A blocked vein can cause leakage of blood into the retina and vision loss. This is known as a branch vein occlusion and can be treated with medication or a laser. There are veins in the retina that drain blood out of the retina, back to the heart. If those veins become blocked, this can cause fluid leakage, which can lead to vision loss.
If you experience sudden loss of your central vision or a blurry or missing area of vision, contact our office immediately.
The type of treatment depends on the cause of the blockage and the extent of damage. A laser can be used to reduce leakage and the growth of abnormal new blood vessels.
Macular degeneration is a disease of the macula, an area of the retina at the back of the eye that is responsible for fine detail vision. Vision loss usually occurs gradually and typically affects both eyes at different rates. Even with a loss of central vision, however, color vision and peripheral vision may remain clear.
The root causes of macular degeneration are still unknown. Women are at a slightly higher risk than men. Caucasians are more likely to develop macular degeneration than African Americans.
There are two forms of age-related macular degeneration, wet and dry.
Wet macular degeneration occurs when abnormal or leaking blood vessels grow underneath the retina in the area of the macula. These changes can lead to distorted or blurred vision and, in some cases, a rapid and severe loss of straight ahead vision.
The vast majority of cases of macular degeneration are the dry type, in which there is thinning or deterioration of the tissues of the macula or the formation of abnormal yellow deposits called drusen. Progression of dry macular degeneration occurs very slowly and does not always affect both eyes equally.
Your eye doctor can identify changes of the macula by looking into your eyes with various instruments. A chart known as an Amsler Grid can be used to pick up subtle changes in vision.
Download the Amsler Grid test and follow the instructions on how to test your vision at home.
Angiography is the most widely used macular degeneration diagnostic test. During the test, a harmless orange-red dye called Fluorescein will be injected into a vein in the arm. The dye travels through the body to the blood vessels in the retina. A special camera takes multiple photographs. The pictures are then analyzed to identify damage to the lining of the retina or atypical new blood vessels. The formation of new blood vessels from blood vessels in and under the macula is often the first physical sign that macular degeneration may develop.
Optical Coherence Tomography (OCT) uses light waves to create a contour map of the retina and can show areas of thickening or fluid accumulation.
There is no cure for macular degeneration, but early treatment can slow its progression and lessen symptoms. Even with effective treatments, symptoms often return. Depending on the type of macular degeneration, treatments include nutritional supplements, and medications.
Nutritional Supplements for Dry Age-Related Macular Degeneration (AMD):
The Age-Related Eye Disease Studies (AREDS and AREDS2) found that a mix of vitamins and minerals might slow the progression of dry AMD.
The original supplements contained beta-carotene, an antioxidant that increases lung cancer risk in smokers and former smokers. The newer version replaces beta-carotene with zeaxanthin and lutein.
Medications for Wet Age-Related Macular Degeneration (AMD):
There are drugs that manage, but do not cure, wet AMD. These include anti-vascular endothelial growth factor (anti-VEGF) injections, which block the production of VEGF, a protein that promotes new blood vessel growth. A retina specialist typically administers these injections after numbing the eye. Anti-VEGF shots can sometimes improve vision.
There has been active research on the use of vitamins and nutritional supplements called antioxidants to try to prevent or slow macular degeneration. Antioxidants are thought to protect against the damaging effects of oxygen-charged molecules called free radicals. A potentially important group of antioxidants are called carotenoids. These are the pigments that give fruits and vegetables their color. Two carotenoids that occur naturally in the macula are lutein and zeaxanthin. Some research studies suggest that people who have diets high in lutein and zeaxanthin may have a lower risk of developing macular degeneration. Kale, raw spinach, and collard greens are vegetables with the highest amount of lutein and zeaxanthin. You can also buy nutritional supplements that are high in these and other antioxidants.
Unfortunately, the vast majority of cases of wet macular degeneration and virtually all cases of dry macular degeneration are not treatable. In these cases, low vision aids may help make it easier to live with the decreased vision of macular degeneration. Low vision aids range from hand-held magnifying glasses to sophisticated systems that use video cameras to enlarge a printed page. Lifestyle aids such as large print books, tape-recorded books or magazines, large print playing cards, talking clocks and scales and many other devices are available.
In rare cases of wet macular degeneration, laser treatment may be recommended. This involves the use of painless laser light to destroy abnormal, leaking blood vessels under the retina. This form of treatment is only possible when the abnormal blood vessels are far enough away from the macula that it will not damage it. Only rare cases of wet macular degeneration meet these criteria. When laser treatment is possible, it may slow or stop the progression of the disease but is generally not expected to bring back any vision that has already been lost.
Diabetes is a disease that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. When the blood vessels in the eyes are affected, this is called diabetic retinopathy. The retina is in the back of the eye. It detects visual images and transmits them to the brain. Major blood vessels lie on the front portion of the retina. When these blood vessels are damaged due to diabetes, they may leak fluid or blood and grow scar tissue. This leakage affects the ability of the retina to detect and transmit images.
During the early stages of diabetic retinopathy, reading vision is typically not affected. However, when retinopathy becomes advanced, new blood vessels grow in the retina. These new vessels are the body’s attempt to overcome and replace the vessels that have been damaged by diabetes. However, these new vessels are not normal. They may bleed and cause the vision to become hazy, occasionally resulting in a complete loss of vision. The growth of abnormal blood vessels on the iris of the eye can lead to glaucoma. Diabetic retinopathy can also cause your body to form cataracts.
The new vessels also may damage the retina by forming scar tissue and pulling the retina away from its proper location. This is called retinal detachment and can lead to blindness if left untreated.
An eye doctor, such as an ophthalmologist or optometrist, can diagnose diabetic retinopathy with a dilated eye exam
In the early stages of Macular Degeneration, regular eye check-ups, attention to diet, in-home monitoring of vision and possibly nutritional supplements may be all that is recommended.
A relatively new form of treatment for some cases of wet macular degeneration is called photodynamic therapy or PDT. In those cases where PDT is appropriate, slowing of the loss of vision and sometimes, even improvement in vision are possible.
Retinal detachment occurs when the retina is lifted or pulled from the wall of the eye. If not treated immediately, a retinal detachment can cause permanent vision loss. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should call the office immediately.
Your eye doctor can diagnose retinal detachments with a dilated eye exam.
Retinal detachments are treated with surgery that may require a hospital stay. In some cases, a scleral buckle, a tiny synthetic band, is attached to the outside of the eyeball to gently push the wall of the eye against the detached retina. If necessary, a vitrectomy may also be performed. Vitrectomy is a procedure in which the vitreous humor is removed and replaced with a gas that pushes the retina back onto the wall of the eye. Over time the eye produces fluid that replaces the gas. In both of these procedures either a laser or a cryopexy (a freezing device) is used to “weld” the retina back in place.
Flashes and floaters can be alarming. Usually, however, an eye examination will confirm that they are harmless and do not require any treatment.
Flashes and floaters are very common. Almost everyone experiences them at one time or another. They become more frequent as we age.
Most flashes and floaters are caused by age-related changes in the gel-like material, called vitreous, that fills the back of the eye.
When you are born, the vitreous is firmly attached to the retina. In the very young, the vitreous is rather thick, like firm gelatin. Within the vitreous, there may be clumps of gel or tiny strands of tissue debris left over from the eye’s early development. These clumps or strands are firmly embedded in the thick, young vitreous and cannot move around much.
As you get older, the vitreous gradually becomes thinner or more watery. By the time you are in your twenties or thirties, the vitreous may be watery enough to allow some of the clumps and strands to move around inside the eye. This material floating inside the eye can cast shadows on the retina, which you see as small floating spots.
Sometime after about age 55, you may experience the onset of larger, more bothersome floaters or flashes of light. By this age, the vitreous gel has usually become much more watery. It jiggles around quite a bit when you move your eye, making flashes and floaters much more common.
Eventually, the aging vitreous can pull away from the retina and shrink into a dense mass of gel in the middle of the eyeball. Shadows cast onto the retina by the detached vitreous can cause you to see large floaters.
Using special instruments to look into your eyes, your doctor can distinguish between harmless floaters and flashes and more serious retinal problems such as holes, tears or detachment. The usual symptoms of these more serious problems include seeing hundreds of small floating spots, persistent flashing lights, or a veil-like blockage of a portion of the vision. If you experience any of these, you should contact your doctor immediately.
There is no way to eliminate the floater through surgery, laser treatment or medication. With time, the floater will become less noticeable as the brain adjusts to its presence and can “tune out” the floater. The floater will always be somewhat observable and present, particularly if one eye is covered and the patient looks at a light-colored background.
Anyone with flashes or the sudden onset of a new floater should be examined promptly by an ophthalmologist. The ophthalmologist will perform a dilated exam and look at the vitreous and retina with specialized equipment.
Sudden flashes or floaters could be symptoms of a vitreous detachment, which is a benign condition that carries the risk of developing into a retinal tear and/or retinal detachment.
