Retina

Understanding the Retina

The retina is a thin layer of nerve tissue that lines the inner wall of the eye. This layer of the eye is the light sensitive layer that is activated when light from the front of the eye is focused on to it. The focused light activates electrical signals in the retina that then are transmitted via the optic nerve to the brain where this information is converted into an image. The retina functions in much the same way as film in a camera. There are many conditions that affect the retina that can lead to temporary or permanent vision loss.

What is a retina specialist?

A retina specialist is an ophthalmologist (Eye MD) who has completed an additional 2 year training fellowship in medical and surgical treatment of retinal disease.

What testing is done to evaluate the retina?

When you see an ophthalmologist for an evaluation of a retinal condition your eyes will be dilated with special dilating eye drops to improve the view to the back of the eye. The ophthalmologist will use a diagnostic microscope called a slit lamp and special lenses to view the retina. The peripheral retina may be examined with a head mounted ophthalmoscope called an indirect ophthalmoscope. Various diagnostic test may be performed which may include ultrasound of the eye, photographs, optical coherence tomography (OCT) or fluorescein angiography of the retina.

Testing for Retinal Disease

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Common Diseases of the Retina

Diabetic Retinopathy

Diabetes can affect the blood vessels in the retina leading to vision loss. Please see our diabetes page for more information.

Posterior Vitreous Detachment (PVD)

The vitreous is the jelly-like substance that fills the middle of the eye cavity. The vitreous is attached to the retina and optic nerve in the young healthy eye. As the eye ages the vitreous jelly shrinks taking up less space in the eye causing it to pull away from it’s normal attachments to the retina and optic nerve in the back of the eye. As the vitreous pulls away from the retina there may be areas that it is more adherent resulting in retinal traction.

The pulling or tugging of the retina in these areas activates the retina producing a flash of light. Patient’s experiencing a PVD may see these flashes that look like a camera flash or lightening bolt in their peripheral vision. Also, as the vitreous releases from the back of the eye the edges of the vitreous can be seen as new floaters. It is important to alert your ophthalmologist if you experience these symptoms. Rarely, the retinal traction from a PVD may result in a tear of the retina or retinal detachment.

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Retinal Detachment

If a tear develops in the retina fluid can track behind the retina causing it to detach from the eye wall. The symptoms of retinal detachment include the same symptoms as a retinal tear (flashes of light, new floaters) in addition to a dark or grey area in your peripheral vision which enlarges over time. A retinal detachment is an eye emergency. If you experience these symptoms contact your ophthalmologist or go to the emergency room for urgent evaluation.

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Macular Edema

Macular edema is a build up of fluid, or swelling, in the area of the retina called the macula. The macula is important for sharp detail vision and when it is swollen it can result in blurred, distorted vision. Macular edema has many causes including blood vessel leakage as in diabetes, macular degeneration or retinal vein occlusion. Macular edema can also result when there is inflammation inside the eye from systemic inflammatory disease, infections or after eye surgery.

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Lattice Degeneration

Lattice degeneration is an area of thinning or weakness that occurs in the peripheral part, or edges, of the retina. These areas of thinned retina are more prone to forming holes or tears in retina that can lead to retinal detachment. If you have lattice degeneration you should have a dilated retinal exam regularly to monitor this condition. Please review the video for additional information.

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Macular Degeneration

Macular degeneration is a condition that affects the central portion of the retina called the macula. The disease process involves accumulation of cellular waste products beneath the retina called drusen. These drusen deposits over time may be associated with a loss of retinal function. Please see our macular degeneration page for additional information.

Retinal Tear

A retinal tear is a break in the retina that can lead to retinal detachment. Signs of retinal tear include flashes of light, new floaters (black spots or lines in vision), hazy vision. If you should experience any of these symptoms contact your ophthalmologist for an immediate evaluation.

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Epiretinal Membrane (ERM)

An epiretinal membrane is a growth of scar tissue over the central part of the retina called the macula. This scar tissue can cause distortion of the macula leading to distorted or blurred vision. A mild ERM can be observed, but, if the ERM is more severe, surgical treatment may be required to restore vision.

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Retinal Vein Occlusion

A retinal vein occlusion occurs when a retinal vein becomes blocked and causes blood and fluid to accumulate in the retina. A vein occlusion can occur to a smaller branch vein or the larger central vein leaving the eye. In either case vision may be affected to varying degrees. Please review the video for additional information.

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Macular Hole

A macular hole forms in the central area of the macula called the fovea. Macular hole causes blurred central vision or dark spots in the central vision. Macular holes can be treated with surgery which are designed to remove traction from the edges of the hole and to reapproximate the edges of the hole to promote healing. Please review the video for additional information.

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