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Treatments |
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Diabetic Retinopathy |
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Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness. It is caused by changes in the blood vessels of the retina. |
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In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.
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If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.
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Diabetic Retinopathy has four stages:
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- Mild Nonproliferative Retinopathy: At this earliest stage, micro aneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels.
- Moderate Nonproliferative Retinopathy: As the disease progresses, some blood vessels that nourish the retina are blocked.
- Severe Nonproliferative Retinopathy: Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
- Proliferative Retinopathy: At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.
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Symptoms: |
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Often there are no symptoms in the early stages of the disease, nor is there any pain. Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year. |
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Blurred vision may occur when the macula—the part of the retina that provides sharp central vision—swells from leaking fluid. This condition is called macular edema. |
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If new blood vessels grow on the surface of the retina, they can bleed into the eye and block vision.
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Retinitis Pigmentosa |
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Retinitis pigmentosa (RP) is the name given to a group of inherited eye diseases that affect the retina. Retinitis pigmentosa causes the degeneration of photoreceptor cells in the retina. Photoreceptor cells capture and process light helping us to see. As these cells degenerate and die, patients experience progressive vision loss. |
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There are two types of photoreceptor cells: rod cells and cone cells. Rod cells are concentrated along the outer perimeter of the retina. Rod cells help us to see images00 that come into our peripheral or side vision. They also help us to see in dark and dimly lit environments. Cone cells are concentrated in the macula, the center of the retina, and allow us to see fine visual detail in the center of our vision. Cone cells also allow us to perceive color. Together, rods and cones are the cells responsible for converting light into electrical impulses that are transmitted to the brain where “seeing” actually occurs. |
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Symptoms |
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The most common feature of all forms of Retinitis Pigmentosa is a gradual degeneration of the rods and cones. Most forms of RP first cause the degeneration of rod cells. These forms of Retinitis pigmentosa, sometimes called rod-cone dystrophy, usually begin with night blindness. Night blindness is somewhat like the experience normally sighted individuals encounter when entering a dark movie theatre on a bright, sunny day. However, patients with Retinitis pigmentosa cannot adjust well to dark and dimly lit environments. |
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As the disease progresses and more rod cells degenerate, patients lose their peripheral vision. Patients with Retinitis Pigmentosa often experience a ring of vision loss in their mid-periphery with small islands of vision in their very far periphery. Others report the sensation of tunnel vision, as though they see the world through a straw. Many patients with Retinitis Pigmentosa retain a small degree of central vision throughout their life.
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Macular Degeneration |
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Age-related macular degeneration, ARMD, Macular degeneration, or age-related macular degeneration (ARMD) is a leading cause of vision loss at the age of 60 and older. It is a disease that destroys your sharp, central vision. You need central vision to see objects clearly and to do tasks such as reading and driving. |
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ARMD affects the macula, the part of the eye that allows you to see fine detail. It does not hurt, but it causes cells in the macula to die. In some cases, ARMD advances so slowly that people notice little change in their vision. In others, the disease progresses faster and may lead to a loss of vision in both eyes. Regular comprehensive eye exams can detect macular degeneration before the disease causes vision loss. Treatment can slow vision loss. It does not restore vision. |
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Symptoms |
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Both dry and wet ARMD cause no pain. |
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For dry ARMD: the most common early sign is blurred vision. As fewer cells in the macula are able to function, people will see details less clearly in front of them, such as faces or words in a book. Often this blurred vision will go away in brighter light. If the loss of these light-sensing cells becomes great, people may see a small--but growing--blind spot in the middle of their field of vision. |
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For wet ARMD: the classic early symptom is that straight lines appear crooked. This results when fluid from the leaking blood vessels gathers and lifts the macula, distorting vision. A small blind spot may also appear in wet ARMD, resulting in loss of one's central vision.
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Glaucoma is a disease caused by increased intraocular pressure (IOP) resulting either from a malformation or malfunction of the eye’s drainage structures. Left untreated, an elevated IOP causes irreversible damage the optic nerve and retinal fibers resulting in a progressive, permanent loss of vision. However, early detection and treatment can slow, or even halt the progression of the disease. Glaucoma is a leading cause of blindness.
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Detachment of Retina or Retinal Detachment |
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A retinal detachment is a serious and sight-threatening event, occurring when the retina becomes separated from its underlying supportive tissue. The retina cannot function when these layers are detached, and unless it is reattached soon, permanent vision loss may result. |
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Symptoms
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If you suddenly notice spots, floaters and flashes of light, you may be experiencing the warning signs of retinal detachment. Your vision might become blurry, or you might have poor vision. Another sign is seeing a shadow or a curtain coming down from the top of the eye or across from the side. These signs can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches immediately.
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There is no pain associated with retinal detachment. If you experience any of the signs, consult your eye doctor right away. Immediate treatment increases your odds of regaining lost vision.
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Often appearing in the teens or early twenties, Keratoconus is a progressive disease in which the normally round cornea thins and begins to bulge into a cone-like shape. This cone shape deflects light as it enters the eye on its way to the light-sensitive retina, causing distorted vision. Keratoconus can occur in one or both eyes.
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Symptoms
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Keratoconus can be difficult to detect, because it usually develops so slowly. However, in some cases, it may proceed rapidly. Nearsightedness and astigmatism also may accompany this disease, creating additional problems with distorted and blurred vision. Glare and light sensitivity also may be noticed. Keratoconic patients often have prescription changes each time they visit their eye care practitioner. It's not unusual to have a delayed diagnosis of keratoconus, if the practitioner is not familiar with the early-stage symptoms of the disease.
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Degenerative myopia is the seventh leading cause of legal blindness. This condition can start at birth, but most often starts during the pre-teen years. It is believed to be hereditary.
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Degenerative myopia is more severe than other forms of myopia and is associated with retina changes, potentially causing severe vision loss. It progresses rapidly, and visual outcome depends largely on the extent of fundus and lenticular changes. The diagnosis of degenerative myopia is accompanied by characteristic chorioretinal degenerations. Pathologic myopes, particularly those with higher refractive errors, are at risk for retinal detachment and macular changes.
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Patients with degenerative myopia typically complain of decreased vision, headaches, and sensitivity to light. If retinal degeneration or detachment is present, patients may also report light flashes and floaters, which are associated with retina changes. Those with degenerative myopia have an increased incidence of cataract formation (nuclear cataracts are most typical).
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Some of the most typical features of degenerative myopia are:
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- Vitreous liquefaction and posterior vitreous detachment
- Peripapillary atrophy appearing as temporal choroidal or scleral crescents or rings around the optic disc
- Lattice degeneration in the peripheral retina
- Tilting or malinsertion of the optic disc, usually associated with myopic conus
- Thinning of the retinal pigment epithelium with resulting atrophic appearance of the fundus
- Ectasia of the sclera posteriorly (posterior staphyloma)
- Breaks in Bruch's membrane and choriocapillaris, resulting in lines across the fundus called "lacquer cracks"
- Fuchs' spot in the macular area.
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