Retina

Basic Anatomy

The eye works like a camera. The lens system in the front of the eye (cornea, pupil and lens) focuses light onto the back of the eye, the retina. The retina is the inner lining of the eye and works like the film in a camera; it senses light and allows you to see by transmitting this information to your brain where it is interpreted as images. The middle of the eye is filled with a clear, jelly-like substance called vitreous. The vitreous and retina are normally in contact with each other.

The retina can be divided into two main anatomic regions – the macula and the peripheral retina. The macula is in the center of the retina and is responsible for our fine, central, and color vision. The peripheral retina comprises over 90 percent of the retina and is responsible for our peripheral and night vision.

retina



WHY COMPREHENSIVE EYE EXAMINATION NEEDED?

As retina is one of the most sensitive organs, Your ophthalmologist or retina specialist can directly see your retinal blood vessels through a comprehensive, dilated eye exam. The appearance of these vessels and your retina are excellent markers of the overall health of your body’s blood vessel system.


MOST COMMON RETINAL CONDITION

HIGH BLOOD PRESSURE AND RETINA HEALTH

WHAT IS HIGH BLOOD PRESSURE?

  • High blood pressure, also known as hypertension, can affect your body and eyes in many ways. It is important to know what your blood pressure is and to maintain good control of it.
  • Asymptomatic individuals with a known history of HT should also undergo complete eye check-up as many changes related to HT are asymptomatic and lead to blinding conditions in future.


Elevated Blood Pressure Can Cause Changes in Your Retina

Changes that can occur include:

  • Bleeding
  • Edema and swelling of your retina
  • Exudation (fluid leakage) and buildup of protein and lipids in the retina
  • Small infarctions of the retina (tissue death due to inadequate blood supply), also known as “cotton wool spots”
  • Arteriosclerosis: arteriolar narrowing, artery-vein crossing changes (also known as “AV nicking”), changes in the color of arterioles and in advanced cases, sclerosis (abnormal hardening) of the blood vessels

Severe cases of hypertension may result in blockages of the retinal veins or arteries. These blockages of circulation (called occlusions), can cause severe loss of vision or even blindness.

Are you hypertensive?


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FLASHES AND FLOATERS

What are flashes and floaters?

  • You may sometimes see small specks, lines, or clouds moving in your field of vision. When these are inside of your eye, they are called floaters. These can develop when the vitreous (a gel-like substance that fills the middle of the eye between the lens and the retina) degenerates or detaches. Floaters are usually due to tiny clumps of cells or connective tissue moving within your eye.
  • When the retina is irritated or disturbed, you may see what look like flashes or streaks of light. This can happen occasionally as people age.
  • If the retina develops a tear or a detachment, you may see a shower of floaters and flashes.



causes and symptoms

    Possible causes of floaters or flashes include:

  • Myopia
  • Retinal tear or detachment
  • Bleeding in the eye
  • Inflammation in the eye
causes and symptoms

    Possible causes of floaters or flashes include:

  • Myopia
  • Retinal tear or detachment
  • Bleeding in the eye
  • Inflammation in the eye
DIAGNOSIS
  • Floaters and flashes are typically diagnosed by the patient.
  • If you are experiencing flashes and floaters, contact your ophthalmologist at Tej eye center at the earliest
  • This could be the earliest symptoms of onset of Retinal detachment
  • Our retina specialists can confirm the diagnosis and specific cause through a dilated eye exam. Retinal surgeons at Tej eye center are specially trained to determine the specific cause of your floaters and flashes, and if treatment is needed.
DIAGNOSIS
  • Floaters and flashes are typically diagnosed by the patient.
  • If you are experiencing flashes and floaters, contact your ophthalmologist at Tej eye center at the earliest
  • This could be the earliest symptoms of onset of Retinal detachment
  • Our retina specialists can confirm the diagnosis and specific cause through a dilated eye exam. Retinal surgeons at Tej eye center are specially trained to determine the specific cause of your floaters and flashes, and if treatment is needed.
Treatment and Prognosis
  • Many times, a posterior vitreous detachment will occur without complication, and no treatment is necessary. Floaters frequently go away on their own over time.
  • A torn or detached retina may require immediate treatment. Our physicians at TEJ EYE CENTER are specially trained and experienced in treating flashes and floaters to restore your vision.
Treatment and Prognosis
  • Many times, a posterior vitreous detachment will occur without complication, and no treatment is necessary. Floaters frequently go away on their own over time.
  • A torn or detached retina may require immediate treatment. Our physicians at TEJ EYE CENTER are specially trained and experienced in treating flashes and floaters to restore your vision.

WHAT IS A POSTERIOR VITREOUS DETACHMENT (PVD)?

  • A posterior vitreous detachment is not the same thing as a retinal detachment. A posterior vitreous detachment occurs when the vitreous gel separates from the retina which lines the back wall of the eye. PVD happens in most eyes as we age and tends to occur earlier in myopic eyes and after trauma or eye surgery.
  • When a posterior vitreous detachment occurs, bleeding can also occur and the vitreous gel can pull holes or rip tears in the retina. A retinal detachment occurs when the retina is separated from its underlying blood supply. This can occur when a retinal hole or tear allows fluid to pass behind the retina. This can be thought of as similar to when water gets under a sheet of wallpaper, it peels the wallpaper off of the wall. In many cases this is an emergency that requires urgent treatment.



PVD


What should I do about it and will I need treatment?

If you notice any new or concerning flashes or floaters, or any change in your vision, contact your eye doctor as soon as possible. Many times a posterior vitreous detachment will occur without complication and no treatment is necessary. In contrast, a torn or detached retina may require immediate treatment. You should be evaluated by an eye care specialist as soon as possible.

ABOUT RETINAL TEARS


As the vitreous gel in the back of the eye starts to liquefy, it can separate from the retina, a condition called posterior vitreous detachment (PVD). If the vitreous gel adheres too firmly to the retina, a retinal tear can occur with a PVD. The tear can also progress to a retinal detachment, a more serious condition that happens when fluid leaks through the tear and separates the retina from the back of the eye.

CAUSES AND SYMPTOMS

Light passes to your retina through a large space in the center of the eye called the vitreous cavity. This cavity is filled with a clear, jelly-like substance called vitreous which is normally in contact with the retina. A posterior vitreous detachment (PVD) occurs when the vitreous gel separates from the retina. This happens in most eyes as we age and tends to occur earlier in myopic (nearsighted) eyes and after trauma or eye surgery. In most cases, this separation does not cause any significant problems. However, when a posterior vitreous detachment occurs, the vitreous gel sometimes pulls holes or rips tears in the retina.

Symptoms of a retinal tear can include the sudden appearance:

of floaters (black spots) or flashes of light. However, some patients experience very few symptoms.

If a vitreous hemorrhage (bleeding)or retinal detachment also occurs, additional symptoms can include blurred vision or loss of peripheral (side) vision.


DIAGNOSIS

  • A retinal tear can be diagnosed through a thorough dilated eye exam. Sometimes our physicians order an ophthalmic ultrasound to assist with the diagnosis.
  • Asymptomatic retinal tear or break detected in routine eye exam also needs attention and treatment because they may also lead to serious and potential blinding condition of retinal detachment
  • Patients who have taken treatment for retinal breaks or tears also need to undergo a complete and thorough examination within 3 to 6 months to detect any new development of breaks or tears.


TREATMENT AND PROGNOSIS

The prognosis is good if a retinal tear is caught early before it progresses to a retinal detachment. Treatment can include:

  • A retinal tear can be diagnosed through a thorough dilated eye exam. Sometimes our physicians order an ophthalmic ultrasound to assist with the diagnosis.
  • Asymptomatic retinal tear or break detected in routine eye exam also needs attention and treatment because they may also lead to serious and potential blinding condition of retinal detachment
  • Patients who have taken treatment for retinal breaks or tears also need to undergo a complete and thorough examination within 3 to 6 months to detect any new development of breaks or tears.

  • Our sub-specialized, board-certified ophthalmologists at TEJ EYE CENTER are experienced in treating both retinal tears and retinal detachment.
  • While retinal tears generally do not cause long-term vision loss and can be effectively repaired through minimally invasive techniques or laser treatment, it is important that the condition is caught early. If not, a retinal detachment may occur which almost always causes vision loss or blindness. At Retina Consultants of TejEye Center, we will evaluate each case promptly, offering a fast and effective diagnosis so treatment can be performed before further damage occurs.



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Lattice Degeneration

  • Lattice degeneration describes a condition in which an area of the peripheral retina is very thin. Lattice degeneration is common and usually found in myopic (nearsighted) individuals.
  • Since the retina overlying lattice degeneration is thinner than normal, it can be predisposed to developing tears or holes. The tears and holes may then lead to retinal detachment in some patients. Lattice degeneration is found in 10 percent of the general population, but 40 percent of people with retinal detachments are found to have lattice degeneration in the peripheral retina.


DIAGNOSIS AND SYMPTOMS OF LATTICE DEGENERATION

Lattice degeneration may be found on routine examination of the retina, and some patients may not experience any symptoms at all. Common symptoms may include floaters and flashing lights.

TREATMENT OF LATTICE DEGENERATION

Lattice degeneration associated with retinal tears is treated with a barrier laser in the office to decrease the risk of the development of retinal detachment. Patients with lattice degeneration who have symptoms of floaters and flashing lights are also generally given preventative barrier laser treatment to prevent any future progression of retinal tears or retinal detachment. Patients are advised to call immediately if they experience a sudden onset of floaters or flashing lights.

Retinal Detachment-OCULAR EMERGENCY

A retinal detachment occurs when the retina is separated from its underlying blood supply. This can occur when a retinal hole or retinal tears allows fluid to pass behind the retina, lifting the retina away from the back surface of the eye like wallpaper peeling off a wall. Retinal detachments are a common cause of visual loss and are often considered surgical emergencies.

Retinal detachment is a surgical emergency and needs immediate surgical intervention for better prognosis. In old/long standing retinal detachment the visual recovery is guarded.

eye vision
eye vision
retina
retina


Causes and Symptoms

Rhegmatogenous retinal detachments are the most common form and develop because of a hole or tears in the retina. Approximately 1 out of every 300 people will develop such a retinal detachment over the course of a lifetime.

Some people have an increased risk of developing a retinal detachment. For example, very nearsighted people have up to a five percent lifetime risk. Other factors that may increase a patient’s risk of developing a retinal detachment include lattice degeneration, eye surgery, trauma or a family history of retinal detachment.


Causes and Symptoms


What is the treatment of a retinal detachment?

In many cases a retinal tear or detachment is an emergency that requires prompt treatment. There are no drops or medications that can reattach a detached retina. A retinal detachment usually requires surgery. There are many ways to surgically repair a detached retina depending on the specific clinical situation.


Examples of interventions your ophthalmologist may recommend include:

  • Laser or freezing (cryo) therapy may be applied to seal off a retinal tear or hole if there is no detachment or if the detachment is very localized. This procedure is performed in the office.
  • Pneumatic retinopexy is a procedure in which laser or freezing therapy is used to seal off retinal tears or holes. This is accompanied by injection of a gas bubble into the eye in order to reattach the retina. This procedure is performed in the office.
  • Scleral buckle surgery, performed in the operating room, involves placing a silicone band around the outside of the eye to provide permanent, external support to retinal tears or holes.
  • Vitrectomy surgery is a procedure performed in the operating room. Tiny instruments are used inside the eye to remove the vitreous gel, reattach the retina and seal off all retinal tears and holes with laser or cryo therapy. A gas bubble or silicone oil bubble will be placed in the eye in order to keep the retina flat until the eye heals. If gas is used, the eye will refill itself with clear fluid as the gas bubble reabsorbs over the course of a few weeks. If silicone oil is used, it may need to be removed surgically from the eye once the retinal is stable.
  • Re-Surgery/second surgery : If a patient has undergone vitrectomy surgery for retinal detachment and if silicone oil was used during the surgery, the patient will need a second intervention 3-4 months after the primary surgery for the removal of silicon oil.

    If the primary surgery is not able to attach the retina, resurgery might be needed within a span of 01 month to attempt reattachment of retina.

Macular Hole

What is a macular hole?

The macula is the small area in the center of the retina responsible for your central vision which helps you to perform tasks such as reading, driving and close-up work. A macular hole is a small break in the macula.

There are three stages of a macular hole:

  • Foveal detachment (Stage I)
  • Partial-thickness hole (Stage II)
  • Full-thickness hole

Causes and Symptoms of Macular Hole
  • Vitreous traction: The vitreous is the clear, jelly-like substance that fills the middle of the eye between the lens and the retina. As you age, the vitreous can begin to pull away from the retina, sometimes causing a macular hole.
  • Injury or trauma to the eye
  • Diabetic eye disease
  • High degree of myopia (nearsightedness)
  • Retinal detachment
  • Macular pucker
Symptoms of a macular hole can include
  • Decline in central vision
  • Blurring of vision
  • Distortion, causing straight lines to appear wavy
  • A dark spot in your central vision

Diagnosis

Ocular coherence tomography (OCT) is used for diagnosing, staging and managing a macular hole.

Treatment and Prognosis

The standard treatment for macular holes is vitrectomy surgery, an outpatient procedure that involves removing the vitreous gel to stop it from pulling on the retina. A gas bubble is then placed in the eye to push against the macular hole, helping it to close and heal. Over a period of several weeks, the gas bubble slowly dissolves and is replaced with natural eye fluids.

Patients with poor vision and long standing macular holes, surgery can be attempted to close the macular hole.


WHAT DOES YOUR OPHTHALMOLOGIST SEE ?

The classic findings of CSR are collections of a clear fluid below the retina and RPE. Other problems can develop including retinal and RPE atrophy or degeneration, subretinal exudation and scarring, RPE tears and the development of choroidal neovascular membranes. Your ophthalmologist may obtain multiple types of ocular imaging including photography, ocular coherence tomography (OCT) and angiography to facilitate diagnosis and treatment.


TREATMENT AND PROGNOSIS

Approximately 50 percent of people with central serous chorioretinopathy (CSR) will have more than one episode, and about 10 percent of patients will have more than three episodes. In most cases, the fluid under the retina will resolve spontaneously within three months, and most people (about 90 percent) will maintain relatively good central vision. Some patients, however, may have significant visual effects, and in its most aggressive form, CSR can cause severe central vision loss.

Risk factors include
  • The use of cortisone-type medications (steroids – oral, inhaled or injected)
  • Smoking
  • Stress

Diagnosis

Your Retina Consultants of TEJ EYE CENTER may obtain multiple types of ocular imaging, including photography, ocular coherence tomography (OCT) and fluorescein angiography (FA) to facilitate diagnosis and treatment of your cystoid macular edema (CME). This includes addressing the underlying cause of your CME.


Treatment and Prognosis

Depending on the cause of your cystoid macular edema (CME), treatment may include some of the following:

  • Anti-inflammatory medications, including steroid and/or non-steroidal anti-inflammatory medications in the form of eye drops, pills, or injections
  • Posterior sub-tenon's injections (OPD procedure)
  • Intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) medication like Avastin, Eylea or Lucentis
  • Surgery such as vitrectomy
  • Laser therapy

Diabetes, high blood pressure, and poorly controlled cholesterol can make cystoid macular edema worse and more difficult to treat. These cardiovascular risk factors should be optimally controlled under the guidance of your primary care physician.

Fortunately, most patients with CME can be successfully treated, and vision often improves, although the healing process can be slow and take several months.


Age-Related Macular Degeneration

What is Age-Related Macular Degeneration?

Age-related macular degeneration (ARMD or AMD) is the most common cause of irreversible vision loss affecting up to 20 percent of people over the age of 60. It is one of the most common conditions that our board-certified retina specialists treat on a daily basis.


Treatment and Prognosis

AMD is caused by the deterioration of the macula, which is the central area of the retina. This condition causes a loss of central vision that occurs slowly over time.


Dry AMD

More than 90% of patients diagnosed with AMD have the dry form, which is often associated with a slower progression of the disease that occurs over many years. It is characterized by drusen formation (yellow deposits under the retina that are made up of lipids, a fatty protein), retinal degeneration, and a gradual wearing away of the retina called atrophy. If these areas of retinal degeneration group together into larger areas, it is called geographic atrophy which is a more advanced stage of the disease. Most patients with early dry AMD with mild retinal changes will have no or minimal problems with their vision. However, in its most advanced form, dry AMD can cause profound central vision loss, often with preserved peripheral (side) vision.

Dry AMD

More than 90% of patients diagnosed with AMD have the dry form, which is often associated with a slower progression of the disease that occurs over many years. It is characterized by drusen formation (yellow deposits under the retina that are made up of lipids, a fatty protein), retinal degeneration, and a gradual wearing away of the retina called atrophy. If these areas of retinal degeneration group together into larger areas, it is called geographic atrophy which is a more advanced stage of the disease. Most patients with early dry AMD with mild retinal changes will have no or minimal problems with their vision. However, in its most advanced form, dry AMD can cause profound central vision loss, often with preserved peripheral (side) vision.

Wet AMD

This form of AMD is characterized by the development of abnormal blood vessels known as choroidal neovascular membranes (CNVM) that disrupt the retina and cause leakage of fluid. This growth of abnormal blood vessels can result in vision loss due to fluid build-up in the retina (macular edema), bleeding in the retina, and scar tissue formation (fibrosis). Wet AMD is generally associated with more rapid visual loss over days to weeks compared to the slower progression of dry AMD.

Wet AMD

This form of AMD is characterized by the development of abnormal blood vessels known as choroidal neovascular membranes (CNVM) that disrupt the retina and cause leakage of fluid. This growth of abnormal blood vessels can result in vision loss due to fluid build-up in the retina (macular edema), bleeding in the retina, and scar tissue formation (fibrosis). Wet AMD is generally associated with more rapid visual loss over days to weeks compared to the slower progression of dry AMD.

Known Causes

Age-related macular degeneration (AMD) usually occurs after age 50 and is often bilateral (present in both eyes). While the exact cause is unknown, genetics play a role. Many patients have a significant family history of AMD. In addition, numerous studies have revealed that nutritional and lifestyle factors play a role in both the onset and progression of macular degeneration, including:

  • Obesity
  • Poor diet (especially high levels of saturated fat)
  • High blood pressure and cholesterol levels
  • Smoking cigarettes
  • Cardiovascular disease

SYMPTOMS OF ARMD

Visual distortion, including warping or bending of straight lines and objects

Blurred central vision in one or both eyes

Increasing difficulty adapting to changing light conditions, especially low light levels

Difficulty with reading or close-up work


EXAMINATION AND DIAGNOSTIC TESTING

Regular eye examinations are important to diagnose and manage AMD. While being evaluated by your eye doctor you may undergo multiple types of ocular imaging including photography, ocular coherence tomography (OCT), and fluorescein angiography (FA) to facilitate diagnosis and treatment.


Treatment and Prognosis

The risk of vision loss from some forms of AMD can be reduced by taking a special combination of supplements. The Age-Related Eye Diseases Studies (AREDS & AREDS2), which were large clinical trials, demonstrated a decreased risk of visual loss from moderate dry AMD by taking a combination of the following:

  • 15 mg of Beta-carotene
  • 400IU of Vitamin E
  • 500 mg of Vitamin C
  • 80 mg of Zinc
  • 2 mg of copper
  • Lutein/Zeaxanthin


In addition, an Amsler grid is a chart to use at home to help monitor your vision. Use it daily for each eye as directed and if you notice changes in your vision, contact your ophthalmologist as soon as possible.

Repeated injections of anti-VEGF agents (Avastin, Lucentis & Eylea) have been firmly established as the optimal treatment for wet AMD. These powerful drugs are given as injections into the eye to suppress abnormal blood vessel growth and leakage. Minimum 03 injections at monthly intervals are required in the treatment of wet AMD. Extensive numbing of the eye makes this injection procedure virtually painless.

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WHAT IS CENTRAL SEROUS RETINOPATHY/CHORIORETINOPATHY?

Central serous retinopathy (CSR) is also known as idiopathic central serous chorioretinopathy (ICSC) because the exact cause is unknown. CSR is believed to be a non-infectious and non-inflammatory disease that results in a collection of fluid below the retina and retinal pigment epithelium (RPE). It most commonly involves the macula. This is believed to be caused by increased and abnormal leakage of fluid under the retina called choroidal vascular permeability.


CAUSES AND SYMPTOMS OF CENTRAL SEROUS
RETINOPATHY/
CHORIORETINOPATHY
  • While central serous chorioretinopathy (CSR) can occur at any age, most patients are between 20 and 50 years old. Men are affected more often than women, and many patients will be affected in both eyes.
Risk factors include
  • The use of cortisone-type medications (steroids – oral, inhaled or injected)
  • Smoking
  • Stress
Symptoms of CSR may include:
  • Blurred vision
  • Metamorphopsia — objects appear distorted or crooked
  • Micropsia — objects appear smaller than normal
  • Central scotomas — areas of decreased vision

DIAGNOSIS

WHAT DOES YOUR OPHTHALMOLOGIST SEE ?

The classic findings of CSR are collections of a clear fluid below the retina and RPE. Other problems can develop including retinal and RPE atrophy or degeneration, subretinal exudation and scarring, RPE tears and the development of choroidal neovascular membranes. Your ophthalmologist may obtain multiple types of ocular imaging including photography, ocular coherence tomography (OCT) and angiography to facilitate diagnosis and treatment.


TREATMENT AND PROGNOSIS

Approximately 50 percent of people with central serous chorioretinopathy (CSR) will have more than one episode, and about 10 percent of patients will have more than three episodes. In most cases, the fluid under the retina will resolve spontaneously within three months, and most people (about 90 percent) will maintain relatively good central vision. Some patients, however, may have significant visual effects, and in its most aggressive form, CSR can cause severe central vision loss.

Risk factors include
  • The use of cortisone-type medications (steroids – oral, inhaled or injected)
  • Smoking
  • Stress

Retinal Vein Occlusion

About RVO

A retinal vein occlusion (RVO) occurs when one of the veins that drains blood from the retina in the back of your eye becomes blocked. A blocked retinal vein damages the retinal blood vessels and can lead to hemorrhage (bleeding), impaired blood flow, and leakage of fluid and blood components (hard exudates) into the retina. RVO can cause visual impairment in four ways:

  • Blood and hard exudates can directly interfere with retinal function.
  • Abnormal fluid can accumulate in the retina, leading to thickening and the presence of cyst-like fluid collections that distort normal retinal architecture. This is called cystoid macular edema(CME).
  • Inadequate blood flow to the retina, which is called ischemia
  • Abnormal blood vessels can grow from the surface of the retina. This is called neovascularization. These fragile blood vessels can bleed and form damaging scar tissue. Sometimes, these abnormal blood vesselscan grow on the iris and drainage canals in the eye, leading to increased eye pressure (neovascular glaucoma).

CAUSES AND SYMPTOMS

Diabetes, high blood pressure, poorly controlled cholesterol and smoking can all increase a patient’s risk of RVO. Many other conditions can cause RVO, including glaucoma, inflammation and blood clotting disorders (hypercoaguable states). Depending on your clinical situation, you may need to be evaluated for these less common conditions.
The most common symptoms of RVO include:

  • Blurred and Distored central vision
  • Dim vision
  • Decreased sensitivity to light

Sometimes, however, patients with CRVO or BRVO experience no symptoms.

Diagnosis

Your Retina Consultants of Tej eye center may obtain multiple types of ocular imaging, including photography, ocular coherence tomography (OCT) and fluorescein angiographyto help with your diagnosis and treatment.

retina

Depending on the cause and severity of a BRVO or CRVO, treatment may include one or more the following:

  • Close clinical observation
  • Intravitreal injections of anti-vascular endothelial growth factor (anti- VEGF) medications (Lucentis, Avastin, Eylea) or steroids
  • Laser therapy
  • Vitrectomy surgery

In addition to treatment of your eye, if you have CRVO or BRVO, it is very important that you work with your primary care physician to optimally control your cardiovascular risk factors, including blood pressure, cholesterol, weight and diabetes.

Cystoid Macular Edema

What is Cystoid Macular Edema?

Cystoid macular edema (CME) occurs when abnormal fluid accumulates in the macula which is located in the center of the retina. This results in retinal thickening and the presence of cyst-like fluid collections that distort the normal retinal architecture and can impact vision.


The most common symptoms of CME include:

Blurred or distorted
central vision

Dim vision

Decreased sensitivity to light Sometimes patients with cystoid macular edema experience no symptoms at all.


CAUSES AND SYMPTOMS OF CYSTOID MACULAR EDEMA

Cystoid macular edema (CME) has many different causes, including:

  • Eye Surgery
  • Diabetic Retinopathy
  • Rentinal vein occlusion
  • uveitis(inflammation of the eye)
  • eye trauma
  • side effects of some medication

It commonly occurs after eye surgery. This is likely related to inflammation. About one to three percent of all cataract surgery patients will experience decreased vision due to CME, usually within a few months of surgery.

Diagnosis

Your Retina Consultants of TEJ EYE CENTER may obtain multiple types of ocular imaging, including photography, ocular coherence tomography (OCT) and fluorescein angiography (FA) to facilitate diagnosis and treatment of your cystoid macular edema (CME). This includes addressing the underlying cause of your CME.


Treatment and Prognosis

Depending on the cause of your cystoid macular edema (CME), treatment may include some of the following:

  • Anti-inflammatory medications, including steroid and/or non-steroidal anti-inflammatory medications in the form of eye drops, pills, or injections
  • Posterior sub-tenon's injections (OPD procedure)
  • Intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) medication like Avastin, Eylea or Lucentis
  • Surgery such as vitrectomy
  • Laser therapy

Diabetes, high blood pressure, and poorly controlled cholesterol can make cystoid macular edema worse and more difficult to treat. These cardiovascular risk factors should be optimally controlled under the guidance of your primary care physician.

Fortunately, most patients with CME can be successfully treated, and vision often improves, although the healing process can be slow and take several months.

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