Retinal Disease Definition, Reason, Symptoms, Treatment & Prevention
Definition
Diseases of the retina can vary greatly, but most can cause vision abnormalities. The retina itself is a thin tissue that lines the inside of the back of the eyeball.
The retina contains millions of light-sensitive cells (rods and cones), as well as other nerve cells that receive and manage visual information. The retina sends these signals to the brain via the optic nerve.
Treatment is available for only some retinal diseases. Depending on the conditions experienced, treatment can be aimed at overcoming or slowing the progress of the disease, as well as maintaining, improving, or restoring sight.
If not treated, some retinal diseases can cause severe visual loss or blindness.
Symptoms
Many retinal diseases have similar signs and symptoms. These signs and symptoms can include:
- Seeing spots or features resembling floating spider webs
- Blurred or distorted vision
- Weakness in side vision
- Loss of sight
Signs and symptoms experienced in retinal disease can appear in one or both eyes, depending on the type of retinal disease that occurs.
Reason
Several types of retinal disease that are commonly found are:
- Retinal tear. Retinal tears can occur when the clear, gel-like object in the center of the eye (vitreous) shrinks and pulls on the retina with enough force to cause damage to the tissue.
This is often accompanied by the sudden onset of symptoms. For example, as if seeing floating nets or flashes of light.
- Retinal detachment. This condition is caused by the presence of fluid under the retina. This generally occurs when fluid passes through a retinal tear, causing the retina to detach from the layers of tissue beneath it.
- Diabetic retinopathy. In people with diabetes, the small blood vessels (capillaries) at the back of the eye can get damaged and leak fluid into and under the retina.
This can cause swelling of the retina, which can make vision blurry or distorted. In addition, there may also be the formation of new capillaries that are abnormal and break easily. This condition can also worsen vision.
- Epiretinal membrane. Epiretinal membrane is a scar tissue or membrane that is above the retina. This membrane can pull the retina upwards, which distorts vision. Objects can appear blurry or shapeless.
- Macular hole. A macular hole is a small deformity in the center of the retina at the back of the eye (macula). The hole can result from abnormal pressure between the retina and vitreous, or it can result from an injury to the eye.
- Macular degeneration. In macular degeneration, the central part of the retina begins to deteriorate. This causes symptoms such as blurry central vision, or a dark spot in the center of the visual field.
There are two types of macular degeneration, namely wet and dry macular degeneration. Most people will experience the dry type first, which can progress to the wet type in one or both eyes.
- Retinitis pigmentosa. Retinitis pigmentosa is a degenerative disease that affects the retina.
Diagnosis
Retinal disease can be related to the aging process, eye injury, or family history. To determine the diagnosis, the ophthalmologist will conduct a medical interview, physical examination of the eye to see any abnormalities in certain parts of the eye, as well as supporting examinations.
Several types of investigations can be performed to determine the location and severity of retinal disease:
- Amsler grid check. Doctors can perform an Amsler grid examination to test the clarity of central vision. The doctor will ask if the lines on the Amsler grid appear blurry, broken, bent, and so on, to further understand the degree of retinal damage experienced.
- Optical Coherence Tomography (OCT). This examination is a technique used to obtain images of the retina to determine the diagnosis of epiretinal membrane, macular holes, and macular swelling, monitoring the degree of age-related wet-type macular degeneration, and monitoring response to treatment.
- Fluorescein angiography. This test uses a dye that causes the retinal blood vessels to appear more clearly when certain lights are used. This examination can identify blocked blood vessels, leaky blood vessels, or new and abnormal blood vessels.
- Ultrasonography (USG). This examination uses high-frequency sound waves to see the structure of the retina and other tissues in the eye. This examination can also be done to identify certain tissue characteristics that can help diagnose and treat eye tumors.
Treatment
The main goal in treating retinal disease is to stop or slow the progression of the disease, as well as to maintain, improve or restore vision. Oftentimes, the damage that has been done cannot be repaired, which makes early detection very important.
Treatment of retinal disease can be complex and sometimes urgent. Some types of treatment that can be done include:
- Use of lasers. Laser surgery can repair tears or holes in the retina. The doctor uses a laser to warm a specific point on the retina, and this causes scar tissue to form that binds the retina to the underlying tissue.
- Shrinking abnormal blood vessels. Doctors can use a technique called scatter laser photocoagulation to shrink new, abnormal blood vessels, which are prone to bleeding. This treatment can be used in people with diabetic retinopathy.
- Freezing. In this procedure, the doctor uses a freezer to repair the tear in the retina, which scars the retina and attaches it to the underlying layer.
- Injection of air or gas into the eye. This technique, called pneumatic retinopexy, is intended to repair certain types of retinal detachment. This technique is generally performed in combination with cryopexy or laser photocoagulation.
- Make an indent in the outer layer of the eye. A technique called scleral buckling is used to repair retinal detachment. The indentation that occurs in the sclera can relieve some of the pressure on the retina due to the pull of the vitreous.
- Evacuate and replace fluid in the eye. This procedure called a vitrectomy, involves the evacuation of the eye’s vitreous, which is then followed by the injection of air, gas, or fluid into the space.
Vitectomy can be done if bleeding or inflammation causes opacity in the vitreous. This technique may be part of the treatment of individuals with retinal tears, diabetic retinopathy, macular holes, infections, eye injuries, or retinal detachment.
- Injecting medication into the eye. The doctor may suggest injecting the drug into the vitreous of the eye. This technique can be used in individuals with wet-type macular degeneration, diabetic retinopathy, or damaged blood vessels in the eye.
Prevention
Prevention of retinal disease depends on the type of retinal disease experienced. It is very important to carry out early detection and treatment if there are complaints, in order to prevent complications from developing retinal disease.