What We Treat
Our practice is limited to disease of the retina and vitreous. These diseases are many and varied. Below we briefly outline some of the more common problems.

  • Vitreous Separation
    With age, or with certain diseases of the eye, the vitreous material begins to contract. When it does so it starts to pull away from the back wall of the eye, the retina. In doing so certain particles or "floaters" become visible. These can be rather annoying at first, but in and of themselves, they are not harmful. While these don't actually go away, most people become used to them, and they are usually not very bothersome after a few months.

    However, when the vitreous separates, sometimes the vitreous can have an abnormal attachment to the retina, and can pull on the retina. This can cause a retinal tear, a condition which may threaten sight.

  • Retinal Tear
    If when the vitreous separates it pulls very strongly against one area of the retina, the retina may tear. This may cause the patient to experience floaters and flashing lights. If the tear takes place across a blood vessel, bleeding within the vitreous may occur causing even more floaters, spots and "cobwebs." A retinal tear can lead to the development of a retinal detachment. Retinal tears which cause symptoms should be treated to decrease the chance a retinal detachment will develop.

  • Retinal Detachment
    RD_pict
    If a retinal tear develops fluid may get under the retina, the inner back wall of the eye. Think of the retina as a thin layer of tissue on the inner back wall of the eye, much like wallpaper is a layer on a wall. Once fluid gets under it, the retina comes loose from the back wall, and it is called a retinal detachment. At this point patients experience a shadow coming over their vision. This is a potentially blinding condition, but fortunately can be treated in most patients. In certain diseases the retina can pull away from the back wall of the eye without a retinal tear as the cause. Usually these conditions can be treated also.

  • Proliferative Vitreoretinopathy (PVR)
    PVR occurs after when scar tissue forms on the retina. The scar tissue pulls on the retina, causing it to pucker into stiff folds and detach from the back wall of the eye. This results in a complicated retinal detachment that may require more extensive surgery.

  • Diabetic Retinopathy
    The longer someone has diabetes the greater the chance it will cause abnormalities in the retina. Diabetic retinopathy occurs when diabetes damages the blood vessels of the eye, causing either poor circulation to the retina, or else causing fluid to leak into the retina. This results in blurred vision. Diabetes may also cause abnormal blood vessels to grow, and these may then break causing bleeding into the vitreous cavity of the eye. This too causes decreased vision. Finally diabetes can cause scar tissue to develop in the eye, and contraction of this scar tissue can be another cause of retinal detachment. Fortunately, timely and appropriate treatment can allow most people with diabetes to retain excellent vision.

  • Macular Degeneration
    The macula is the center part of the retina, the part responsible for our reading vision and for the ability of our eye to see clear details. Macular degeneration is a condition which occurs with increasing age in which the macula part of the retina begins to deteriorate. Patients may notice distorted vision, missing spots, and blur. The most common type of macular degeneration is the "dry" type where the macular cells begin to thin out, and don't work as well. However, some cases of macular degeneration are "wet" and are caused by abnormal blood vessels leaking either fluid or blood under the retina. There have been dramatic recent changes in the treatment of macular degeneration. New drugs including Lucentis, Avastin and Eylea have improved the prognosis for many patients with new wet macular degeneration. Treatment can often be effective in limiting the rate of further vision loss, and sometimes in improving vision.

  • Macular Hole
    When the macula, which is the very center of the retina, develops a small hole, central vision may become blurred. This causes poor reading vision but the peripheral vision remains normal. A Surgical treatment can improve vision in many patients.

  • Macular Pucker or Epiretinal Membranes
    If scar tissue forms on top of the macula, the scar tissue can contract the retina and cause it to pucker or wrinkle. These wrinkles may result in vision loss, distorted or double vision. Surgical treatment can improve vision in many patients.

  • Choroidal melanoma
    A choroidal melanoma is a tumor that arises beneath the retina. It can sometimes cause blurred vision, flashes, or floaters but often is asymptomatic and found during a routine exam. It can be treated in different ways depending on the size of the tumor. It can spread to other parts of the body, so evaluation with an internist is also necessary.

  • Uveitis
    Uveitis describes inflammation of the middle layer of the eye called the uvea. It can affect one or both eyes and often presents with redness, pain, light sensitivity, and blurred vision. It can occur secondary to autoimmune diseases, systemic inflammatory conditions, or infections; however, in many cases, the cause is unknown. Treatment can include steroids if there is no underlying infection.