A variety of conditions can affect the retina and vitreous at the back of the eye. At Wilkinson Eye Center in Pontiac and Clarkston, MI, our experienced team treats conditions such as macular degeneration and diabetic eye disease, and we repair retinal detachments and tears.
- Treatment for diseases of the retina and vitreous, including macular degeneration
- Treatment of Diabetic Eye Disease
- Repair of retinal detachments
At Wilkinson Eye Center, we regularly treat age-related macular degeneration. Age-related macular degeneration is the leading cause of blindness in people 50 and older in the industrialized world. It is caused by the loss of retinal photoreceptor cells in the center of the retina, the macula. This is the area of our eyes where our vision is the sharpest.
Dry vs. Wet Macular Degeneration
There are two forms of macular degeneration. The first is dry macular degeneration. This most common form of macular degeneration begins with small areas of vision damage in the macula. It progresses slowly and most patients retain some vision in at least one eye.
The second form of age-related macular degeneration, known as wet macular degeneration, occurs when abnormal blood vessels form underneath the retina. These blood vessels bleed and leak fluid causing significant vision loss. Eventually, a scar forms under the macula and central vision are lost.
Diabetic retinopathy is the leading cause of blindness in working-aged adults in the U.S. It occurs in two ways: non-proliferative and proliferative retinopathy.
Proliferative vs. Non-Proliferative Diabetic Retinopathy
In non-proliferative diabetic retinopathy, the blood vessels of the retina bleed or leak fluid. This leads to swelling of the retina, small hemorrhages, and the formation of deposits on the retina.
Proliferative retinopathy is more severe. It occurs when the blood vessels in the retina or the optic nerve become blocked, starving the retina of necessary nutrients. Proliferative diabetic retinopathy can lead to vitreous hemorrhage, where profuse bleeding into the eye blocks vision; retinal detachment, where scar tissue pulls the retina, causing it to tear or detach; and neovascular glaucoma, where the abnormal blood vessels block drainage of fluid from the eye, raising the pressure within the eye.
Retinal Vein Occlusion
A retinal vein occlusion is a sudden blockage of a vein draining blood from inside the eye. When this vein is blocked it leads to bleeding, swelling, and loss of blood flow to the retina. Retinal vein occlusion typically occurs in older patients with a history of high blood pressure and heart disease.
Retinal Detachment and Tears
Retinal tears occur when the vitreous pulls away from the retina. The liquid that passes through the tear and settles under the retina can make the retina separate from the back wall of the eye. This is a retinal detachment.
As we age, the gel-like material in the middle of the eye, the vitreous, shrinks and begins to pull away from the retina. In most people, this is simply a part of aging and there are no consequences to vision. In a small number of people, however, the vitreous pulls on the retina to such a degree that it creates a hole. This hole is usually in the center of the macula and causes blurring and vision distortion.
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Retina Treatment Options
Macular Degeneration Treatment
The goal in patients with wet macular degeneration is to convert it to the dry form. In wet age-related macular degeneration, a chemical called vascular endothelial growth factor (VEGF) causes abnormal blood vessels to grow under the retina. These blood vessels leak and bleed, damaging the central vision. Treatment for wet macular degeneration is direct injections of VEGF inhibitors into the eye. This converts wet degeneration to dry. At this time, there are no medications or treatments for dry macular degeneration, but certain lifestyle changes and vitamin therapies can slow its progress.
Treating Diabetic Retinopathy
For diabetic retinopathy, laser surgery is used to shrink abnormal vessels or to treat leaking blood vessels. This reduces the risk of severe vision loss by around 60 percent. More recently, anti-VEGF medicines have been injected into the eye in combination with laser surgery to further reduce retinal swelling and lessen vision loss.
Retinal Vein Occlusion Treatment
The goal of treatment is to reduce the swelling of the blocked vessels. Retinal lasers have been shown to lessen vision loss, as have the injection of anti-leakage medicines into the eye.
We treat retinal detachments with surgery. In pneumatic retinopexy, a gas bubble is injected into the vitreous space. The bubble pushes the retinal tear against the back of the eye, which is then treated with laser or freezing therapy to close the tear. A “scleral buckle” may be used. In this procedure, a tiny silicone band is attached to the outside of the eyeball to gently push the wall of the eye against the detached retina and hold it in position. Finally, we may use a vitrectomy, where we remove the vitreous and replace it with a gas bubble or a clear sterile solution.
Macular Hole Surgery
Macular holes can be successfully treated with surgery. In this surgery, a gas bubble is injected into the eye. The gas acts as an internal temporary bandage that holds the edge of the macular hole in place as it heals. The patient must keep his or her face down for a few days after the bubble is placed. Over time, the bubble is gradually absorbed and the vitreous cavity refills with fluid.
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Wilkinson Eye Center offers services for the retina such as, macular degeneration and retinal detachment to patients in Clarkston and Pontiac, MI. Call (248) 334-4931 to schedule an appointment.