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Retinal Diseases

Diagnosis

Mayo Clinic physicians have expertise in the diagnosis of all retinal diseases. Retinal diseases can be associated with aging, diabetes, trauma to the eye or family history. Symptoms might include seeing floating specks or cobwebs, blurred vision or lost vision.

To make a diagnosis, an ophthalmologist conducts a thorough eye examination. A standard diagnostic tool is an ophthalmoscope, which allows the doctor to view the inside of the eyes in three dimensions. The ophthalmologist looks for abnormalities anywhere in the eye. Additional tests may be done to determine the location and extent of the disease.

Other diagnostic tools include:

Image of a distorted view of the Amsler grid

Distortion in Amsler grid due to macular degeneration

Amsler grid test

Your physician may use a printed grid to test clarity of 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. By evaluating the location of the distortion, the physician will better understand the extent of retinal damage.

Optical coherence tomography (OCT)

Optical coherence tomography image

Optical coherence tomography image of the retina

Enlarge

Similar in principle to ultrasonography, OCT uses light waves reflected off tissues in the back of the eye. The light waves produce a "back scattering" that converts into high-resolution, cross-sectional images of the retina, macula and optic nerve.

OCT is considered an excellent technique for capturing images of the retina because it's noninvasive and produces precise images.

OCT is particularly useful to diagnose epiretinal membranes, macular holes and macular edema (swelling). It's very helpful in monitoring the progress of wet age-related macular degeneration.

X-ray showing leakage from abnormal blood vessels (center) in the retina.

Fluorescein angiography image showing blood vessel leakage in the retina

Enlarge

Fluorescein angiography

Fluorescein angiography pinpoints leaking blood vessels. First, a dye is injected into a vein in your arm. As the dye circulates through the bloodstream and eventually to the eye, the blood vessels in the retina stand out as bright yellow when observed with a special blue light. A camera takes flash photographs of the eye every few seconds for several minutes. The images help identify the blood vessels, new abnormal blood vessels and 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. Infrared light is used to take pictures of the back of the eye, which creates images showing retinal blood vessels and the deeper, harder-to-see choroidal blood vessels. It is used only in select cases, such as polypoidal choroidal vasculopathy, certain inflammations of the choroid, and rarely, in macular degeneration and other conditions.

Ultrasound

Ultrasound is a painless test that uses sound waves to get a precise picture of the retina. Ultrasound is used to measure the size of growths in the back of the eye. It is useful when the view to the back of the eye is obscured, for example, by blood, to see if the retina is attached.

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