When the retina is detached from the back wall of the eye, it is separated from its blood supply and no longer functions properly. The typical symptoms of a retinal detachment include floaters, flashing lights, and a shadow or curtain in the peripheral (noncentral) vision that can be stationary (non-moving) or progress toward, and involve, the center of vision. In other cases of retinal detachment, patients may not be aware of any changes in their vision. The severity of the symptoms is often related to the extent of the detachment.
The retina is the inner lining of the eye; it is the thin, light-sensitive tissue that generates vision. Tears can form in the retina, creating a risk of retinal detachment and severe loss of vision. A patient with an acute retinal tear may experience the sudden onset of black spots or “floaters” in the affected eye. This can have the appearance of someone shaking pepper in your vision. Flashes of light (Photopsia) are another common symptom.
Malignant intraocular melanoma is the most common eye cancer in adults. The tumor affects the uveal tract, which is the middle layer of the wall of the eye. The most common site for ocular melanoma is the choroid, followed by the ciliary body, and the iris. In the United States, choroidal melanoma affects approximately 2500 people per year with an incidence of 6 per million. Ocular melanoma is more common in fair-skinned individuals. Smoking increases the risk for the condition, which typically affects people in their 60s.
The vitreous humor is a transparent, gel-like material that fills the space within the eye between the lens and the retina. The vitreous is encapsulated in a thin shell called the vitreous cortex, and the cortex in young, healthy eyes is usually sealed to the retina. Age-related degeneration of the gel-like vitreous humor leads to the formation of pockets of fluid within the vitreous, causing contraction and loss of volume.
Diabetic retinopathy is a series of pathological changes in the retina caused by long term elevation of blood sugar from diabetes. The clinical findings first consist of abnormal blood vessels, tiny hemorrhages (bleeds), and exudates in the retina and later progress into areas of non-perfusion (no blood flow), macular edema (swelling in the center of the retina), and new blood vessel growth. Diabetic retinopathy is usually asymptomatic in the early phases and you may not be aware that there is a problem. Later in the disease, patients can lose vision in several ways:
Macular degeneration, or Age Related Macular degeneration (AMD) is a degenerative disease affecting people over 55 years of age. It becomes much more common as we age and is the leading cause of severe, irreversible vision loss in patients over 60. The exact cause is unknown, but several risk factors, including smoking, genetics, and age are associated with AMD. There are three stages of AMD: Early, Intermediate, and Advanced.
An epiretinal membrane, or macular pucker, is a thin layer of scar tissue that can grow over the surface of the retina. As this tissue contracts, the retinal surface can become wrinkled or distorted. This creates symptoms of distortion (images are bent or wavy) or blurry vision in the patient. Most epiretinal membranes are mild and do not require surgery, however, when an epiretinal membrane progresses to the point where it is causing symptoms, surgery (vitrectomy) to remove the membrane can be performed. A gas bubble and post-operative positioning is not usually needed.
Retinal vein occlusions occur when there is a blockage of veins carrying blood with needed oxygen and nutrients away from the nerve cells in the retina. A blockage in the retina’s main vein is referred to as a central retinal vein occlusion (CRVO), while a blockage in a smaller vein is called a branch retinal vein occlusion (BRVO). Most BRVOs occur at an arteriovenous crossing—an intersection between a retinal artery and vein.
