Retina

Retina is a thin layer of tissue that lines the back of the eye on the inside. It is located near the optic nerve.

The function of retina is to receive light that the lens has focused, convert the light into neural signals, and send these signals on to the brain for visual recognition.

Vitreous is clear, jelly-like substance that fills the middle of the eye. Also called the vitreous humor. It maintains the structural integrity of the eyeball.

When should one see a doctor?+

There are few warning signs for retina related pathologies /diseases. It is important to pay attention to any changes in your vision and seek immediate medical attention if you suddenly have floaters, flashes or reduced vision/distorted vision.

Risk factors should be kept in mind. Aging, having diabetes or other diseases, eye trauma, and a family history of retinal diseases are few of them.

Common retinal diseases and conditions+

Diabetic Retinopathy: – Over a period of time, patients, who have diabetes tend to have changes in their blood vessels(capillaries) which initially leak blood and fluid into the retinal layers, causing swelling and latter may develop new vessels which are very fragile and they can easily bleed into the vitreous cavity, causing sudden loss of vision.

Normal Fundus
Normal Fundus
Diabetic Retinopathy
Diabetic Retinopathy

Retinopathy of Prematurity:

ROP
ROP

It affects premature/ preterm and low birth babies or even term babies with associated systemic conditions. It is a blinding disease and needs major awareness . All such babies should be screened for any ROP changes and the paediatrician should make sure that it is done before the discharge of the baby from the hospital.

Retinal detachment:
Retinal detachment is caused by the presence of fluid under the retina, which usually is secondary to a retinal break. There may also be other causes of RD (exudative retinal detachments and tractional retinal detachments). It is often accompanied by the sudden onset of symptoms such as floaters and flashing lights and sudden defective vision.

Macular degeneration:

In this case, the center of the eye, which enables, best vision begins to deteriorate. There are two types of macular degeneration — wet macular degeneration and dry macular degeneration. Dry form is more common than wet but dry form can become wet form progressively.

Vascular occlusive disease:

Retinal arteries and veins can get occluded due to various systemic diseases. This occlusion can cause bleeding and swelling in the eye, which in turn causes sudden defective vision. Vision loss in central artery occlusions is usually permanent if treatment is delayed.

Epiretinal membrane:

Epiretinal membrane is a delicate tissue-like scar or membrane that looks like crinkled cellophane lying on top of the retina. This membrane constricts the retina, which distorts one’s vision. In this case scenario, objects may appear blurred or crooked.

Treatment is available for retinal diseases+

Depending on one’s condition, treatment goals may aim to stop or slow the disease and preserve, improve or restore your vision. Untreated, some retinal diseases can cause severe vision loss or blindness. Unfortunately, treatment of some diseases, yet await a breakthrough while a lot of research is being conducted, for the same.

In many cases, damage that has already occurred, cannot be reversed, hence making early detection vital.

Equipments available at H. V. Desai Eye Hospital+
Zeiss-OCT
Retina-ROP
Retina-FFA-Machine
Retina-ERG

Fundus camera:
for detailed viewing and documentation of retinal images.

Optical Coherence Tomography (OCT):
to evaluate retinal thickness in cases of edema, to detect macular holes, tumours, retinal detachment, epiretinal membrane and various other retinal diseases.

Ultrasound B scan:
to view intraocular structures in opaque media and trauma.

Fundus Fluorescein Angiography (FFA):
to view leaking vessels, neovascularization and non perfused areas of the retina.

Indocyanine Green Angiography:
to view choroidal circulation

Electrophysiograms (eletroretinogram, electrooculogram):
to graphically represent functional capacity of the retinal cells.

Visually Evoked Potential:
used to measure electrical activity of visual system to detect mechanical and neural abnormalities related to vision.

Paediatric wide field camera:
Advanced high resolution imaging technology for consistency of reports to detect retinopathy of prematurity, detailed evaluation without long exposure of new born to the examination procedure and documentation. Highly trained personal available for the use of such advanced technology.

All these instruments are vital in diagnosing /prognosticating the retinal diseases.

Treatments available+

Various medical and surgical treatments are available for the above mentioned conditions. Complicated vitreo-retinal surgeries are performed successfully everyday. Various types of lasers and intravitreal injections are also available.

Various types of lasers are used to stabilise retinal diseases like diabetic retinopathy, vascular diseases, tumours, retinopathy of prematurity and many more. These are delivered either with the help of a slit lamp or by indirect ophthalmoscope. Diode, frequency doubled Nd:Yag laser, argon laser, subthreshold micropulse laser are available.

Transpupillary thermotherapy is used in tumours to damage the abnormally growing vessels while causing minimal trauma to normal retina.

Intravitreal Injections:

Intravitreal anti-VEGF injections are used to treat conditions in which there is growth of new abnormal leaky vessels due to underlying disease which has caused ischaemia of the retina. It can also be used in cases of macula edema. Intravitreal steroids can also be used to effectively treat macular edema. Intravitreal antibiotics are used to treat grave ocular infections to effectively deliver these drugs into the eyeball.

Pars plana vitrectomy with silicon oil or gas injection, core vitrectomy, epiretinal membrane peeling, macular hole surgery, scleral buckling and intraocular foreign body removal are performed regularly in H. V. Desai eye hospital. Modern day surgeries use smaller size trocar/ cannula systems like 23G, 25G and 27G. These help in better wound reconstruction and healing and avoid post- operative infections. All the vitreous-retinal surgeries conducted at H. V. Desai Eye Hospital are performed by highly skilled surgeons, who have years of valuable experience in this field.

Research+

We conduct research in retinal disease and share knowledge gained, in order to advance care for more and more people. Our research activities include national studies that investigate innovative ways to preserve, rejuvenate and restore vision. You may have the opportunity to participate in clinical trials.

FAQ for patient information+
Anterior Uveitis
Anterior Uveitis
Posterior Uveitis
Posterior Uveitis

What is uvea?

Uvea is the middle layer of the eyeball.

What is the function of uvea?

Uvea has many blood vessels that nourish the eye.

What are the common uveal diseases?

Uveitis or inflammation ( swelling and redness ) of the eye are mainly of three types, depending on the part of uvea affected.

  • Swelling of the uvea near the front of eye is called anterior uveitis.
  • Swelling of the middle of uvea is called intermediate uveitis.
  • Swelling of uvea towards back of the eye is called posterior uveitis.
  • In severe cases all these parts may be involved and is called panuveitis.

All these types can start suddenly and can occour in forms of cycles of getting better and getting worse.

All these types can be manifestations of different systemic illnesses.

Can vision be restored after treatment of uveal diseases?

 

Uveitis can damage vital eye tissue, and if treated inadequately, can lead to permanent visual loss.

What are the equipment available at H. V. Desai Eye Hospital?

At H. V. Desai Eye Hospital we have specialist uvea consultant and various ocular investigation facilities like FFA, OCT, OCT Angioplex, B scan ultrasonography. Laboratory facility for various related blood investigations to look for systemic causes.

What all treatments are available at H. V. Desai Eye Hospital?

Intra and peri ocular steroid injections in form of posterior sub-tenon, intravitreal injections like Ozurdex Implant, TA

Systematic evaluation and tapering steroidal and steroid sparing medications by specialist uvea consultant.