Retina Service

Oftalmología

Retinal Detachment

It is a medical emergency requiring immediate surgery.
When a retinal detachment occurs, it is separated from the underlying choroid responsible for supplying oxygen and nutrients.

What are the symptoms?
  • Vision of light flashes (like lightning or flash) that sometimes are repeated and are collected on the same field of vision. These visual symptoms usually appear before retinal detachment occurs.
  • Partial or total loss of their visual field, more or less quickly, with or without the presence of the light flashes. It may feel like a black curtain that covers vision.
  • No pain.
    With the emergence of some or all of these symptoms seek immediate medical attention.

Unfortunately, many times the query is postponed in the hope that the symptoms disappear which worsens the table if diagnosed and treated early have a more favorable prognosis.

Causes

Retinal detachment can occur as a result of:

  • Retinal break (hole or tear in the retina) which may happen after a vitreous detachment. Rhegmatogenous type is called and is the most common cause.
  • Lesions characteristic of diabetic retinopathy. Tractional type is called.
  • When there are problems or secondary to vascular tumors or inflammatory disorders permeability. Exudative type is called.
Methods of Prevention and Diagnosis

It is advisable to perform a background annual retinal eye to detect some lesions that are considered predisposing to trigger a detached retina. These lesions, if they are detected early can be fotocoaguladas Argon laser to prevent it.

It is important to consider the described symptoms as warning signs and seek urgently to an ophthalmologist for eye examination and fundus emergency, which could help save your vision.

Treatment

For cases of retinal tear preventive laser treatment (argon) which can also be used in lesions predisposing to peripheral retinal detachment is advised.

When retinal detachment has already generated the treatment is always surgical. The retina must be reset either by external means (indentation can placing procedures) or inner track (vitrectomy), depending on the particular case.

Types of surgery:
– Surgery argon laser (photocoagulation)
– Freezing (Cryopexy)
– Pneumatic retinopexy
– Conventional scleral Surgery
– The transconjunctival vitrectomy.

Floaters

The perception of “floaters” or mobile floaters as spots, threads or other forms is one of the most frequent reasons ophthalmologist and are called floaters.

Characteristically, these floaters move with the movements we make with eyes. In most cases, they are related to physiological changes of the vitreous humor and irrelevant, but sometimes they can be associated with serious eye conditions that require specific treatment.

The main predisposing factors include increasing age and myopia.

These floaters are condensations (aggregates of collagen fibers) that form in the vitreous (transparent gel that fills the eyeball) and when light passes cast shadows on the retina image sensing backlit.

Vitreous volume gradually decreases, which can result in separation of the retina (vitreous detachment), this can cause more floating bodies and the perception of acute-onset floaters.

Diagnosis

The diagnosis is made by the substantive examination of eyes and / or eye scan.

Treatment

There is no medical treatment at present to definitively eliminate floaters.

In extreme cases in which the floating bodies interfere significantly in vision, vitrectomy may be indicated. During this procedure the vitreous gel is removed and replaced with condensation with a saline solution. This is a highly specialized surgery done with local anesthetic drops and usually does not require stitches.

Diabetic Retinopathy

Diabetes can hurt your eyes causing damage to the small blood vessels of the retina (diabetic retinopathy), increasing the risk of glaucoma or cataracts and other eye problems. The possibility of complications increases if:

  • You have had diabetes for a long time.
  • Your diabetes is poorly controlled with high blood sugar levels.
  • You have high blood pressure (HBP)
  • You have the high cholesterol level
  • You are a smoker
  • You are overweight
  • You are sedentary
  • You are pregnant
  • How does It feel?

    Initially you probably do not feel anything, but as the disease progresses, your vision may gradually decrease.

    Can it be treated?

    The treatment will depend on the degree of the injuries. In any case, the main thing is to keep diabetes well controlled.

    What I can do?

    You can improve your prognosis by maintaining good control of blood sugar and blood pressure, exercise, follow the diet that your doctor tells you and avoid smoking.

    Ophthalmological eye fundoscopy control should be done once a year if your diabetes is controlled, but more often. The sooner the better!

    Related macular degeneration age

    RELATED MACULAR DEGENERATION AGE (DRY)

    Related macular degeneration with age is a disease that usually affects people over 50, causing a decrease in vision due to the presence of lesions in the macula (central area of ​​the retina).

    Symptoms

    Macular degeneration is painless and gradually evolves. The vision may fail in one eye while the other remains normal, which may result in not noticed the change. As the disease progresses, these are the changes in vision:
    – Need more light for reading or near vision.
    – Difficulty adapting to low light levels.
    – Occurrence of blind spots in the center of the visual field combined with a steep drop in the sharpness of your central vision.
    – Your vision and lifestyle begin to be dramatically affected when this condition occurs in both eyes.
    – Distorted images (metamorphopsia): Some people may experience visual disturbances which may include unusual patterns and geometric shapes, animals or even faces, these images may mistakenly believe associated with hallucinations.

    Diagnosis

    To make diagnosis of macular degeneration related to age should conduct a thorough eye examination with fundus observation and precise combination with complementary studies such as:
    – Retinofluoresceinografía (RFG) contrast (sodium fluorescein) is injected intravenous and choroidal and retinal behavior level is studied by taking pictures.
    – Optical coherence tomography (OCT) is a noninvasive diagnostic test where the macula is scanned and used to detect the presence or otherwise of a neovascular membrane and / or macular edema.
    These studies are necessary for both diagnosis and monitoring of patients with macular degeneration (maculopathy).

    Treatment

    At present there is no treatment to cure dry macular degeneration. Usually progresses slowly, and many people with this condition are able to live a normal productive life, especially if only one eye is affected.

    Dry AMD can turn into wet macular degeneration. Treatment with tablets of high doses of antioxidants and zinc may reverse the progression.

    RELATED MACULAR DEGENERATION AGE (Wet)

    As macular degeneration related to age dry, this is a disease that usually affects people over 50, causing a decrease in vision due to the presence of lesions in the macula (central area of ​​the retina). The difference is in the presence of intraretinal fluid and will differ in their evolution, treatment and prognosis.

    Symptoms

    The following signs and symptoms may come and fast forward:
    – Visual distortions, such as straight lines appear wavy or objects appearing smaller or farther away than they really are.
    – Changes of central vision (deformed or a stain).
    – Impaired ability to see colors and fine details.

    Diagnosis

    To make diagnosis of macular degeneration related to age should conduct a thorough eye examination with fundus observation and precise combination with complementary studies such as:
    – Retinofluoresceinografía (RFG) contrast (sodium fluorescein) is injected intravenous and choroidal and retinal behavior level is studied by taking pictures.
    – Optical coherence tomography (OCT) is a noninvasive diagnostic test where the macula is scanned and used to detect the presence or otherwise of a neovascular membrane and / or macular edema.

    These studies are necessary for both diagnosis and monitoring of patients with macular degeneration (maculopathy).

    Treatment

    The treatment of wet AMD, although in many cases possible to recover vision is focused on halting the progression of the disease.

    These treatments include:
    – Photocoagulation (argon laser)
    – Photodynamic Therapy (PDT)
    – Macular Translocation Surgery
    – Intravitreal injections of anti-angiogenic factors antagonists Vascular Endothelial Growth Factor (anti-VEGF).

    Macular Edema

    Macular edema is an abnormal accumulation of fluid that expands and thickens the intra-and extracellular space of the macula by a change in the permeability of the capillaries that irrigate.

    It is a common disease that affects the central area of the retina, called the macula.

    Causes

    Although the most frequent cause is associated with diabetic retinopathy can occur in various eye diseases:

    – De vascular and venous thrombosis, diabetic retinopathy, etc.
    – Inflammatory processes as uveitis or vasculitis
    – In the context of certain congenital retinal dystrophies such as retinitis pigmentosa
    – Associated with intraocular tumors
    – A tensile phenomena such as epiretinal membrane or vitreomacular traction syndrome.

    Symptoms

    – Impairment of central vision and usually painless slowly progressive, although occasionally occurs rapidly (eg in venous thrombosis of the retina).
    – Perception of distorted images, metamorphopsia.

    Diagnosis

    To make diagnosis of macular edema should conduct a thorough eye examination with fundus observation and precise combination with complementary studies such as:

    – Retinofluoresceinografía (RFG) contrast (sodium fluorescein) is injected intravenous and choroidal and retinal behavior level is studied by taking pictures.

    – Optical coherence tomography (OCT) is a noninvasive diagnostic test where the macula is scanned and used to detect the presence or otherwise of a neovascular membrane and / or macular edema.

    These studies are necessary for both diagnosis and monitoring of patients with macular degeneration (maculopathy).

    Treatment

    To make diagnosis of macular edema should conduct a thorough eye examination with fundus observation and precise combination with complementary studies such as:

    – Retinofluoresceinografía (RFG) contrast (sodium fluorescein) is injected intravenous and choroidal and retinal behavior level is studied by taking pictures.

    – Optical coherence tomography (OCT) is a noninvasive diagnostic test where the macula is scanned and used to detect the presence or otherwise of a neovascular membrane and / or macular edema.

    These studies are necessary for both diagnosis and monitoring of patients with macular degeneration (maculopathy).

    Pigmentosa Retinitis

    Retinitis pigmentosa is a disease caused by many genes (part of the 12 different genes which have already been identified), and there is usually a high percentage of family history of blindness or severe loss of visual function.

    The most common age of onset of this disease is between 25-40 years and appears silently and slowly.

    Symptoms

    – Important nocturnal decrease and / or slow ability to adapt to the dark.
    – Progressive loss of visual field leading to a vision and tunnel.
    – Loss of central vision (does not affect all people equally).

    Tratment

    There is hope that in the future they can locate all of the altered genes.

    Another option being studied is the transplantation of stem cells in the retina, but much remains to be done.

    Forecast

    The prognosis in retinitis pigmentosa depends on the mode of inheritance and age of presentation. The later the disease appears, the better the prognosis.

    Patients with this disease must follow a strict protocol for diagnosis and monitoring of retinitis pigmentosa.

    Maculopathy

    There are in the retina two zones or sides: the central retina and the peripheral retina. The central retina has got a little central depression (1 mm x 1.5 mm) which is called “Macula” which is formed in its whole by cellular elements highly differentiated called cones. These are the ones that allow the discriminatory vision and color’s vision. The “Macula” allows us to read, write, and see objects in detail. Any disease that affects this area is called Maculopathy.