The retina is the most critical component of your eye for vision, converting light into signals that your brain interprets as images. At Longwood Eye & LASIK Center, our retinal specialists understand that retinal diseases pose some of the most serious threats to vision, often developing silently until significant damage occurs.
This is why we combine state-of-the-art diagnostic equipment with proven treatment protocols to detect retinal conditions early and preserve your sight for years to come.
What is the Retina?
Your retina is the light-sensitive tissue lining the back of your eye, functioning much like film in a camera. When light enters through your cornea and passes through your pupil and lens, it focuses on the retina, which contains millions of specialized cells called photoreceptors.
These cells convert light into electrical impulses that travel through the optic nerve to your brain, where they become the images you see. The macula, located at the center of your retina, handles your central vision and allows you to see fine details necessary for reading, driving, and recognizing faces.
Any damage to retinal tissue can result in permanent vision loss, making early detection and treatment essential for maintaining your sight. Common retinal conditions include macular degeneration, diabetic retinopathy, and flashes and floaters.
We also treat other retinal conditions, such as retinal detachment/tears, retinal vein occlusion, and macular holes.
What is Macular Degeneration?
Macular degeneration affects the macula, the central portion of your retina responsible for detailed vision. This progressive condition primarily impacts people over 50 and is a leading cause of vision loss in older adults.
The disease appears in two distinct forms with different progression patterns and treatment approaches:
Dry Macular Degeneration
Dry macular degeneration accounts for approximately 80 percent of all cases and develops when the macula gradually thins with age. Small protein deposits called drusen begin accumulating beneath the retina, and the light-sensitive cells in the macula slowly break down.
This form typically progresses gradually over years, causing a slow decline in central vision. Most people with dry macular degeneration retain some central vision, though reading and detailed tasks may become increasingly difficult.
Wet Macular Degeneration
Wet macular degeneration is the more severe form, though it affects only about 20 percent of patients with the condition. This condition develops when abnormal blood vessels begin to grow beneath the retina and macula.
These fragile vessels leak blood and fluid, causing scarring and rapid damage to the macula. Vision loss occurs much faster with wet macular degeneration, sometimes progressing over weeks or months rather than years.
Although less common, wet macular degeneration accounts for the majority of severe vision loss cases associated with this condition.
What is Diabetic Retinopathy?
Diabetic retinopathy develops when high blood sugar levels damage the small blood vessels in your retina. This complication affects nearly all people who have had diabetes for 20 years or more, making regular eye examinations crucial for patients with diabetes.
The condition progresses through distinct stages, each requiring different monitoring and treatment approaches.
Non-Proliferative Diabetic Retinopathy
Non-proliferative diabetic retinopathy is the earlier stage of the disease. During this phase, retinal blood vessels begin to weaken and may develop small bulges or leak fluid into surrounding tissue.
When fluid accumulates in the macula, it causes swelling known as macular edema, which is the most common cause of vision loss in patients with diabetic retinopathy. Blood vessels may also close completely, preventing adequate blood flow to retinal tissues.
Many patients experience no symptoms during this stage, which makes regular screening essential for early detection.
Proliferative Diabetic Retinopathy
Proliferative diabetic retinopathy occurs when extensive blood vessel damage triggers the growth of new, abnormal vessels on the retinal surface. These vessels develop in response to oxygen deprivation but are fragile and prone to bleeding.
When these vessels bleed into the vitreous gel that fills your eye, you may notice new floaters or experience sudden vision loss. The new vessels can also create scar tissue that may pull on the retina, causing detachment.
This advanced stage requires immediate treatment to prevent severe vision loss or blindness.
What are Flashes and Floaters?
Floaters appear as small specks, threads, or cobweb-like shapes that drift across your field of vision. These visual phenomena result from tiny clumps of cells or gel that form within the vitreous and cast shadows on your retina.
While floaters become more noticeable when looking at plain backgrounds, such as blank walls or clear skies, they exist inside your eye rather than on its surface. Flashes manifest as brief streaks or bursts of light, typically in your peripheral vision.
They occur when the vitreous gel tugs on retinal tissue, stimulating the light-sensitive cells and creating the sensation of seeing light where none exists. As you age, the vitreous gel naturally shrinks and may pull away from the retina in a process called posterior vitreous detachment.
This common occurrence often produces new floaters and occasional flashes. Most floaters and flashes associated with normal aging pose no threat to vision and typically become less noticeable over time as your brain adapts to their presence.
However, certain patterns of flashes and floaters indicate serious retinal problems requiring immediate attention. Contact your eye doctor immediately if you notice a sudden increase in floaters, persistent flashing lights, a shadow or curtain effect in your peripheral vision, or any combination of these symptoms.
These signs may indicate a retinal tear or detachment, conditions that can lead to permanent vision loss if left untreated.
Who is at Risk for Retinal Disease?
Several factors increase your likelihood of developing retinal conditions. Age is the most significant risk factor, as many retinal diseases become more prevalent after the age of 50.
People with diabetes face substantially higher risks due to potential blood vessel damage throughout the body, including the delicate vessels in the retina. High blood pressure can similarly affect retinal blood vessels and contribute to various eye conditions.
Additional risk factors include:
- Family history of retinal diseases
- Previous eye injuries or surgeries
- Severe nearsightedness
- Smoking and obesity
- Certain medications like hydroxychloroquine
- Previous retinal tears or detachments
If you have diabetes, hypertension, or other systemic conditions, maintaining regular eye examinations becomes particularly important for catching retinal problems before they cause irreversible vision loss.
How are Retinal Conditions Diagnosed?
At Longwood Eye & LASIK Center, we use advanced diagnostic technology to detect retinal diseases in their earliest stages:
Dilated Eye Examination
Every retinal evaluation includes dilating your pupils with specialized eye drops. This allows our ophthalmologists to thoroughly examine your retina, macula, and optic nerve using high-powered lenses and specialized lighting systems.
During this examination, we look for signs of blood vessel damage, abnormal growths, fluid accumulation, and other changes that may indicate retinal disease.
Optical Coherence Tomography (OCT)
Optical coherence tomography (OCT) provides detailed cross-sectional images of your retinal layers. This non-invasive imaging technique utilizes light waves to create high-resolution images that reveal retinal thickness, fluid accumulation, and structural changes not visible during standard examinations.
OCT testing proves particularly valuable for monitoring macular conditions and tracking treatment responses over time.
Fluorescein Angiography
This specialized imaging test utilizes a yellow dye called fluorescein and a specialized camera to capture detailed retinal photographs that reveal blood flow patterns. The test reveals areas where blood vessels leak, regions of poor circulation, and abnormal vessel growth that may necessitate treatment.
How are Retinal Conditions Treated?
Treatment approaches for retinal diseases vary significantly depending on the specific condition, its severity, and your individual circumstances. At Longwood Eye & LASIK Center, we offer a comprehensive range of retinal treatments, from injections to advanced surgical procedures:
Retinal Injections
Anti-VEGF injections are the standard treatment for wet macular degeneration and diabetic macular edema. These medications block vascular endothelial growth factor, a protein that promotes the growth of abnormal blood vessels and leakage.
We offer the latest anti-VEGF medications, including Eylea, Eylea HD, Vabysmo, Lucentis, and Avastin. Each injection is performed in our office using topical anesthesia to ensure your comfort.
Treatment typically involves a series of monthly injections initially, followed by a monitoring phase to determine the optimal maintenance schedule for your condition. For specific conditions, we provide specialized injection therapies. Izervay offers treatment for geographic atrophy in patients with dry macular degeneration.
Iluvien and Ozurdex provide sustained-release steroid treatment for diabetic macular edema and other inflammatory conditions. These longer-acting treatments reduce the frequency of injections while maintaining therapeutic effects.
Laser Photocoagulation
Laser photocoagulation uses focused light energy to seal leaking blood vessels and destroy abnormal tissue. This outpatient procedure helps preserve remaining vision in some instances of diabetic retinopathy and retinal vascular conditions.
The laser creates small burns that seal off problematic blood vessels, reducing the risk of further bleeding or leakage. While laser treatment cannot restore lost vision, it effectively prevents additional damage in many cases.
Vitrectomy
Vitrectomy involves removing the vitreous gel from inside your eye to address various retinal conditions. During this microsurgical procedure, your surgeon makes tiny incisions and uses specialized instruments to remove cloudy or blood-filled vitreous.
The surgery allows direct access to the retina for repairs such as removing scar tissue, reattaching detached retina, or treating macular holes. The vitreous is replaced with a clear solution, gas bubble, or silicone oil, depending on your specific needs.
Scleral Buckle
Scleral buckle surgery involves placing a silicone band around the eye to relieve tension on the retina and help it reattach. The buckle remains permanently in place but is not visible externally.
Combined with laser treatment or cryotherapy to seal retinal tears, these procedures successfully reattach the retina in most cases when performed promptly.
Protecting your vision requires early detection and appropriate treatment of retinal conditions. Our experienced team provides comprehensive retinal care using the latest diagnostic technology and treatment methods to protect your sight and keep your eyes healthy.
Do you have risk factors for retinal disease or have you noticed changes in your vision? Schedule a comprehensive eye examination at Longwood Eye & LASIK Center in West Springfield, MA, today!