Macular degeneration is an age-related eye disease that affects the macula, the part of the retina that contains our fovea, or center of vision. There are classically two forms of macular degeneration: dry versus wet.
It is critical to distinguish between these forms of the disease as the recommended management plans are vastly different.
Diabetes is a disease that primarily affects the competency of our small blood vessels. The eyes are frequently affected in diabetes, a condition called diabetic retinopathy. Diabetic retinopathy can cause a wide range of complications that can be visually threatening, from diabetic macular edema (or swelling around our visual center) to proliferative diabetic retinopathy (growth of new, fragile blood vessels on the retina which are prone to bleeding). Every diabetic patient deserves a dilated eye exam at least once annually; however, your prescribed follow-up schedule may require more frequent visits depending on the severity of your retinopathy.
An epiretinal membrane, also known as a "macular pucker", is a very common diagnosis and denotes a growth of a fine membrane of tissue over the macula. While it is not a part of normal aging, it often occurs as a consequence of it. Though typically a surgical problem, not all epiretinal membranes will require surgery for removal. A comprehensive evaluation, including spectral domain optical coherence tomography and intravenous fluorescein angiography, is recommended to assess the visual significance of the epiretinal membrane.
A macular hole is a full thickness defect which can form in our fovea, or visual center, which is the thinnest part of our retina.
Vitrectomy surgery with intraocular gas injection is often necessary for successful hole closure, which is expected to improve vision.
Vitreomacular traction syndrome is characterized by traction (or pulling) on the macula and fovea, our visual center, by the vitreous body. This traction can cause a decrease in the quality of our vision, distorted vision and can put us at risk for partial or full thickness macular holes. On the other hand, vitreomacular traction could be completely asymptomatic.
The recommended treatment plan is tailored based on each patient's symptoms, visual acuity and imaging studies.
Frequently a surgical urgency, a diagnosis of a retinal tear usually requires prompt in-office treatment with laser. Retinal tears put us at great risk of developing a retinal detachment, which is a separation of the retina from the wall of the eye.
A retinal detachment due to a retinal tear is surgical problem that is often reparable by either scleral buckling or vitrectomy surgery.
Central or branch retinal vein occlusions are a common cause of vision loss. They are most commonly related to a history of high blood pressure or a history of poorly controlled glaucoma. Based on the prognosis of the retinal vein occlusion, current treatment modalities offer an excellent chance at recovery of vision. Central or branch retinal artery occlusions are essentially small "strokes" which can happen in the retina that can affect our central and/or peripheral vision. This diagnosis underscores the importance of control of underlying diabetes, high blood pressure and high cholesterol.
Uveitis is a generalized term that refers to inappropriate inflammation in one or more parts of the eye.
A comprehensive evaluation, including dilated fundoscopic exam, imaging studies, and blood work is often necessary to best characterize the uveitis and establish an accurate diagnosis.
A choroidal nevus is a benign, pigmented spot in the choroid, one of the outer layers of our eye. It is analogous to a freckle in our skin. Most choroidal nevi are harmless lesions that do not change over time in size or character. A small percentage of choroidal nevi can become something more concerning, like a choroidal melanoma, which is why it is important to have choroidal nevi checked at least once annually by a dilated fundoscopic exam and fundus photography.
Retinal dystrophies are genetic diseases affecting the retina, retinal pigment epithelium and choroid that can affect visual acuity. Incredible advances have recently been made in the field of retinal dystrophies where until recently the treatment options were quite limited.