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A List of Frequently Asked Questions

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What Is a Vitreo-Retinal specialist?

Retinal specialists are eye physicians and surgeons who focus on diseases in the back of the eye such as macular degeneration, diabetic disease, retinal detachment, eye trauma and intraocular infection. Our physicians are medical doctors have completed many years of training in diseases and surgery of the eye including a 3 year ophthalmology residency followed by a 2 year vitreoretinal fellowship.

What Is the Retina?

The retina is the delicate, light-sensitive tissue that covers the interior wall of the eye. Like the film in a camera, it receives images projected through the lens of the eye. The retina then sends these images to your brain through the optic nerve. When the retina is damaged, your vision may become impaired. Damage to the retina may be caused by injury, illness or as a result of aging.

What is the vitreous?

The vitreous is a gel-like substance that fills the back cavity of the eye and is loosely attached to the retina.

What are floaters?

Floaters are cobwebs, strings, or speck-like objects that float in the field of vision. They may occur from any opacity within the vitreous gel that casts a shadow on the retina. They are usually black and may float in and out of view. Floaters can be an indicator that the gel-like vitreous is liquefying, which is a normal aging process but can also reflect inflammation, infection, or bleeding within the eye or be related to systemic diseases.

What is a posterior vitreous detachment (PVD)?

A posterior vitreous detachment is a separation of the vitreous gel from the inner back wall of the eye and is usually associated with floaters and flashing lights. Liquefaction of the vitreous gel is usually an age related change that continues until the vitreous separates from the retina to which it is loosely attached. The vast majority of PVDs do not cause problems except annoying floaters and sometimes brief flashes of light. Improvement in symptoms is usually seen within a few months. Occasionally retinal tears can occur from a PVD. Retinal tears can lead to a detached retina if the retina tear is not treated. There is no way to tell if a PVD caused a retinal tear so if someone has symptoms of a PVD, they need a prompt dilated retinal exam.

What is a retinal detachment?

When the retina detaches, it separates or pulls away from its normal position lining the inner back wall of the eye. A retinal detachment can occur from retina holes, retinal tears or from traction on the retina from scar tissue on the retinal surface or in the vitreous gel. If not promptly treated, a retinal detachment can cause permanent loss of vision.

What are the symptoms of retinal detachment?

Symptoms include flashing lights, new floaters or a sudden or gradual increase in either the number and or severity of floaters, which are like cobwebs, strings or specks that float about in your field of vision. Another symptom is the appearance of a curtain over the field of vision, typically starting in the periphery and progressing towards the center part of the visual field. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.

Who is at risk for retinal detachment?

A retinal detachment can occur at any age, but it is more common in people over age 40. It affects men more than women. A retinal detachment is also more likely to occur in people who are nearsighted or have had a retinal detachment in the other eye, a family history of retinal detachment, cataract surgery, an eye injury or certain systemic diseases.

How can vitreo-retinal problems be treated?

Problems with the retina and vitreous including retinal tear, retinal detachment, severe intraocular infection, eye disease and trauma can lead to vision loss and even blindness. Surgery, lasers and injections can correct problems before vision is lost, prevent further deterioration from occurring and often restore vision.

What is diabetic retinopathy?

Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina. When the weak vessels leak, swell or develop thin branches, vision loss may occur. In its advanced stages, the disease can cause blurred or cloudy vision, floaters and blind spots and eventually, blindness.

Can diabetic retinopathy be prevented?

Your risk of diabetic retinopathy can be reduced if you follow your prescribed diet and medications, exercise regularly, control your high blood pressure and cholesterol and avoid alcohol and cigarettes. Regular eye exams are an integral part of making sure your eyes are healthy.

Can diabetic retinopathy be treated?

Yes. Many of the problems caused by diabetic retinopathy such as swelling of the retina, bleeding in the vitreous and scar tissue on the retina can be treated with modern techniques such as injections, laser or surgery. The earlier problems are found, the easier they are to treat and in general, the better the visual results. Early and periodic dilated eye exams are very important.

What is macular degeneration?

Macular Degeneration is a disease characterized by a breakdown of the macula, the center, most sensitive part of the retina, the area we use to read and carry out our finest visual tasks.

What are the two main forms of macular degeneration?

Dry macular degeneration  is associated with degeneration of the pigment cells under the macula and development of drusen. The pigment cells are necessary for normal retinal function so when the cells are lost, the overlying retina stops functioning and blind spots and distortion may occur. Drusen are by-products of retinal metabolism that accumulate under the macula causing distortion and blind spots.

Wet macular degeneration  is associated with abnormal blood vessel growth under the macula which can lead to leakage of fluid, bleeding and scar-tissue growth under and within the retina. The onset of vision loss with the wet form of macular degeneration is usually more rapid and severe than in the dry form of macular degeneration.

What causes age-related macular degeneration?

Studies have found that both genetic and environmental risk factors like smoking play a major role in the development of age-related macular degeneration. Rarer forms of macular degeneration can occur in younger people and can be inherited or associated with trauma, infection or systemic disease.

What are the symptoms of macular degeneration?

  • Blurring of central vision
  • Blind spots in the central vision
  • Difficulty seeing detail up close and at a distance
  • Distortion of lines and shapes
  • Diminished color vision

Are there special tests to diagnose macular degeneration?

Yes. Your doctor will examine your eyes with special lenses to view the interior of the eye through the pupil. Other tests for macular degeneration include:

Acuity Tests: this test measures the sensitivity of your central vision at specific distances in specific lighting situations.

Amsler Grid Test: this test checks for blind spots, loss of sight and distortion.

Fluorescein Angiogram Test: a dye is injected in the vein of your arm and then photos are taken of the retina and the macula in order to identify new blood vessel growth and leakage from blood vessels.

Optical Coherence Tonography (OCT): this test takes a cross sectional image of almost microscopic detail of the layers of the retina and underlying structures affected by macular degeneration. It is very helpful in determining if there is fluid leaking in or under the retina, and abnormal blood vessels or scar tissue in the macula.

Can macular degeneration lead to total blindness?

Most people with macular degeneration retain peripheral vision and learn to optimize the use of their remaining vision. Low vision aides can sometimes be helpful also. Macular degeneration, in its late stages, can severely affect central vision. However, macular degeneration alone will never lead to total blindness. People with macular degeneration retain peripheral vision and learn to optimize the use of their remaining vision. Low vision aides can sometimes be helpful also.

Can macular degeneration be prevented?

No, the most important thing to do is to have regular eye exams, which may allow early detection and diagnosis. This is particularly important if a close relative has been diagnosed with macular degeneration.

What treatment options are available for dry macular degeneration?

The progression and severity of dry macular degeneration can be reduced with certain vitamins, minerals and Omega III fatty acids. Controlling high blood pressure and quitting smoking can be helpful.

What treatment options are available for wet macular degeneration?

There is no cure for wet macular degeneration. However, several treatment options are available. The most common anti-VEGF medications used are bevacizumab (Avastin (R)), aflibercept (Eylea (R)), and ranibizumab (Lucentis (R)). Ask your doctor which medication is best for you.

Thermal Laser was the first treatment used to treat wet macular degeneration and is still occasionally used. A laser beam is focused on the blood vessels to cauterize them.

Photodynamic therapy (PDT)  uses a low intensity laser to stimulate a light sensitive drug that is injected intravenously to cause shrinking of the abnormal blood vessels in the macula associated with macular degeneration.

Anti-VEGF medication  is the newest and best treatment for wet macular degeneration. These medications are injected into the eye and decrease leakage from and the progression of the abnormal blood vessels growing under the retina in macular degeneration. Anti-VEGF medications are not a cure and continued treatment is necessary to minimize the adverse effects of the abnormal blood vessels and maximize the patients vision.

Treatment for wet macular degeneration can involve combining these types of treatments.

What are the risk factors associated with macular degeneration?

  • Age
  • Smoking
  • Family history of macular degeneration

Is macular degeneration curable?

No, but treatment can slow or even stop the progression of the disease and in some cases, reverse some of the damage. The earlier the diagnosis is made, in general, the better the outcome.

What is a macula pucker?

A macula pucker is a distortion of the macula from scar tissue growing on the surface of the macula or from the vitreous gel pulling on the macula. The wrinkles, creases or bulges formed lead to symptoms of blurred central vision, distorted or wavy central vision, difficulty reading or performing tasks that require detailed vision, and gray and/or cloudy areas in the central vision. Vitreous surgery with removal of the scar tissue is very successful in restoring vision and decreasing or eliminating distortion.

What is a macula hole?

A macula hole is a hole in the macula, the central most sensitive part of the retina. It occurs when the shrinking vitreous gel adheres to and stretches a hole in the macula. As the hole progresses and enlarges, a blind spot develops in your central vision and impairs the ability to see at both distant and close ranges. Vitrectomy surgery is the most effective treatment option to repair a macula hole.

How do I schedule an appointment?

Typically our patients are referred by their primary eye care physician, however, call Retina Specialists of Tampa at (813) 973-3333 to schedule an appointment with Dr. Tarabishy or Dr. Dunn.

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