Retinal Disease

The rear part of the eyeball is lined with a transparent tissue structure, the retina. It interprets the image information that the lens and cornea deliver with its sensory cells and nerves, converts it to electrical impulses which are sent to the brain via the optic nerve. The area of retina responsible for the most focused vision is called the macula.

All diseases related to the retina are painless, because the retina doesn't possess nerves. For this reason, one can't depend on pain as an alarm sign. Changes to the eye, and its respective visual ability should thus be carefully tracked and monitored.

The center of vision, the macula, is the most important area of the eye and crucial for good vision. The most endangering disease of the macula is age-related macula degeneration, or AMD.

There are no blood vessels in the macula, nevertheless, a very active metabolism exists. If this is restricted, one's central vision is blurred, distorted or consists of a dark spot. The causes haven't yet been distinctly discovered. It is suspected that with advancing age, substances are deposited underneath the retinal tissue. Additionally, metabolic changes could also be a cause.

One special type of this disease is wet macula degeneration (wet AMD). In this case, small blood vessels begin to grow underneath the macula. These blood vessels leak, resulting in a collection of fluid in the tissue underlying the retina, thus lifting it up. Initially this distorts one's vision. Slowly, the sensory cells above are damaged, resulting in poorer vision. Sub retinal bleeding, as a result of the newly formed blood vessels can even occur. Vision become rapidly impaired.

With Diabetes mellitus changes in the small retinal blood vessels take place. Their walls become thicker and at the same time weak and fragile, so that bulging of the walls, with water leakage(oedema), bleeding and blockage result. During this initial stage, one only first realises problems, after water has built up in the macula, a macula oedema. The result is considerable vision loss.

During the 2nd stage, retinal blood circulation increasingly deteriorates. As a result, new blood vessels are formed. These grow over the retina into the inner eye sometimes causing bleeding and/or tissue scarring. This scar tissue shrinks resulting in pulling forces that may cause retinal detachment. Leaving this condition untreated can lead to blindness.

The patient is unaware of the changes that may cause damage to his/her vision for a long time. That is why it is important for every diabetic to regularly see an ophthalmologist soon after he has been diagnosed with diabetes. The necessary examination to determine the type and stage of a diabetic retinopathy is simple and uncomplicated.

Retinal damage can be determined by a fluorescence angiography. The flourescence angiography is a special imaging process that can display the retinal blood vessel structure and changes in the eye's background. This is important especially for diabetes, retinal circulatory problems (for example, because of a thrombosis), inflammation, age-related macula degeneration and tumors.

The earlier an eye doctor can recognize and treat for changes in blood vessel structure, the milder the treatment is. Through prompt treatment in the earlier stages of diabetic retinopathy, it is possible to carry out a practically painless laser treatment (laser coagulation) to stop the alteration in blood vessel structure. With advanced forms, thanks to the advancements in ophthalmologic surgery, complete blindness can be avoided with an operation (virectomy).