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Diabetic retinopathy

 

Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina. When the weak vessels leak, swell or develop thin branches, vision loss may occur. In its advanced stages, the disease can cause blurred or cloudy vision, floaters and blind spots and eventually, blindness.   

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Diabetic retinopathy prevention

 

Your risk of diabetic retinopathy can be reduced if you follow your prescribed diet and medications, exercise regularly, control your high blood pressure and cholesterol and avoid alcohol and cigarettes. Regular eye exams are an integral part of making sure your eyes are healthy.    

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Diabetic retinopathy treatment

 

Yes. Many of the problems caused by diabetic retinopathy such as swelling of the retina, bleeding in the vitreous and scar tissue on the retina can be treated with modern techniques such as injections, laser or surgery. The earlier problems are found, the easier they are to treat and in general, the better the visual results. Early and periodic dilated eye exams are very important.    

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Dry macular degeneration

 

Dry macular degeneration is associated with degeneration of the pigment cells under the macula and development of drusen. The pigment cells are necessary for normal retinal function so when the cells are lost, the overlying retina stops functioning and blind spots and distortion may occur. Drusen are by-products of retinal metabolism that accumulate under the macula causing distortion and blind spots.

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Floaters

 

Floaters are cobwebs, strings, or speck-like objects that float in the field of vision. They may occur from any opacity within the vitreous gel that casts a shadow on the retina. They are usually black and may float in and out of view. Floaters can be an indicator that the gel-like vitreous is liquefying, which is a normal ageing process but can also reflect inflammation, infection, or bleeding within the eye or be related to systemic diseases.

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Macular degeneration

 

Macular Degeneration is a disease characterized by a breakdown of the macula, the center, most sensitive part of the retina, the area we use to read and carry out our finest visual tasks.

Most people with macular degeneration retain peripheral vision and learn to optimize the use of their remaining vision. Low vision aides can sometimes be helpful too.

Dry Macular Degeneration

Dry macular degeneration is associated with degeneration of the pigment cells under the macula and development of drusen. The pigment cells are necessary for normal retinal function so when the cells are lost, the overlying retina stops functioning and blind spots and distortion may occur. Drusen are by-products of retinal metabolism that accumulate under the macula causing distortion and blind spots.

Wet Macular degeneration

Wet macular degeneration is associated with abnormal blood vessel growth under the macula which can lead to leakage of fluid, bleeding and scar-tissue growth under and within the retina. The onset of vision loss with the wet form of macular degeneration is usually more rapid and severe than in the dry form of macular degeneration.

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Macular degeneration causes

 

Macular Degeneration is a disease characterized by a breakdown of the macula, the center, most sensitive part of the retina, the area we use to read and carry out our finest visual tasks.   

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Macular degeneration prevention

 

Though macular degneration cannot be prevented, the most important thing to do is to have regular eye exams, which may allow early detection and diagnosis. This is particularly important if a close relative has been diagnosed with macular degeneration.  

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Macular degeneration risk factors

 
  • History of hypertension
  • History of cardiovascular disease
  • Smoking
  • Sun Exposure
  • Hyperopia (farsightedness)
  • Light skin & eye color
  • Lens opacities (cataracts

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Macular degeneration symptoms

 
  • Blurring of central vision
  • Blind spots in the central vision
  • Difficulty seeing details up close and at a distance
  • Distortion of lines and shapes
  • Diminished color vision  

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Macular degeneration tests

 

Your doctor will examine your eyes with special lenses to view the interior of the eye through the pupil. Other tests for macular degeneration include: 

Acuity Tests

This test measures the sensitivity of your central vision at specific distances in specific lighting situations. 

Amsler Grid Test

This test checks for blind spots, loss of sight and distortion. Fluorescein Angiogram Test: a dye is injected in the vein of your arm and then photos are taken of the retina and the macula in order to identify new blood vessel growth and leakage from blood vessels.  

Optical Coherence Tonography (OCT)

This test takes a cross sectional image of almost microscopic detail of the layers of the retina and underlying structures affected by macular degeneration. It is very helpful in determining if there is fluid leaking in or under the retina, and abnormal blood vessels or scar tissue in the macula. 

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Macular degeneration treatment

 

Dry Macular Degeneration

The progression and severity of dry macular degeneration can be reduced with certain vitamins, minerals and Omega III fatty acids. Controlling high blood pressure and quitting smoking can be helpful.

Wet Macular Degeneration

There is no cure for wet macular degeneration. However, several treatment options are available. 

Thermal Laser was the first treatment used to treat wet macular degeneration and is still occasionally used. A laser beam is focused on the blood vessels to cauterize them.  

Photodynamic therapy (PDT) uses a low intensity laser to stimulate a light sensitive drug that is injected intravenously to cause shrinking of the abnormal blood vessels in the macula associated with macular degeneration.  

Anti-VEGF medication is the newest and best treatment for wet macular degeneration. These medications are injected into the eye and decrease leakage from and the progression of the abnormal blood vessels growing under the retina in macular degeneration. Anti-VEGF medications are not a cure and continued treatment is necessary to minimize the adverse effects of the abnormal blood vessels and maximize the patient's vision.  

Treatment for wet macular degeneration can involve combining these types of treatments.  

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Macular hole

 

A macula hole is a hole in the macula, the central most sensitive part of the retina. It occurs when the shrinking vitreous gel adheres to and stretches a hole in the macula. As the hole progresses and enlarges, a blind spot develops in your central vision and impairs the ability to see at both distant and close ranges. Vitrectomy surgery is the most effective treatment option to repair a macula hole.

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Macular pucker

 

A macula pucker is a distortion of the macula from scar tissue growing on the surface of the macula or from the vitreous gel pulling on the macula. The wrinkles, creases or bulges formed lead to symptoms of blurred central vision, distorted or wavy central vision, difficulty reading or performing tasks that require detailed vision, and gray and/or cloudy areas in the central vision. Vitreous surgery with removal of the scar tissue is very successful in restoring vision and decreasing or eliminating distortion.

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Post vitreous detachment (PVD)

 

A posterior vitreous detachment is a separation of the vitreous gel from the inner back wall of the eye and is usually associated with floaters and flashing lights. Liquefaction of the vitreous gel is usually an age related change that continues until the vitreous separates from the retina to which it is loosely attached. The vast majority of PVDs do not cause problems except annoying floaters and sometimes brief flashes of light. Improvement in symptoms is usually seen within a few months. Occasionally retinal tears can occur from a PVD. Retinal tears can lead to a detached retina if the retina tear is not treated. There is no way to tell if a PVD caused a retinal tear so if someone has symptoms of a PVD, they need a prompt dilated retinal exam. 

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Retina

 

The retina is the delicate, light-sensitive tissue that covers the interior wall of the eye. Like the film in a camera, it receives images projected through the lens of the eye. The retina then sends these images to your brain through the optic nerve. When the retina is damaged, your vision may become impaired. Damage to the retina may be caused by injury, illness or as a result of aging.

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Retinal detachment

 

When the retina detaches, it separates or pulls away from its normal position lining the inner back wall of the eye. A retinal detachment can occur from retina holes, retinal tears or from traction on the retina from scar tissue on the retinal surface or in the vitreous gel. If not promptly treated, a retinal detachment can cause permanent loss of vision. 

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Retinal detachment risk

 

A retinal detachment can occur at any age, but it is more common in people over age 40. It affects men more than women. A retinal detachment is also more likely to occur in people who are nearsighted or have had a retinal detachment in the other eye, a family history of retinal detachment, cataract surgery, an eye injury or certain systemic diseases.  

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Retinal detachment symptoms

 

Symptoms include flashing lights, new floaters or a sudden or gradual increase in either the number and or severity of floaters, which are like cobwebs, strings or specks that float about in your field of vision. Another symptom is the appearance of a curtain over the field of vision, typically starting in the periphery and progressing towards the center part of the visual field. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.  

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Vitreous

 

The vitreous is a gel-like substance that fills the back cavity of the eye and is loosely attached to the retina.

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Vitreo-retinal specialist

 

Retinal specialists are eye physicians and surgeons who focus on diseases in the back of the eye such as macular degeneration, diabetic disease, retinal detachment, eye trauma and intraocular infection. Our physicians are medical doctors have completed many years of training in diseases and surgery of the eye including a 3 year ophthalmology residency followed by a 2 year vitreoretinal fellowship.

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Vitreo-retinal treatment

 

Problems with the retina and vitreous including retinal tear, retinal detachment, severe intraocular infection, eye disease and trauma can lead to vision loss and even blindness. Surgery, lasers and injections can correct problems before vision is lost, prevent further deterioration from occurring and often restore vision.   

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Wet macular degeneration

 

Wet Macular degeneration

Wet macular degeneration is associated with abnormal blood vessel growth under the macula which can lead to leakage of fluid, bleeding and scar-tissue growth under and within the retina. The onset of vision loss with the wet form of macular degeneration is usually more rapid and severe than in the dry form of macular degeneration.

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