Our Bay area retina practice was formed to provide the highest level of eye care for patients with retinal conditions. We specialize in all aspects of medical and surgical retina care. Below is a list of some of the more common conditions treated in our office.
While some patients with retina problems may have minimal or no symptoms, such as diabetic patients with minimal retinopathy, it is more common for patients to experience blurred vision, flashes or floaters, or visual distortion. Certain conditions such as retinal detachment may cause sudden loss of vision and require urgent treatment. When the diagnosis is in question, we are always available to answer questions by phone and make sure you receive timely care.
Common Retinal Conditions //
DIABETIC EYE CARE
In addition to affecting the heart and kidneys, high blood sugar can affect the eyes. Therefore it is recommended that diabetics have a dilated retinal exam at least yearly. There are three primary ways in which diabetic eye damage can occur:
1. The retinal blood vessels may become leaky causing fluid build up in the retina (macular edema).
2. The retina may become nonperfused and ischemic, causing vision loss (retinal ischemia).
3. New blood vessels may form, either on the retina or on the iris (neovascularization). The new vessels can bleed, filling the eye with blood (vitreous hemorrhage).
The effects of diabetes on the eye can be quantified by our retina specialist and treated with a variety of procedures available in our office, including laser photocoagulation and intravitreal injections of pharmacologic agents.
Retinal Neovascularization and Vitreous Hemorrhage
FLASHES AND FLOATERS
Some patients with flashes and floaters have a retinal tear or retinal detachment, and since these conditions are both urgent and treatable you should have your eyes examined by a retina specialist as soon as possible.
RETINAL TEARS AND RETINAL DETACHMENTS
Both retinal tears and retinal detachments are urgent conditions that should be evaluated immediately.
Retinal tears can be of different numbers, shapes, and sizes. When caught early enough, laser can be used to surround the tear.
A retinal detachment results from an untreated retinal tear, and means the retina is detached from the underlying retinal pigment epithelium. Retinal detachments can be treated with vitrectomy, pneumatic retinopexy, and scleral buckling procedures.
Retinal Tear treated with laser demarcation
An epiretinal membrane is a sheet or layer of connective tissue on the surface of the retina which can contract and cause retinal wrinkling. Similar to macular holes, patients with epiretinal membranes complain of central visual distortion.
The treatment for epiretinal membrane is vitrectomy surgery with peeling of the membrane from the retinal surface. Patients often notice improvement in the distortion following surgery.
A macular hole is a full thickness defect in the retina. Patients with a macular hole often complain of distortion in their central vision. Patients should expect to receive a dilated exam and OCT testing at our Bay area retina office. The treatment is vitrectomy surgery with peeling of the internal limiting membrane or, in selected cases, injection of a pharmacologic agent to induce vitreous condensation.
Patients who undergo surgery will have their eye filled with an expansile gas at the end of the surgery. Bay area retina patients are prohibited from climbing to high altitudes (mountaineering) and from air travel until the gas bubble has disappeared from the eye.
There are two types of macular degeneration, the wet form and the dry form.
The more advanced form of macular degeneration is the wet type, and consists of abnormal new blood vessels growing underneath the retina or retinal pigment epithelium. Treatment plans for this form are customized by your retina specialist and can include intravitreal injections, photodynamic therapy, and retinal laser.
The dry type of macular degeneration may progress to the wet form, and therefore regular examinations are recommended. An Amsler grid may be used to monitor the vision for changes that may indicate progression from dry to wet macular degeneration. In some cases, AREDS vitamins are prescribed to reduce the risk of conversion to the wet form.
SUDDEN LOSS OF VISION
Sudden painless loss of vison can be due to a number of retinal conditions including retinal vein occlusions, retinal arterial occlusions, macular degeneration, diabetic eye disease, and retinal detachment. An examination by Dr. Bharadwaj and testing can help determine what type of condition is affecting your eyes.
RETINAL VEIN OCCLUSIONS
Retinal vein occlusions occur often as a complication of long-standing hypertension.
These occlusions may occur in a limited part of the retina (branch retinal vein occlusions, hemiretinal vein occlusions), or they may affect the entire retina (central retinal vein occlusions).
The diagnosis of retinal vein occlusions requires testing in the clinic and a complete dilated examination. The intraocular pressure, iris, and retina must be checked for abnormalities.
A variety of treatment options exist for macular edema associated with vein occlusions. These may include intravitreal injections or laser in selected cases.
To avoid complications from the disease, such as neovascularization of the retina or iris, patients should have a retinal examination and be treated in a timely manner.
RETINAL ARTERY OCCLUSIONS
Similar to retinal vein occlusions, retinal arteries can also become blocked. This results in limited blood flow to part of the retina (branch retinal artery occlusion) or to the entire retina (central retinal artery occlusion).
There is no proven treatment for the acute stage of retinal artery occlusions. However, it is important to make the correct diagnosis to avoid treatable complications of these disorders.
Patients need to undergo testing of their carotid arteries and heart as part of the workup. Your doctor will help coordinate this testing.