can be related to aging, diabetes or other diseases, trauma to the eye, or family history. To make a diagnosis, your ophthalmologist conducts a thorough eye exam and looks for abnormalities anywhere in the eye.
The following tests may be done to determine the location and extent of the disease:
- Amsler grid test. Your doctor may use an Amsler grid to test the clarity of your central vision. He or she will ask you if the lines of the grid seem faded, broken or distorted and will note where the distortion occurs on the grid to better understand the extent of retinal damage. If you have macular degeneration, he or she might also ask you to use this test to self-monitor your condition at home.
- Optical coherence tomography (OCT). This test is an excellent technique for capturing precise images of the retina to diagnose epiretinal membranes, macular holes and macular swelling (edema), to monitor the extent of age-related wet macular degeneration, and to monitor responses to treatment.
- Fluorescein angiography. This test uses a dye that causes blood vessels in the retina to stand out under a special light. This helps to exactly identify closed blood vessels, leaking blood vessels, new abnormal blood vessels and subtle changes in the back of the eye.
- Indocyanine green angiography. This test uses a dye that lights up when exposed to infrared light. The resulting images show retinal blood vessels and the deeper, harder-to-see blood vessels behind the retina in a tissue called the choroid.
- Ultrasound. This test uses high-frequency sound waves (ultrasonography) to help view the retina and other structures in the eye. It can also identify certain tissue characteristics that can help in the diagnosis and treatment of eye tumors.
- CT and MRI. In rare instances, these imaging methods can be used to help evaluate eye injuries or tumors.
The main goals of treatment are to stop or slow disease progression and preserve, improve or restore your vision. In many cases, damage that has already occurred can't be reversed, making early detection important. Your doctor will work with you to determine the best treatment.
Treatment of retinal disease may be complex and sometimes urgent. Options include:
Vitrectomy may be used if bleeding or inflammation clouds the vitreous and obstructs the surgeon's view of the retina. This technique may be part of the treatment for people with a retinal tear, diabetic retinopathy, a macular hole, an infection, eye trauma or a retinal detachment.
- Using a laser. Laser surgery can repair a retinal tear or hole. Your surgeon uses a laser to heat small pinpoints on the retina. This creates scarring that usually binds (welds) the retina to the underlying tissue. Immediate laser treatment of a new retinal tear can decrease the chance of it causing a retinal detachment.
- Shrinking abnormal blood vessels. Your doctor may use a technique called scatter laser photocoagulation to shrink abnormal new blood vessels that are bleeding or threatening to bleed into the eye. This treatment may help people with diabetic retinopathy. Extensive use of this treatment may cause the loss of some side (peripheral) or night vision.
- Freezing. In this process, called cryopexy (KRY-o-pek-see), your surgeon applies a freezing probe to the external wall of the eye to treat a retinal tear. Intense cold reaches the inside of the eye and freezes the retina. The treated area will later scar and secure the retina to the eye wall.
- Injecting air or gas into your eye. This technique, called pneumatic retinopexy (RET-ih-no-pek-see), is used to help repair certain types of retinal detachment. It can be used in combination with cryopexy or laser photocoagulation.
- Indenting the surface of your eye. This surgery, called scleral (SKLEER-ul) buckling, is used to repair a retinal detachment. Your surgeon sews a small piece of silicone material to the outside eye surface (sclera). This indents the sclera and relieves some of the force caused by the vitreous tugging on the retina. This technique may be used with other treatments.
Evacuating and replacing the fluid in the eye. In this procedure, called vitrectomy (vih-TREK-tuh-me), your surgeon removes the gel-like fluid that fills the inside of your eye (vitreous). He or she then injects air, gas or liquid into the space.
- Injecting medicine into the eye. Your doctor may suggest injecting medication into the vitreous in the eye. This technique may be effective in treating people with wet macular degeneration, diabetic retinopathy or broken blood vessels within the eye.
- Implanting a retinal prosthesis. People who have severe vision loss or blindness owing to retinal disease may be a candidate for surgery. One surgical option not widely available is called retinal prosthesis.