Vitreoretinal Diseases and Surgery
Our eyes are our windows to the world, so it can be frightening when something goes wrong. It’s good to know that PacMed has in-house, board-certified ophthalmologists who can help. Among these specialists, we have a vitreoretinal surgeon who subspecializes in the diagnosis and treatment of conditions and diseases affecting the vitreous, retina, and macula. Our specialist has the experience and extensive training needed to qualify as a vitreoretinal surgeon. This training includes a two-year fellowship focused solely on the diagnosis and treatment of vitreoretinal diseases. This is in addition to the completion of a three-year ophthalmology residency approved by the Accreditation Council for Graduate Medical Education (ACGME). This level of training allows our specialist to diagnose and treat a broad range of eye conditions.
Some conditions and diseases that should be seen by a vitreoretinal specialist include:
Diabetic retinopathy is a serious complication of diabetes that can lead to damage of the blood vessels in the eye. This in turn can cause decreased vision and even blindness. Luckily, there are many different treatments for the complications of diabetic retinopathy including laser therapy, medications, and surgery. Patients who have diabetes should have a full dilated exam at least once a year.
Age-Related Macular Degeneration (AMD)
Age-related macular degeneration is the leading cause of legal blindness in people over the age of 55. It is a disease that affects the macula, the central portion of the retina that is responsible for providing the sharp, central vision necessary to perform tasks such as reading and driving. Age-related macular degeneration has two main forms, a dry and a wet type. While both can cause decreased vision, it is the wet type that can cause bleeding and abnormal swelling in the macula that can lead to rapid and severe vision loss. There are new medications available that can not only prevent vision loss, but improve vision as well.
Uveitis is a family of inflammatory conditions that affects the part of the eye called the uvea (an inner vascular layer that lines the majority of the eye). The causes and severity of these conditions are quite varied, and they may be associated with serious systemic conditions. A careful, detailed evaluation is crucial in the management and treatment of this complex set of diseases. Treatments include topical medications as well as medications taken by mouth or by injections.
Epiretinal membranes are thin membranes that can develop over the macula causing thickening and distortion of the macula. This can lead to significant blurred or distorted vision. While steroid eye drops and injections may be able to improve vision in some cases, it is often necessary to remove these membranes surgically. Advanced microsurgical techniques have allowed this to be done safely and in the outpatient setting.
Anatomy of the Macula
Macular holes are small defects that can develop in the macula as a result of aging changes of the macula and vitreous (the jelly-like substance inside the eye). Rarely, they can also be caused by trauma to the eye. Macular holes can cause decreased and distorted vision as well as a central blind spot. If left untreated, macular holes can lead to permanent vision loss. The treatment for macular holes involves physically closing the hole with microsurgery. Current techniques lead to highly successful outcomes with improvement in vision.
Retinal Detachments and Tears
The retina is the light-sensitive, inner layer of tissue that lines the inside of the eye and sends messages through the optic nerve to the brain. As a result of trauma, diseases, or aging processes of the vitreous and retina, a tear in the retina can develop. If not properly treated, these tears can lead to the entire retina detaching from the inside of the eye. This can lead to severe and permanent vision loss if left untreated. However, if a retinal tear is diagnosed early, it can be treated with laser therapy or cryotherapy (freezing) which would prevent the tear from leading to a retinal detachment. If a retinal detachment is present, it can be repaired by several different techniques ranging from in-office procedures to outpatient surgical procedures performed in the operating room.