurry or distorted vision, a dark spot in the center of the visual field, and difficulty seeing fine details. In some cases, a macular hole may not cause any symptoms, and the condition may only be detected during a routine eye exam.

Treatment for a macular hole usually involves surgery to close the hole and improve vision. One common surgical procedure is called vitrectomy, which involves removing the vitreous gel that fills the inside of the eye and replacing it with a gas bubble. The gas bubble helps to close the macular hole by pushing the retina against the back of the eye, allowing it to heal. Patients may need to maintain a specific head position for 3 to 5 days after the surgery to help the gas bubble stay in the correct position and help close the hole.

The Arlington Eye Physician surgeons have extensive experience diagnosing and treating macular holes using the most advanced and up to date techniques. Your surgeon will discuss with you the specifics of the surgery on positioning time, as these may vary from case to case. 

Vitrectomy

Vitrectomy is a surgical procedure used to remove the vitreous humor, the gel-like substance that fills the center of the eye. The procedure is performed by a vitreoretinal surgeon and is typically done under local or general anesthesia.

Vitrectomy may be used to treat a variety of eye conditions, including retinal detachment, macular hole, diabetic retinopathy, and vitreous hemorrhage. During the procedure, tiny incisions are made in the eye, and a small instrument called a vitrector is inserted to rapidly cut and remove the vitreous. During surgery the eye remains stabilized by an infusion of saline. The vitreous is replaced with a saline solution or gas, which helps to stabilize the retina and promote healing. As part of the vitrectomy, various other techniques may be used to remove scar tissue, place laser burns or drain fluid depending on the disease treated.

After the surgery, patients may need to wear an eye patch and avoid certain activities for a period of time to allow the eye to heal. Depending on the type of gas or oil used, patients may need to maintain a certain head position to keep the gas bubble in the correct location while the eye heals.

The Arlington Eye Physician surgeons have extensive experience performing vitrectomies using all the techniques listed above. Your surgeon will discuss with you in detail the surgical procedure and any additional measures which may be necessary. 

Laser Retinopexy

Laser retinopexy is a surgical procedure that uses a laser to repair a tear or hole in the retina. The goal of the procedure is to seal the tear or hole and prevent it from progressing into a retinal detachment, a serious condition that can cause permanent vision loss and that requires emergency surgery.

During the procedure, our ophthalmologist uses a special laser to create small burns around the tear in the retina. The burns cause scarring, which seals the tear or hole and helps to hold the retina in place and therefore prevents formation of a detachment.

Laser retinopexy is typically performed in the office on an outpatient basis and typically does not require any activity restrictions or post operative drops.  The procedure itself is usually well tolerated without much discomfort.

Patients typically will need to return to the office for follow-up visits to monitor the healing process and ensure that the retina remains attached.

Laser retinopexy is considered a safe and effective treatment for retinal tears and holes and may help prevent the need for more involved and invasive surgery. 

Intravitreal Injections

Intravitreal injections are performed to place a medication directly into the vitreous cavity of the eye. The vitreous is a clear, jelly-like substance that fills the inside of the eye and helps maintain its shape.  These treatments are necessary in order to deliver medicine to the retina, as drops on the surface of the eye are unable to penetrate that far.

Intravitreal injections are typically used to treat a variety of eye conditions, including macular degeneration, diabetic retinopathy, and retinal vein occlusion. The medication delivered through the injection is typically an anti-VEGF (vascular endothelial growth factor) or steroid medication. These medications work to reduce inflammation, leakage and swelling in the retina, which can help improve vision and prevent further damage.

The injection is performed in the office and the patient may be given local anesthesia or numbing eye drops to minimize discomfort during the procedure. The injection itself lasts only a matter of seconds and is typically well tolerated without significant discomfort. After the injection, the patient is advised to use lubricating drops or gels for mild irritation, which typically lasts less than 24 hours. 

Intravitreal injections are generally considered very safe and effective, but they do carry some risks, including infection, bleeding, and retinal detachment – all of which are extremely rare. The retina specialists at Arlington Eye Physicians will discuss the risks and benefits of the procedure with the patients, if this treatment is deemed to be necessary. Patients may need to receive multiple injections over a period of time to achieve the desired therapeutic effect. 

Pan Retinal Photocoagulation

Pan retinal photocoagulation, also known as scatter laser treatment, is a surgical procedure used to treat proliferative diabetic retinopathy, a complication of diabetes that can cause abnormal blood vessels to grow on the retina and potentially cause vision loss.

During the procedure, an ophthalmologist uses a special laser to create small burns in the peripheral retina, away from the macula (the central part of the retina responsible for sharp, detailed vision). These burns destroy the abnormal blood vessels and help to reduce the risk of bleeding and other complications associated with proliferative diabetic retinopathy.

The procedure is typically performed on an outpatient basis, and patients may be given local anesthesia or numbing eye drops to minimize discomfort during the procedure. The laser treatment may be completed in a single session or may require multiple sessions over several weeks or months.

After the procedure, patients may experience some discomfort or sensitivity to light, but this typically resolves within 24 hours. Patients will also need to return for follow-up visits to monitor the healing process and ensure that the treatment was effective.

Pan retinal photocoagulation is a safe and effective treatment which may be used in combination with other therapies such as intravitreal injections to manage diabetic retinopathy, retinal vein occlusions and other vascular disorders of the retina. 

Focal Retinal Laser

Focal laser treatment, also known as macular laser treatment, is a surgical procedure used to treat macular edema, a swelling of the macula (the central part of the retina responsible for sharp, detailed vision) that can occur as a result of a variety of conditions, including diabetic retinopathy, macular degeneration, and retinal vein occlusion.

During the procedure, an ophthalmologist uses a special laser to create small burns in the macula. These burns help to seal leaking blood vessels and reduce fluid buildup, which can improve vision and prevent further damage to the retina.

The procedure is typically performed on an outpatient basis, and patients may be given local anesthesia or numbing eye drops to minimize discomfort during the procedure. The laser treatment may be completed in a single session or may require multiple sessions over several weeks or months.

After the procedure, patients may experience some discomfort or sensitivity to light, but this typically resolves within a few days. Patients will also need to return for follow-up visits with their ophthalmologist to monitor the healing process and ensure that the treatment was effective.

Focal laser treatment is a safe and effective treatment which may be used in combination with other therapies such as intravitreal injections to manage diabetic retinopathy, retinal vein occlusions and other vascular disorders of the retina.