Let's learn about Retinal Diseases in a simple way!

Our eyes are like precious gems. These two eyes help us see the beautiful things in this world, our loved ones. So, there is a very complex and very important part of these eyes, which we call the retina . Imagine, it works like the film roll of an old camera inside the eye. It is this one that creates images from the light that enters the eye and sends them to the brain. So, today we are going to talk about the diseases that can occur in this precious retina, that is, `(Retinal Diseases)`.

What are Retinal Diseases? How do your eyes work?

Simply put, retinal diseases are a variety of conditions that affect the very delicate membrane at the back of your eye, your retina.

Now look, the way our eyes work is amazing.

1. First, light from the outside enters the eye through the transparent part at the front of the eye, the cornea .

2. Then this light passes through the small hole in the middle of the iris, the pupil . That's why the iris of the eye becomes smaller in bright light and larger in dark light.

3. Next, the lens inside the eye focuses this light directly onto the retina, just like we use a magnifying glass to focus the light into one spot.

Your retina is a place where millions of very specialized cells are located. These cells are what convert light that enters your eye into electrical signals. These signals then travel through your optic nerve to your brain. The brain analyzes these signals and turns them into images like "Oh, there's a flower," "Here's mom," and lets us see. It's a pretty amazing mechanism, isn't it?

Retinal Disease can affect any part of the retina. In particular, the macula, the central part of the retina that helps us see fine details, read a book, and recognize letters, can be damaged. The sad thing is that some of these conditions can be inherited .

Many retinal diseases cause symptoms that affect your vision. It is important to diagnose and treat these diseases early, as some diseases can lead to permanent blindness or vision loss if left untreated.

What are the types of retinal diseases?

There are actually several types of diseases that affect the retina. Let's look at the main ones.

Diseases that commonly affect the retina:

• Diabetes -related retinopathy: As you know, diabetes is a problem that many people have now. So, if it is not properly controlled, the delicate blood vessels in the eyes can be damaged, causing the retina to bleed and swell. This is called diabetes-related retinopathy.
• Retinal detachment : This is an emergency. This is when the retina separates from the inner wall of the eye. It's like a poster coming off a wall.
• Retinal tears or holes : Sometimes small tears or holes can develop in the retina. These are often the beginning of a retinal detachment.
• Retinal vein occlusion: This condition can occur when a vein that supplies blood to the retina becomes blocked . This can be in the main vein (central retinal vein occlusion) or in a branch vein (branch retinal vein occlusion).
• Infectious retinitis: The retina can become swollen and inflamed due to various viral, bacterial, or fungal infections.
• Central serous retinopathy : This is a condition in which fluid builds up under the retina. It is often associated with stress.
• Birdshot chorioretinopathy and other inflammatory diseases: These are also rare inflammatory conditions that affect the retina and its associated structures.

Diseases that specifically affect the macula:

The macula, as we mentioned earlier, is the central part of the retina that provides clear, sharp vision. So there are several diseases that affect it:

• Macular pucker (also called epiretinal membrane): This is a thin film that forms over the macula, like a sheet of cellophane. This can cause blurred vision and blurred vision.
• Macular hole : A small hole in the macula.
• Age-related macular degeneration (AMD): This is a common condition that comes with age. There are two types: dry AMD and wet AMD.
• Macular edema : Swelling of the macula. This is caused by fluid buildup.

Hereditary retinal diseases:

These are diseases that are congenital and caused by genetic influences:

• Retinitis pigmentosa : This is a condition that causes gradual loss of peripheral vision. Night blindness is also a symptom.
• Usher syndrome : This is a hereditary condition that causes hearing loss along with retinitis pigmentosa.
• Stargardt disease : This mostly affects young people and impairs central vision.
• Retinoschisis : A separation of the layers of the retina. This can be present at birth or develop later.

What are these symptoms we feel?

If you have retinal disease, you may experience one or more of these symptoms:

• Eye floaters and flashes . It can feel like small spiders are moving around in front of your eyes.
• Blurred or altered vision. Letters may not be clearly visible, and images may appear as two.
• Blind spots occur in direct vision (central vision) or peripheral vision .
• Visual distortions. For example, straight lines may appear to be drawn in a wavy manner. This can be noticed when looking at things like window frames and door frames.
• Sudden loss of vision.
• Difficulty seeing at night or having difficulty adjusting to changes in light (such as when going outside in the dark).

If you have any of these symptoms, it is very important to see an ophthalmologist immediately.

What are the causes of this disease?

There is no single cause for retinal diseases. There can be many different causes.

• Some conditions, such as Usher syndrome, Stargardt disease, and Retinitis pigmentosa, are inherited.
• Retinopathy can occur with other medical conditions. Diabetes and high blood pressure can damage the delicate blood vessels in the eye, which can lead to damage to the retina. Inflammatory conditions in the body can also cause damage.
• Eye injuries can cause damage to the retina and macula. For example, if a cricket ball hits your eye, or if something sharp gets stuck in your eye, it can cause serious damage.
• Sometimes, conditions like ``Macular pucker`` can occur after eye surgery .
• Some retinal diseases, such as cytomegalovirus retinitis, are caused by an infection . However, retinal disease itself is not contagious.

What are the risk factors for these diseases?

Some things can increase the risk of developing retinal diseases. They are:

• Aging.
• Smoking.
• Obesity or overweight .
• Having other medical conditions such as diabetes and hypertension .
• Previous retinal tears or detachments .
• Previous eye injuries or surgeries.
• Having a family history of retinal diseases .
• Severe nearsightedness (people with very high prescription glasses - `Severe myopia`).
• Long-term use of certain medications, such as hydroxychloroquine (Plaquenil®) and pentosane polysulfate.

Sometimes, gender or race can also be a risk factor for a specific retinal disease.

What are the possible complications of these diseases?

If retinal diseases are not treated properly, they can lead to complete loss of vision and blindness .

These diseases are treated by ophthalmologists. However, doctors cannot cure every retinal disease. Therefore, it is important to diagnose the disease early and control it as best as possible.

How are these retinal diseases diagnosed?

When you go for a regular eye exam, the eye doctor will always check for retinal diseases. That's why it's important to have your eyes checked at the intervals your doctor recommends.

During the exam, the doctor will put eye drops in your eyes to dilate your pupils. This will allow the doctor to examine your retina more closely. If the doctor suspects that there is a problem with your retina after this exam, he or she may order more specialized tests or refer you to a retina specialist.

What tests are done to diagnose or monitor diseases?

The doctor may order tests like these:

• Optical Coherence Tomography (OCT): This is like taking a cross-section of the retina. This is very important for detecting things like swelling and holes in the macula.
• Fluorescein angiography : This involves injecting a special dye into a vein in your arm and taking pictures of the blood vessels inside your eye. It can look at things like the pattern of blood flow and whether blood is leaking from the veins.
• Fundus autofluorescence : This is also a noninvasive imaging test.
• Electroretinography (ERG): This measures how well the retina is working.
• Genetic testing : If a hereditary disease is suspected, this test is performed to confirm it.

How are these diseases treated?

Treatment options depend on the type of retinal disease you have. In some cases, treatment can stop the disease or slow down the rate at which it gets worse. Treatment options include surgical procedures, laser treatments , and injections of medicines into or around the eye .

Surgical Procedures:

Vitrectomy is a surgical procedure performed for the following conditions:

• Retinal detachments.
• Macular pucker `(Macular pucker / Epiretinal membrane)`.
• Macular hole.
• Eye injuries (e.g., foreign objects getting into the eye).
• Eye infections.

Eye injections:

Vitreous injection is done for the following conditions:

• Wet age-related macular degeneration (Wet AMD).
• Advanced diabetic retinopathy.
• Macular edema occurs due to various causes.
• Eye infections.
• Inflammatory eye diseases.

Laser Treatments:

Laser treatment is used in cases such as:

• Treat unwanted blood vessels.
• Close retinal tears.
• Central serous retinopathy.
• Macular edema.

Other treatments for retinal detachment:

• Scleral buckle surgery : In this procedure, a surgeon places a silicone band around the eye and sews it in. This pushes the white part of the eye (sclera) inward, allowing the retina to rest against the wall.
• Cryoplexy : Cryotherapy is used to create a scar and close the tear or detachment.
• Pneumatic retinopexy : A surgeon injects a gas bubble into the eye. This bubble helps to hold the retina in place. This treatment may be combined with cryotherapy or laser treatment.

Other treatments:

• Antibacterial , antifungal , or antiviral medications for severe infections.
• "Cold" laser treatment for central serous retinopathy and some other retinal diseases.

Are there any side effects or complications of the treatment?

The side effects or complications of treatments for retinal diseases depend on many factors, such as the type of treatment you receive, your general health, and the condition you have.

In general, there may be risks such as:

• Infection.
• Scarring.
• Dry eyes.
• Blurred vision.
• High or low pressure in your eye.
• Decreased vision.
• High eye pressure.
• Bleeding.

Therefore, before starting any treatment, it is very important to thoroughly discuss and understand the pros, cons, and possible side effects with your doctor.

How long does it take to recover after treatment?

The recovery time depends on the type of treatment you had and the type of retinal disease you had. For example, if you have a gas bubble in your eye, it may take several weeks for the bubble to disappear. You may not be able to go to work for two to four weeks. Also, you cannot fly or breathe nitrous oxide, which is used in some dental procedures, while you have a gas bubble in your eye (but this is temporary).

If you have eye injections, your doctor will tell you to rest your eyes, use artificial tears, and not rub your eyes. But there is no real "recovery period" for that.

Can a damaged retina be completely healed?

In some cases, a damaged retina can be cured or repaired. However, some conditions have no permanent cure. Therefore, it is best to talk to your doctor about your individual situation. He or she can explain your condition to you and give you the best treatment plan.

Can these retinal diseases be prevented? How can the risk be reduced?

We cannot prevent some retinal diseases, especially those that are hereditary. However, there are things we can do to reduce the risk of developing some other diseases:

• Managing chronic diseases: If you have diseases like high blood pressure (Hypertension) or diabetes, it is important to control them well. It is also important to control body weight (Overweight or obesity).
• Regular eye exams: Get your eyes checked according to the schedule recommended by your eye doctor. This way, if there is a problem, it can be identified at an early stage.
• Eye protection: Wear eye protection (goggles, shields) when working (e.g., woodworking, metalworking) or playing contact sports. Even a seemingly minor accident to the eyes can cause serious damage.

What happens if I have this kind of disease? What should I expect?

The outlook for retinal disease depends on the type of disease you have. So, talk to your doctor about your condition. He or she can explain your condition and help you choose the best treatment for you. You will also know what to expect from your vision and overall recovery.

When should I see a doctor?

It is very important to have regular eye exams, especially if you have a medical condition that is a risk factor for retinal disease, such as diabetes.

If you notice any sudden changes in your vision (e.g., sudden loss of vision, black spots starting to float in front of your eyes, seeing lights, seeing straight lines), see an eye doctor immediately. Don't waste time.

When should I go to the emergency room?

In this situation, you should go to an emergency room immediately, or call 1990:

• If you suddenly lose all or part of your vision.
• If you experience severe eye pain.
• If there is a serious accident or injury to the eye.

These are emergency situations, so don't delay.

What questions should I ask my doctor about retinal diseases?

You have every right to ask your doctor any questions you have. You can ask questions like these:

• Can this condition I have be treated? Can it be completely cured?
• What side effects can be expected from the treatment?
• What medications or lifestyle changes can I make to help stop my symptoms from getting worse?
• What are the chances of me losing my sight?
• What services can you recommend to help people live with vision loss?
• Am I eligible to participate in a clinical trial?

Finally, things to remember

Not all retinal disease is the same. It is important to understand your specific condition and be aware of any changes in your vision. Early detection and treatment usually yield the best results.

You may have a variety of feelings about your eye condition. You may feel scared, worried, or sad. That's normal. Talk to your medical team and your family about what you need and how you're feeling. They are there to help you in any way they can. Remember, you're not alone.

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