Jan Jyotie

E-Mail: jjssehjbp@gmail.com

Retina FAQ

Q1. What is vitreous?

It is a transparent, gel and colourless substance that is responsible for filling the gap between the retina and the lens inside the eye. This is completely made of water along with a compact percentage of glycosaminoglycan’s,  proteins, and electrolytes. Where electrolytes are salts, glycosaminoglycan’s are sugars. There are two segments of the human eye first segment and the back segment where the first segment is named anterior and the back segment is known as posterior. The Vitreous is located in the back segment of the eye and 80 per cent of the eye is made of posterior segments that fill the vitreous segment. The Vitreous is responsible for maintaining the round shape of the eye and it ensures the attachment of the eye with the retina which is sensitive to light and is situated at the back of the eye. As vitreous humour is a clear substance it is located in such a way with the other part of the eye which ensures vision clarity. This clear substance helps to pass the light through the eye to the retina at the back, if any disturbance happened in the eye vitreous human is very helpful in absorbing that. It absorbs all the disturbances that prevent damage to the eye. It is the important element of the eye which performs different activities because of which the visual information is translated. Most of the time posterior segment that contains the vitreous humour is confused with the aqueous humour but the aqueous humour is situated in the anterior segment.


Q.2 Are there any early warning signs of Diabetic retinopathy (DR)?

During the early stage, you might not experience any symptoms related to the retinopathy but  slowly as the condition tends to progress you might develop diabetic retinopathy. Some of the symptoms can be sport or floaters which are dark strings floating in your vision, blurry vision, vision loss, fluctuation in vision and empty areas in your vision. People having type 1 and 2 diabetes are more likely to develop this condition. Diabetes results in less control of blood sugar and people might develop complications in the eye. If you are more likely to develop the diabetic retinopathy problem you will gradually notice that your vision worsens with time along with the redness and patchy vision. There are no such signs in the early stage as this requires time to develop til you notice the complications these complications are caused because of high blood pressure and the diabetic patient that damages the retina which leads to complete blindness if not treated on time properly.  High blood sugar problems can damage the blood vessels in 3 stages. The first stage is named background retinopathy, 2nd stage is pre-proliferative retinopathy and the third stage is proliferative retinopathy. If you had diabetes for a longer period,  high blood pressure or women who are pregnant. Obvious symptoms are visible after some time it doesn’t happen initially who might not feel any symptoms as it takes time to develop. if you see any symptoms contact your GP or the family doctors as earlier is always better.


Q.3 Who are at risk of getting diabetic retinopathy?

Anyone who has a long-duration history of type 1 and type  2 diabetes which when left uncontrolled developers fluctuations in the blood sugar level which are the most risking factors that help deviation retinopathy to evolve progressively. Some other factors like chronic kidney disease, deranged cholesterol, and hypertension can lead to diabetic retinopathy. Some pregnant women or people belonging to an Asian or afro- Caribbean background can be at risk of getting diagnosed with diabetic retinopathy. When cholesterol level and blood pressure levels are controlled then the risk of getting diabetic retinopathy can be reduced.  If you observe any of the above-mentioned symptoms you are not necessarily diagnosed with this condition but you should definitely see your doctor for further care and prevention. The doctor will evaluate your eye and you will be asked to wait till your other screening. Diabetes can be seen in children as well and everyone who belongs to the age group of 12 years and above is recommended to attend at least one eye screen once a year as there are no specific symptoms that are observed in the early stages also it is very helpful in the evaluation of the eye problems to be treated on time.


Q4. I am diabetic, how can I prevent Diabetic Retinopathy (DR)?

You can prevent diabetic retinopathy by managing your diabetes, keeping track of your blood sugar level, glycosylated haemoglobin test, controlling blood pressure and cholesterol levels, and quitting smoking if you consume this ask for your doctors helps and most importantly observe the changes in your vision.  Keep in mind you can’t always prevent diabetic retinopathy but can have good control by taking regular eye examinations and intervening invisionn problems which can further help in preventing major vision loss. Diabetes can be a symptom and remember it can always lead to vision loss as it varies from person to person. It is recommended that you should see your  doctor if you observe major changes in your vision and also takes care of your weight , have balanced diet , creates exercise routine and quit smoking it can also lead to other health problems.


Q5. What is retina?

The retina is located at the back of the eye that sends and receives messages to the brain through the optic nerve. In simple words, the retina converts the light into a not electrical signal and transfers the message to rain through electrical signals. The retina is the most important and crucial element of the eye. Our eye has a lens and whenever the light passes through the lens it hits the retina and the further the other process takes place that provides signals to the brain to function. Because of the presence of the retina, we can pictures the world and see. It acts as a translator for the brain to process and understand which helps us to visualise the world.  If the retina is damaged eye might still work but your brain won’t be able to receive signals. Damaged retina or anything that has a bad impact on retina may worsen the vision and makes it difficult to visualise things. The macula and peripheral are two parts of the retina the centre of the retina is known as the macula where as peripheral acts as the bridge that fills visions. The retina involves many types of cells such as photoreceptors which passes the light into signals to the brain, rods that help to visualise dim and night lights, and cones that visualise the colours. all this helps the retina to function and visualise the world and picture what colour we see and the amount of light as well.


Q6. How is retina check-up done?

There is an exam called ophthalmoscopy through which the eye’s retina is evaluated this helps the doctor to see the retina that sense the light and signals.  The eye is the only part where the nerve can be seen and evaluated through which doctors can also examine the central nervous system – the optic nerve. It is very important for doctors to observe eye tough examination n.  health-related issues such as haemoglobin, diabetes, blood pressure, brain tumour, arterial plaque, multiple sclerosis and many other conditions. For the full examination of the optic nerve and health pupil dilation is performed by increasing the size of the pupil. Dilation is an important process for examining as this helps doctors to evaluate the problems more easily. Drops are given for widening the pupil which is the centre part of the eye. dilation process allows more light to enter the eye and once the eye is dilated it enables doctors to easily examine the problems and provide treatment based on the eye condition.


Q7. Will my eyes be dilated on every visit?

Yes, it is  important to perform the dilation process as it helps the doctor to examine the issues but depends on the reason why you are visiting for the eye checkup. For retina examination dilation is importation. Suppose you want to examine the problem in the retina then it cannot be evaluated properly without the dilation process as it allows the yey the widen which in turn allows more amount light. With help of dilation, your eye becomes sensitive for some time which will impact your activities such as driving or working. Eye dilation can lead to inconvenience in some cases where you might have to perform some activity which will hamper the dilation process then ask the doctore for the next appointment. Before the dilation doctors consider some personal details such as age, ethic background, eye health, overall health and the reason behind eye evaluation. Certain symptoms decide the need for dilation and follow-up for examinations and might not need dilation at every visit until your doctors observe some serious symptoms or any other concerns.


Q8. Can I drive after retinal exam?

No, you are not recommended to drive after the dilation process as vision gets blurred and it might get difficult for you to see. In most cases, patients are suggested to drive but at a slow speed to avoid an accident.  Eye dilation has a different impact on different people some people gets comfortable while other is not in a position to perform activities as it creates pressure on the eye. You cant get sure of how your eyes will react after the dilation process so it will be better if you wait and see and don’t drive yourself alone home. Make sure to wear sunglasses if you want to drive yourself home as not wearing sunglasses is not a good idea. Dilation can worsen your vision if you are diagnosed with cataracts or glaucoma. In order to drive you have to be comfortable behind the wheel and look after your condition if you can’t drive it is better to ask someone to pick you up. There is no such permanent or significant effect on the eye and no examination can ever have the worst effects but dilation requires care as it can worsen the vision and can make it difficult for your drive back home afterwards and take your doctor’s advice whether you are okay to go home or your need to take precautions.


Q9. When should I see a retina specialist?

The retina is a specialised part of the eye that helps in controlling the vision as it is delicate and can be damaged by minor ignorance which might worsen the vision. Not every symptom indicate a serious issue in the retina but there is some symptom which needs to be considered in order to see an eye specialist for further checkups. you should see the retina specialist when you have constant redness in the eye, experienced itchiness, eye swelling, blurriness, flashing of lights, unable to focus and stirred vision. Distorted vision is the condition where you experience straight lines or curved lines appearing during your visualise.  When you observe any of the symptoms appearing all of sudden you should immediately see your doctor as these symptoms can indicate serious problems and might need emergency treatment and if not treated on time can lead to permanent vision loss. if the symptoms are early detected can be given the prior treatment it can preserve many serious issues so it is very important to consider even minor symptoms that occur suddenly. Some other moderate symptoms like occasional blurriness if left untreated can also lead to a serious problem. So it is recommended that if you experience discomfort or difficulty with any of the symptoms you should seek help from the retina specialist as soon as possible.


Q10. What are floaters?

Floaters are the spot that  interrupts  vision. It can be grey or black specks or cobwebs. when you try to look  at them they might propel and cannot be observed directly. These eye floaters  can be formed due to the ageing. Due to aging it looks like jelly like substance inside your eye. This caste the tiny shadow on your retina which affect the vision and you  experience tiny dots or sport. If you notice the tat floater are expanding you should  immediately see your doctor . floater may comprise  of small shapes appearing in your vision as transparent thing floating , spots that moves with your and when you try to look at them  they quickly move away,  noticeable sports when you satere the plain background  or it  can  be in the form of small string and s ahsps that immediately drift and settle down. You should see you doctor immediately if you see many more floater than usual,  onset of  floater suddenly, grey curtain or darkness on the side of your vision. There are all the painless symptoms but when left untreated can lead to the serious problems and which also requires the immediate attention. It doesn’t mean they are painful or pain less but as you observe the  increase in floater you should seek doctors helps. Usually it happens with age but this symptoms need not to be ignored.


Q11. What are the common causes of floaters?

Vitreous changes can lead to the formation of eye floaters which are related to ageing and some underlying conditions which were left untreated. Inflammation, ageing, bleeding, torn retina and some medications or eye surgery can cause floaters in your eye. Vitreous changes with the age. It is a jelly-like substance which is made of water, collagen (protein) and a carbohydrate called hyaluronan. Due to the ageing process it also contracts and liquefies and With the change in age vitreous clumps up and leads to the casting of shadow. Uveitis is the type of inflammation that happened in the middle layer of the tissue. It impacts the back of the eye that involves the retina and a layer known as a choroid. These inflammation source floaters in the vitreous eye and bleeding in the eye itself have many problems an causes that comprise the tears in the retinas and retina detachment. blocking in blood vessels can also lead to bleeding in the eye. retina tear can not get better without treatment as this lead to the retinal detachment where fluid leaks behind the tear and because of which the retina separate. Injecting medications in the vitreous leads to the formation of bubbles and they can be observed as shadows until the eye absorbs them completely.


Q12. What are the risk factors for a retinal detachment(RD)?

It is an emergency situation caused because of the thinning of the tissue layer at the back of the eye and it gets detached from its normal position. Retinal cells get separated from the blood vessels as blood vessels are responsible for providing nourishment and oxygen to the eye. Reduction in vision and sudden increase in the floater are some of the risk factors for retinal detachment. Though retina detachment is painless it has warning signs such as blurred vision, gradual changes in vision, the occurrence of shadow in the field of vision or photopsia which flashes the light in one or both eyes. Retinal detachment can occur at any stage but it is commonly seen in people over 40 years of age or someone who has cataract surgery, eye injury, family history or myopia.


Q13. What to do if I have floaters and flashes

Your eyes will be checked if you experience any floaters or flashes in your eye. An ophthalmologist is a specialised doctor that evaluates the issues related to the eye and might ask you to take more tests based on the examination. If doctors observe any issues you will be recommended further treatment. Floaters rea harmless and pian ess but if you observe that they are increasing you should Ophthalmologist. Observe the warning signs and get a checkup done. They are harmless it doesn’t mean they should be avoided but if they are left untreated they can worsen the vision and cause discomfort. Floaters are also caused by retinal detachment and due to ageing as well. there are many symptoms that need to be considered and if you think you might be diagnosed with this condition you should see a doctor. Some tests are done, and doctors will evaluate and examine the problmes after which you will be provided medication. This can be minimised by wearing dark glasses during sunlight. Flashes diapers in many cases with time and floaters also get less noticeable if your brain adjusts to the changes. Floaters are caused because of the tear vitreous and if they are detected you should complete your treatment. this usually happens with time and the ageing process but in some rare cases due to some underlying weaknesses or deficiencies vitreous might shrink and cause floater.


Q14. What is rental detachment ?

It is a medical emergency which requires doctors’ recommendations. Retinal detachment happens when your retina layer gets torn apart at the back of your eye. It is an emergency situation caused because of the thinning of the tissue layer at the back of the eye and it gets detached from its normal position. Retinal cells get separated from the blood vessels as blood vessels are responsible for providing nourishment and oxygen to the eye. Some serious symptoms are observed only when a large part of the retina gets detached but if the small part of the retina gets detached you might not observe any symptoms. Because of the large detachment, you will be able to notice the symptoms like flashing in both the eyes and dark shadow. Retinal detachment symptoms might be observed quickly if there is some serious issue. Retinal detachment needs to b treated immediately it might lead to a major detachment which increases the risk of blindness and permanent vision loss. an eye injury and ageing are some of the most common causes that lead to retinal detachment. Usually, there are three types of retinal detachment such as exudative, rhegmatogenous and tractional.  These three types of retinal detachments have different causes that result in the movement of the retina at the back of the eye.


Q15. What’s the treatment for retinal detachment?

It depends on what type of retinal detachment or how much of your retina is affected your retina will be treated accordingly. In some cases, it s recommended to have laser surgery or other surgery that helps fix breaks and tears caused due to this condition. During the surgery, your retina gets attached back. Sometimes doctors m might implement other methods for treating retinal detachment. Usually, there are two types of treatment such as freeze treatment or laser surgery (cryopexy) and normal surgery. The laser treatment of the freezing method is done when there is a tiny or little hole where as the surgery is for the larger detachments or tear and this surgery takes place in the hospital. If the detachment is evaluated at the early stages the treatment work well but in some cases, people might be recommended second surgery as the retina might get detached again this happens in 1 out of 10 people other 9 people go through a successful surgery and need no second surgery.


Q16. How long does it take for a detached retina to heal?

Retina detachment usually recovers in 2 to 4 weeks after which you can continue performing your daily activities. There is just a general idea of how much time will it take to recover as the recovery rate might differ in people as each people recover at a different pace.. recovery timeline depends on various factors such as the overall health of the person, how surgery is performed or the implementation of the different approaches while performing surgery. There are three types of surgery such as vitrectomy, scleral buckling and pneumatic retinopexy and the recovery time for these three different kinds of surgery is different. Pneumatic retinopexy takes three weeks approximately and is performed in-office-like settings, scleral buckling requires two or four weeks whereas vitrectomy requires six weeks to recover approximately. After the surgery people are recommended to wait for at least 3 weeks and are not allowed to travel by air as this can expand the bubble. If the patient still o b served reduction in vision, any signs of infection, flashes or floater or any eye discharge you should immediately see your doctor for further evaluation.


Q17. What is treatment of diabetic retinopathy?

Eye injections, laser treatments and eye surgery are some of the treatments for diabetic retinopathy. You can prevent diabetic retinopathy by managing your diabetes, keeping a track of your blood sugar level, glycosylated haemoglobin test, controlling blood pressure and cholesterol levels, quitting smoking if you consume this and ask for your doctors helps and most importantly observing the changes in your vision. Laser treatments help in treating blood vessels as they provide oxygen and nourishment but this is done at the advanced stage of retinopathy as new blood vessels are weak and this can lead to eye bleeding. laser treatment helps in stabilising the changes and helps to manage vision. Anti- VEGF is an injection given to patients diagnosed with diabetic maculopathy. it is directly injected into the eyes to stop the formation of blood vessels. Ranibizumab (Lucentis) & aflibercept (eylea) are the main medicines which stop problems and help avoid major complications. These injections are given once a month by cleaning the skin around the eye with the small clips that help in keeping the eye open after which local anaesthetic drops are given.  vitreous humour is removed with the help of eye surgery it is a jelly-like substance which fills the back of the eye and causes discomfort.


Q19. Is there any treatment for floaters?

Floaters require no root of time to be treated in some cases they can naturally fade away with time. with the symptoms you should see your doctors and later on based on examination and the valuation doctors will recommend to prescription according to your medical condition as many eye floater doesn’t require treatment but in case of some serious issues it needs to be operated on with the recommendation of a doctor.  Floaters can be treated with the help of surgery and laser treatment but it completely varies and is based on the medical condition. With the help of the small incisions, the vitreous is removed and replaced with the solution to maintain the shape of an eye. This surgery comes with some complications such as eye infection, retinal tears or bleeding. with the help of laser, floaters can be disrupted as laser breaks the floaters and makes them less recognizable.


Q20. Is it safe to get cataract surgery done in an immature cataract?

There is no cure for this eye condition but there are some ways that might help with the discomfort and also slow down its progression.  Supplements, a healthy lifestyle, injections and laser slows down the formation of new blood vessels in the retina. Consumption of some micronutrients and multivitamins can also help in treating ARMD. PDT known as some special types of laser and intravitreal injections are also recommended for ARMD.


Q21. What is venous occlusion CRVO/BRVO?

As mentioned by doctors around the world there is the right time to consider any operation or surgery. This completely varies from person to person some wait till it ripens or gets mature and some opt for the surgery according to their need. Due to blurry vision, yellowed vision or dull glares and light, it might get difficult for the person to manage the daily activities that bring lots of discomfort and they end up getting cataract operated on. In some cases, people wait till it gets mature because there is no harm or loss in delaying the surgery but waiting for too long with the unmanageable discomfort  will make it difficult as it hardens over time.


Q22. What is CSR?

Central serous chorioretinopathy occurs when the fluid builds up in the retina which leads to the distortion of vision. The choroid is the layer behind the retina which when damaged leads to the leakage of fluid. RPE is known as retinal pigment epithelium which connects the retina and choroid and when doesn’t work as it should it leads to  the formation of fluid under the retina. This condition fades ways in two to three months naturally but if it doesn’t fade away you should seek immediate help from your doctor.


Q23. What is OCT?

Non-invasive test is known as optical coherence tomography (OCT) which helps doctors to evaluate distinctive layers of your retina and this evaluation benefits the measurement of further treatment.


Q24. What is FFA?

This is the process that helps in examining the tiny blood vessels where fluorescein is injected in the arm and photographs are taken as it is dye and helps to highlight the vessels form the back of the eye