The retina is a thin layer of tissue on the inside back wall of your eye. It contains millions of light-sensitive cells and other nerve cells that receive and organize visual information. Your retina sends this information to your brain through your optic nerve, enabling you to see.
Retinal diseases can affect any part of your retina and can cause total blindness. Disease affecting the edge of your retina can affect your side (peripheral) vision. Some diseases affect the part of your retina that serves your central vision (the macula and the fovea). Many retinal diseases share some common symptoms and treatments. The main goals of treatment are to stop or slow the disease and preserve, improve or restore your vision.
- Expertise and experience. Each year, Mayo Clinic eye disease specialists (ophthalmologists) treat thousands of people for all types of retinal conditions. Highly skilled Mayo retinal specialists have advanced diagnostic tools and offer the latest treatments in an effort to restore, preserve or improve vision or to slow or stop a disease.
- Multidisciplinary team of specialized experts. Mayo Clinic retinal experts collaborate with other specialists to provide care for the whole person. For example, if you have diabetic retinopathy, your ophthalmologist can consult with Mayo diabetes specialists to provide comprehensive care as needed.
- New medical advancements and treatments. Our mission to promote research and share knowledge helps advance care. Mayo Clinic's research activities include national studies that investigate innovative ways to preserve, rejuvenate and restore vision.
Retinal diseases and disorders vary widely, but most of them cause visual symptoms. Some retinal disorders are common and easily diagnosed. 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 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 break in the tissue. It's often accompanied by the sudden onset of symptoms such as floaters and flashing lights.
- Retinal detachment. A retinal detachment is defined by the presence of fluid under the retina. This usually occurs when fluid passes through a retinal tear, causing the retina to lift 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. This causes 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. This also worsens your vision.
- Epiretinal membrane. Epiretinal membrane is a delicate tissue-like scar or membrane that looks like crinkled cellophane lying on top of the retina. When it occurs over the center of the retina at the back of your eye, it's known as macular pucker. This condition distorts 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 abnormality involving the interface between the retina and the overlying vitreous. The macular hole may develop suddenly for no apparent reason, or it may follow an injury to the eye.
- Macular degeneration. In macular degeneration, the center of your retina begins to deteriorate. This causes symptoms such as blurred central vision or a blind spot in the center of the visual field. There are two types — wet macular degeneration and dry macular degeneration. Many people will first have the dry form, which can progress to the wet form in one or both eyes. Mayo Clinic offers the most advanced treatments for macular degeneration, including laser therapy and — for dry macular degeneration — implanting a telescope in one eye.
- Retinitis pigmentosa. Retinitis pigmentosa is a degenerative disease that affects the retina. The retina is the part of the eye that transmits light signals to the optic nerve and brain. As the disease progresses, you may first lose side (peripheral) vision and night vision. Eventually, the condition can lead to severe vision loss or blindness. Treatment options are available to help slow the process of retinal degeneration. And Mayo Clinic offers a new option called retinal prosthesis for people with severe vision loss or blindness owing to retinal disease.
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Specialists in ophthalmology at Mayo Clinic treat adults 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. 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). 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 age-related wet 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 closed blood vessels, leaking blood vessels, new abnormal blood vessels and subtle pigmentary changes in the back of the eye. These abnormalities may be signs of diabetic retinopathy or 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. This can be especially useful if you have a dense cataract or hemorrhage in your eye that prevents the doctor from evaluating your retina with standard optical instruments. Ultrasonography can also identify certain tissue characteristics that can help in the diagnosis and management of tumors of the eye.
- CT and MRI. In rare instances, these imaging methods can be used to help evaluate tumors of the eye.
The main goals of treatment are 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. Your doctor will work with you to determine the best treatment. Options may include:
Using a laser. A certain type of laser surgery (focal laser photocoagulation) 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, or welds, the retina to the underlying tissue. Immediate treatment of a new retinal tear with a laser can decrease the risk of the tear leading to 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 vitreous. This treatment may help people with conditions such as diabetic retinopathy. With extensive scatter laser photocoagulation, you may experience loss of some side (peripheral) vision 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's used with cryopexy or laser photocoagulation.
Indenting the surface of your eye. This surgery, called scleral (SKLEER-ul) buckling, is used in the repair of a retinal detachment caused by one or more retinal tears. 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 cryopexy, laser photocoagulation or vitrectomy.
A scleral buckle can involve a segment of your eye (segmental buckle), or it can encircle the entire circumference of your eye (encircling buckle).
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 vitreous space.
Vitrectomy may be used if bleeding or inflammation clouds the vitreous fluid and obstructs the surgeon's view of the retina. This technique may be part of the treatment for people with conditions such as retinal tear, diabetic retinopathy, macular hole, infection, eye trauma or retinal detachment.
Injecting drugs into the eye. Your doctor may suggest injecting medication into the vitreous fluid in the eye. This technique may be effective in treating people with wet macular degeneration, diabetic retinopathy or 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.
- Implanting a retinal prosthesis. People who have severe vision loss or blindness owing to retinal disease may be a candidate for surgery. Mayo Clinic offers a new surgical option called retinal prosthesis.
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.
April 22, 2015
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