Examples of Eye Conditions
Diabetic Retinopathy
Diabetic Retinopathy is a complication of systemic diabetes mellitus. High levels of blood sugar cause numerous problems in different parts of the body. Treatment involves control of the blood sugar through diet and medications including insulin. Despite treatment complication may still occur. In the eye the tiny blood vessels that nourish the retina become weak. Fluid and blood leak from the weakened blood vessels. New vessels develop like weeds and can injure the retina leading to loss of vision.
Symptoms:
In the early stages of this disease you may have little or no vision loss. This is call non-proliferative diabetic retinopathy or background diabetic retinopathy. The only way to tell whether you have retinopathy is through an eye exam. Background diabetic retinopathy accounts for 80% of all diabetic retinopathy.
In the advanced stages, vision problems become more pronounced with cloudy, distorted or loss of central vision. This stage is called proliferative diabetic retinopathy. Blind spots, floaters and retinal hemorrhages and irreversible blindness may occur in this stage due to the abnormal leaking blood vessels. It is important to realize that the damage can occur without pain or any symptoms to alert the patient.
Diabetic macular edema can occur with either non proliferative or proliferative diabetic retinopathy. It refers to the condition in which the blood vessel walls have weakened to the extent that blood and serum leak in to retinal tissue. The retina becomes wet and swollen and the result is blurry distorted vision.
Care and Treatment:
Special lasers can be used to treat macular edema and proliferative diabetic retinopathy. The laser beams seals the weakened or leaking vessels to prevent further growth and deterioration.
A vitrectomy may be performed to remove blood from an intraocular hemorrhage that has failed to reabsorb after many months. Pan Retinal Photocoagulation, a laser treatment may also be preformed at the same time to prevent further bleeding of the retina.
Reduce your Risk of Diabetic Retinopathy:
The most important way that you can control your risk of developing or progression of diabetic retinopathy is to make appropriate changes in your lifestyle. This means controlling your blood sugar levels and other risk factors. These include: controlling blood pressure, a balanced monitored diet, regular exercise, stopping smoking and taking medications as directed by your physician. Finally, regular exams, at least once a year, or more often, may be recommended. If proliferation or macular edema are noted further testing and treatment may be required.
Glaucoma
Glaucoma is the term for a diverse group of eye diseases, all of which involve progressive damage to the optic nerve. Glaucoma is usually, but not always, accompanied by high intraocular (internal) fluid pressure. Optic nerve damage produces certain characteristic visual field defects in the individual's peripheral (side), as well as central, vision. The vision lost is not reversible and cannot be restored. However, with early detection and treatment, further loss can be prevented.
Risk Factors for Glaucoma:
Older age
Race: African American, Asian , or Native Alaskan
Family history of glaucoma (parents, siblings, grandprents)
Diabetes, heart disease, hypertension
Eye injury, disease, or tumor.
Diagnosis:
Early signs have no symptoms; therefore an eye exam is the only way to determine if you have the disease. Intraocular pressure with Tonometry. Examination of your optic nerve. Visual field Testing to assess the peripheral vision. Stereo optic nerve photography to monitor any changes of the optic nerve over time. Gonioscopy to assess the drainage angle in the eye.
Types of Glaucoma:
Open angle glaucoma is the most common type seen in the United States. It occurs when the eye’s drainage canals become clogged over time. This causes increased intraoular pressure due to poor drainage of fluid out of the eye. Treatment is aimed at reducing pressure using eye drops, pills, laser surgery and possibly surgery in the operating room if the pressure cannot be controlled and vision loss is occurring.
Closed angle glaucoma is not as common. It occurs acutely as an attack in people who have anatomically narrow angles. It is characterized by sever eye pain and blurred vision. Often patients will describe a “brow ache” and haloes around streetlights. According to the Glaucoma Research Foundation, eye pressure increases rapidly due to blockage of the drainage canals. There is an abnormal bunching of the iris over the drainage canals when the pupil enlarges (as in entering a dark room). Treatment is urgent. Eye drops, pills, laser and possibly surgery in the operating room may be required to immediately lower the intraocular pressure.
Secondary glaucoma occurs as a complication to injury, inflammation, vascular disease and diabetes. Treatments are similar to primary glaucoma.
Congenital glaucoma is caused by a developmental abnormality in the drainage canals.
Protect your vision by working with your eye doctor at regular 3-4 month intervals. Using your medications as directed by your doctor and controlling your other medical conditions such as high blood pressure, heart disease and diabetes.
For more information go to www.glaucoma.org
Macular Degeneration
Macular Degeneration is the leading cause of blindness in people 55 years and older in the US, affecting more than 10 million Americans. It is caused by the deterioration of the central portion of the retina called the macula. The macula is responsible for focusing and gives us the ability to read, drive a car, and recognize faces, color and fine detail.
There are two types of macular degeneration- dry and wet. Approximately 85%-90% are the dry atrophic type. “Dry age related macular degeneration does not involve any leakage of blood vessels. Loss of vision and distorted vision still may occur despite maintaining 20/40 or better central vision. Patients still have difficulty with reading, fluctuating vision, and limiting lighting conditions.
Approximately 10-15% of patients develop the “wet” or exudative type of macular degeneration. Abnormal vessels grow under the retina and macula (choroidal neovascularization). These blood vessels bleed and leak fluid into the central macula causing it to bulge and lift upward. The central vision become distorted and destroyed rapidly.
There is no treatment for the dry form. However, the AREDs study found that multivitamins including A, C, E and Zinc can slow the progression of the disease.
The wet form depending on the type of lesion may have treatment options that can be discussed in the office.
For more information go to www.macular.org or http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
Flashes and Floaters and Vitreous Detachments
Flashes are bright points of light that you can see when your eyes are closed. Flashes come and go in an instant and typically occur in one eye at a time.
They are caused by the vitreous pulling on the retina. As we age the vitreous begins to shrink and pull away from the retina (vitreous detachment). The flashes are a result of the tugging on the retina. If the vitreous pulls too hard on the retina, it may cause a tear, which can lead to a retinal detachment. This may need urgent treatment to repair the retina, therefore you should see your eye doctor immediately if you are seeing new flashes.
Floaters are dark spots that move through your vision. They move with your eye movements and are often describes as pieces of a spider web or “a fly” in the vision. They are usually gray and appear as strands or hairs in the vision. As we age the vitreous softens and bit of proteins in the softened “jelly” can appear as floaters. People who are nearsighted, have cataracts, or have had laser surgery tend to notice the floaters more often. If there is an acute increase or change in the floaters it may be a sign of an impending retinal detachment and requires an immediate evaluation.
For more information go to: http://www.nei.nih.gov/health/retinaldetach/index.asp