The retina is a thin layer of tissue on the inside back wall of your eye, containing millions of light-sensitive cells and other nerve cells that receive and organize visual information. Your retina sends this information to the brain through your optic nerve, enabling you to see.
Retinal diseases can affect the area of the retina that serves your central vision (the macula and the fovea at the center of the macula). Many retinal diseases share common symptoms and treatments, but each has unique characteristics. The goal of retinal disease treatments is to stop or slow disease progression and preserve, improve or restore vision.
- Expertise and experience. Each year, Mayo Clinic eye disease specialists (ophthalmologists) treat thousands of people for all types of retinal diseases and disorders. Highly skilled Mayo retinal specialists have advanced diagnostic tools and offer the latest treatments to restore vision or to slow or stop the disease and preserve as much vision as possible.
- Multispecialty team. Mayo Clinic's retinal experts work together with other specialists as needed to provide comprehensive care, treating your eye disease and other related conditions at the same time. For example, your ophthalmologist can consult with Mayo's diabetes specialists if you have diabetic retinopathy, a complication from diabetes that can result in blindness.
- Latest research. Mayo Clinic's research activities include national regenerative studies that investigate innovative ways to preserve, rejuvenate and restore vision.
Types of Retinal Diseases
Retinal diseases and disorders vary widely, but most cause visual symptoms. Some retinal disorders are common and easily diagnosed, while others are rare and hard to diagnose. These may require complex and sometimes urgent treatment. Untreated, some retinal diseases can cause severe vision loss or blindness. It's important to pay attention to any changes in your vision or new visual symptoms and seek appropriate care quickly.
Common retinal diseases and conditions include:
- Retinal tear. A retinal tear occurs when the clear, gel-like substance in the center of your eye (vitreous) shrinks and tugs on the thin layer of tissue lining the back of your eye (retina) with enough traction to cause a tear.
- Retinal detachment. A sign of retinal detachment includes the presence of fluid under the retina. This usually occurs when fluid passes through a retinal tear or break, causing the retina to lift or blister away from the underlying tissue layers.
- Diabetic retinopathy. If you have diabetes, the tiny blood vessels (capillaries) in the back of your eye can deteriorate and leak fluid into and under the retina, causing the retina to swell, typically resulting in blurry vision. Or, you may develop new, abnormal capillaries that break and bleed into the retina or into the center of the eye, further worsening vision.
- Epiretinal membrane. Epiretinal membrane, also known as macular pucker, is a delicate tissue-like scar or membrane that forms over the center of the retina at the back of your eye (macula). Epiretinal membrane may distort the surface of the retina, which results in distortion of your vision — objects may appear blurred or crooked.
- Macular hole. A macular hole is a small defect or hole in the center of the retina at the back of your eye (macula). In most cases, this is due to an age-related degeneration of the macula. The macular hole may also develop for no apparent reason, or it may be caused by eye trauma.
- Macular degeneration. In macular degeneration, the center of your retina begins to deteriorate, causing symptoms that range from blurred or slightly distorted central vision to a blind spot in the center of the visual field. There are two types — wet and dry.
Learn about retinal detachment, diabetic retinopathy, dry macular degeneration and wet macular degeneration.
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Specialists in ophthalmology at Mayo Clinic in Florida treat adults who have retinal diseases and disorders.
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Specialists in ophthalmology at Mayo Clinic in Minnesota treat adults, children and teenagers who have retinal diseases and disorders.
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Retinal diseases can be associated with aging, diabetes or other diseases, trauma to the eye or family history. Symptoms might include seeing floating specks or cobwebs, blurred vision, distorted vision, defects in the field of vision, lost vision or other problems. To make a diagnosis, your ophthalmologist conducts a thorough eye exam and looks for abnormalities anywhere in the eye. These 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. The doctor 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.
- Optical coherence tomography (OCT). OCT 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 wet age-related macular degeneration, and to monitor responses to treatment. Details of the cross-sectional anatomy of the retina can be displayed almost at a cellular level.
- Fluorescein angiography. Fluorescein angiography uses a dye that causes blood vessels in the retina to stand out under a special light. This helps to exactly identify leaking blood vessels, new abnormal blood vessels, subtle pigmentation changes in the back of the eye, signs of diabetic retinopathy and other eye disorders.
- Indocyanine green angiography. Indocyanine green angiography uses a dye that lights up when exposed to infrared light, creating images showing retinal blood vessels and the deeper, harder-to-see blood vessels behind the retina in a tissue called the choroid.
- Ultrasound. Ultrasound (ultrasonography) uses high-frequency sound waves to help view the retina and other structures in the eye, helping to distinguish cancerous (malignant) from noncancerous (benign) tumors. Also, an ultrasound can help "see through" a dense cataract or a dense hemorrhage so that your doctor can assess the retina and other structures.
The goal of most treatments is to stop disease progression and preserve or improve vision. In many cases, damage that has already occurred can't be reversed, making early detection important to preserve vision. Your doctor will work with you to determine the best treatment for you, which may include:
- Laser therapy (focal laser photocoagulation). To repair a retinal tear or hole, your surgeon may use a high-energy laser to heat small pinpoints on the retina that then create scar tissue which binds (or "welds") the retina to the underlying wall of the eye.
- Scatter laser treatment (panretinal photocoagulation). This laser treatment often can shrink abnormal new blood vessels that are bleeding into the vitreous in diseases such as diabetic retinopathy. Multiple laser burns cause the new blood vessels to shrink and scar. Although this may result in some loss of side (peripheral) vision, it may be necessary to sacrifice some side vision to preserve central vision.
- Freezing (cryopexy). Cryopexy (KRI-oh-pek-see) is often used to treat retinal tears along the retinal periphery that are hard to reach with a laser. Intense cold freezes the area around a retinal tear or hole, producing a tissue reaction that results in a delicate scar. The scarring secures the retina to the eye wall, sealing the holes and preventing retinal detachment.
- Pneumatic retinopexy. Pneumatic retinopexy (noo-MAT-ik RET-ih-no-pek-see) is used to treat certain types of retinal detachment such as a tear in the upper half of the retina. After cryopexy, a bubble of air or gas is injected into the inside of the eye (vitreous cavity). The bubble floats in the eye, pushing the retina against the wall of the eye so that a scar develops on the eye wall. This seals the retinal tear so that the retina reattaches itself. The bubble will gradually be absorbed.
- Scleral buckling. In this surgery to repair retinal detachment, your surgeon sews a small piece of silicone material to the outside eye surface (sclera). This creates a buckle that flattens or indents the sclera, relieving the tugging of the vitreous on the retina. Sometimes the surgeon drains fluid under the retina through a tiny hole in the eye wall. A scleral buckle can be used for a segment of your eye (segmental buckle) or to encircle the entire circumference of your eye (encircling buckle).
- Vitrectomy. When bleeding or inflammation clouds the vitreous fluid in the eye and obstructs the surgeon's view of the retina, the blood-filled vitreous can be removed (vitrectomy) and replaced with a salt solution to maintain the shape of the eye and improve vision. The cause of the blood can be identified and treated with delicate instruments that often include the use of a microlaser probe inside the eye. Vitrectomy may be performed for diabetic retinopathy, macular hole, epiretinal membrane, infection within the eye, eye trauma or to manage retinal detachment.
- Eye injections. Injection of medication into the vitreous fluid in the eye may be effective in treating wet macular degeneration, diabetic retinopathy and broken blood vessels within the eye. For example, to treat wet macular degeneration, periodic injections of medications directly into your eye may help stop disease progression. In some cases, this treatment may help to partially recover vision.
Learn more about treatment of retinal detachment, diabetic retinopathy, dry macular degeneration and wet macular degeneration.
Mayo Clinic has a long history of research on retinal diseases and cancers of the eye. The large number of people who seek care at Mayo Clinic aids in performing research that evaluates new treatments. Mayo Clinic eye experts combine patient care with research to expand the understanding of retinal conditions.
See a list of publications by Mayo Clinic doctors on retinal diseases on PubMed, a service of the National Library of Medicine.
Nov. 19, 2012