The retina is a very delicate, but extremely complex structure that lines the inner wall of the back of the eye. It contains the light sensitive elements – the rods and cones that allow us to see in dim and bright lighting conditions. It also contains numerous other cells and nerve fibers that are required for information processing. The vitreous is a jelly-like mass that fills up the back of the eye and has shock absorbing and nutritional functions.

• Horseshoe retinal tear

• Tear surrounded by laser treatment

• Retina

What can go wrong with these structures?

In premature children with low birth weight, retinal changes affecting sight can develop – retinopathy of prematurity. These and other developmental abnormalities of the retina and vitreous can also affect vision and need early care. Some infections can also affect these structures in children. The most serious lesion however, is a tumor termed retinoblastoma, arising from the retinal cells, threatening the eye and life of the baby.

In young adults, injuries can cause significant changes that affect sight. Sometimes however, there can be changes in the structure of the vitreous gel that are seen as floaters in front of the eye. These are usually harmless, although it is wise to have an eye exam to rule out serious retinal problems.

In older people, changes in the vitreous can result in pulling forces on the retina that can cause either a vitreous bleed, or a retinal detachment. A sudden increase in floaters without flashes of light is a matter for concern. Other aging changes can affect the center of the retina – the macula, an area needed for fine vision – changes in this zone result in black shadows in central vision, blurring or distortion of straight lines metamorphopsia.

The retina is affected in other systemic diseases-notably, diabetes mellitus and systemic hypertension. Blockage of the retinal vessels can result in vision threatening changes unless treated promptly. Infections of the structures within the eye are a very serious problem – endophthalmitis, and may occur after eye surgery. Prompt care is often successful in restoring sight in these eyes.

How will I know if I have these problems?

Since the primary function of these structures is to provide vision, most diseases affect sight – blurring, loss of field, floaters, flashes, central black shadows, and total loss of vision may occur. However, changes in the peripheral retina can be silent and require a detailed eye exam for detection.

What are the common causes of these diseases?

Genetic causes, injuries, infection, tumors, systemic

conditions, high refractive errors, and ageing changes account

for most of these diseases.

How can these conditions be detected?

A detailed evaluation of the back of the eye after dilation of the pupil, using an instrument called the indirect ophthalmoscope is required. In patients with diabetes, an imaging of blood flow in the retinal vessels is helpful- fundus fluorescein angiography. In age related changes of the central retina, two other examinations coherence tomography may be needed. If there is bleeding in indocyanine green angiography and optical the vitreous, ultrasonographic examination can help identify retinal changes.

How can these conditions be treated?

In changes of the blood vessels, the use of retinal lasers is often helpful, and these are also used to prevent serious eye disease in diabetics. In patients with infections, antibiotics; and in those with inflammation, steroids can be used. If there is serious vitreous bleeding or retinal detachment, surgery is required to restore vision. In age related central retinal disease, in addition to laser therapy, the injection of medications into the eye can be helpful.

Recent advances in vitreous and retinal diseases

Instruments are now available that allow the diagnosis of these diseases at a very early stage. Newer treatment option include photodynamic therapy for subretinalneovascularization, the use of intravitreal triamcinolone injections for diabetic macular edema, and anti VEGF agents for age related macular degeneration, all of which have improved our ability to treat retinal diseases.

General information

High myopes may be prone to central and peripheral retinal changes and should have a routine yearly eye exam. Similarly, diabetics and hypertensives should have a yearly eye exam in addition to good control of the systemic condition to protect their eyes and sight.

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Disclaimer: These are just our views expressed here. Please ensure to always contact your doctor for exact instructions and process to follow. In case of queries feel free to reach us. This article is in no way promoting or suggesting any procedure or treatment and is purely for educating oneself and or for academic interests as an individual. No information in this site is intended to be a substitute for actual professional medical advice, diagnosis or treatment. Always seek the consultation and or guidance of a qualified doctor / healthcare provider with any questions you may have regarding a medical treatment, procedure, and or before undertaking a new medical health care regimen in any manner whatsoever and never disregard or take specific action or professional medical advice or delay in seeking it just because of what you have read in this website or any of our communications, online or otherwise. Any and all images used here are for representation purposes only

Glaucoma is a leading cause of blindness especially for older people. It is a disease of the optic nerve. When damage to the optic nerve occurs, Blind spots in the field of vision develop, and usually go undetected until the optic nerve is significantly damaged. Early detection and treatment are the keys to preventing optic nerve damage.

What causes glaucoma?

Clear liquid called aqueous humor circulates inside the front portion of the eye and flows out through a drainage system (located in the angle of the anterior chamber). If the drainage angle is blocked or inefficient, the aqueous humor cannot flow out of the eye. Fluid pressure within the eye increases, pushing against the optic nerve and causing damage.

What are the different types of glaucoma?

Chronic open-angle glaucoma: This is the most common form of glaucoma. The drainage angle becomes less efficient over time, and pressure within the eye gradually increases, which can damage the optic nerve. Typically, open-angle glaucoma has no symptoms in its early stages, and vision remains normal. As the optic nerve becomes more damaged, black spots begin to appear in your field of vision. Closed angle glaucoma: Some eyes are formed with the iris (the colored part of the eye) too close to the drainage angle. In these eyes, which are often small and farsighted, the iris can block the drainage angle completely. The pressure inside the eye builds rapidly and causes an acute closed-angle attack. Symptoms may include: blurred vision, severe eye pain headache, rainbow-colored halos around lights, and nausea and vomiting. This is a true eye emergency -call your eye doctor immediately. Unless this type of glaucoma is treated quickly, blindness can result.

Who is at risk for glaucoma?

The most important risk factors include age, elevated eye pressure, family history of glaucoma. farsightedness or nearsightedness, past eye injuries, thinner central corneal thickness, systemic health problems, including diabetes, migraine headaches, and poor circulation. Your ophthalmologist will weigh all of these factors before deciding whether you need treatment for glaucoma, or whether you should be monitored closely as a glaucoma suspect.

How is glaucoma detected?

Regular eye examinations by your ophthalmologist are the best way to detect glaucoma. The only sure way to detect glaucoma is to have a complete eye examination. During your glaucoma evaluation, your ophthalmologist will: measure your intraocular pressure (tonometry); inspect the drainage angle of your eye (gonioscopy); evaluate whether or not there is any optic nerve damage (ophthalmoscopy); and test the peripheral vision of each eye (visual field testing, or perimetry.)

How is glaucoma treated?

As a rule, damage caused by glaucoma cannot be reversed. Eye drops, laser surgery, and surgery in the operating room are used to help prevent further damage. In some cases, oral medications may also be prescribed. Periodic examinations are very important to prevent vision loss. Because glaucoma can progress without your knowledge, adjustments to your treatment may be necessary from time to time.

General information:

Regular medical eye exams help prevent unnecessary vision loss. Recommended intervals for eye exams are: Ages 20 to 29: Individuals with a family history of glaucoma should have an eye examination every 3 to 5 years. Others should have an eye exam at least once during this period. Ages 30 to 39: Individuals with a family history of glaucoma should have an eye examination every 2 to 4 years. Others should have an eye exam atleast twice during this period.

Age 40 and older: Every year

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Disclaimer: These are just our views expressed here. Please ensure to always contact your doctor for exact instructions and process to follow. In case of queries feel free to reach us. This article is in no way promoting or suggesting any procedure or treatment and is purely for educating oneself and or for academic interests as an individual. No information in this site is intended to be a substitute for actual professional medical advice, diagnosis or treatment. Always seek the consultation and or guidance of a qualified doctor / healthcare provider with any questions you may have regarding a medical treatment, procedure, and or before undertaking a new medical health care regimen in any manner whatsoever and never disregard or take specific action or professional medical advice or delay in seeking it just because of what you have read in this website or any of our communications, online or otherwise. Any and all images used here are for representation purposes only