Retinal Diseases - Diagnosis and Treatment

The retina is a thin layer of tissue at the back of the eye that plays a vital role in vision. The macula, located in the center of the retina, helps with sharp, central vision needed for tasks like reading and recognizing faces.

Some medicines help with certain tumors. For example, doctors may use a targeted therapy to treat children with plexiform neurofibromas.

This type of medicine may shrink tumors and improve symptoms. Researchers are testing other similar treatments in children and adults to see if they work for more people.

Diagnosis

Eye specialists conduct several tests to discover and monitor conditions like macular degeneration, retinal detachment, and diabetic retinopathy.

A full eye exam is key. During these exams, doctors check the retina, macula, and vitreous for any changes.

Common tests and their uses include:

Amsler Grid Exam: This simple chart helps spot wavy or missing lines, which can reveal early signs of macular degeneration or a macular hole. Doctors may ask patients with vision loss or changes to use this grid at home to track their eyesight.
Optical Coherence Tomography (OCT): OCT gives detailed images of the retina. It can show swelling (macular edema), tears, or tiny holes. Doctors also use it to track treatment progress for wet macular degeneration.
Fundus Autofluorescence (FAF): This test highlights the build-up of pigments like lipofuscin, which occurs in many retinal diseases. Detecting these changes helps doctors stage conditions such as retinitis pigmentosa.
Fluorescein Angiography: In this examination, dye highlights the blood vessels in the retina. It lets doctors find leaking vessels, new abnormal growth, or hidden retinal tears—common in diabetic eye disease and advanced macular issues.
Indocyanine Green Angiography: This test also uses a dye but focuses on deeper layers under the retina. Doctors often use it to detect difficult-to-see problems behind the retina, especially in the choroid.
Ultrasound Imaging: High-frequency waves let doctors view structures inside the eye, even when blood or cloudiness blocks other methods. They use this to find vitreous hemorrhage, retinal detachment, or eye tumors like retinoblastoma.
CT and MRI Scans: Doctors rarely order these scans for routine eye diseases. However, they are useful for serious injuries or when they suspect eye tumors.

Here is a summary table of key diagnostic tests:

Test Name	What it Detects	Common Uses
Amsler Grid	Central vision changes	Macular degeneration, macular hole
OCT	Retinal thickness, swelling, tears	Macular edema, pucker, hole
FAF	Pigment changes in retina	Retinitis pigmentosa, degeneration
Fluorescein Angiography	Blood vessel problems	Diabetic retinopathy, macular issues
Indocyanine Green Angiography	Deep vessel issues	Choroidal disease
Ultrasound	Structural issues, tumors	Retinoblastoma, detachments
CT/MRI	Tumors, serious injury	Eye trauma, cancer

These tests help eye doctors find retinal tears, floaters, and flashes before they lead to more damage.

Treatment

Treating retinal diseases aims to keep vision as strong as possible and prevent further harm.

The right care plan depends on the type and seriousness of the retinal issue. Most treatments focus on stopping more damage and helping patients keep their eyesight.

Main treatment options include:

Laser Surgery: A laser seals a retinal tear or hole. The doctor uses light energy to make tiny burns on the retina, forming a scar that attaches the retina to the tissue underneath. This keeps the retina in place and prevents detachment.
Laser Photocoagulation: For people with abnormal or leaking blood vessels, this method uses scattered laser spots to shrink these vessels. Doctors often use this for diabetic retinopathy, but it can lead to some loss of side or night vision.
Cryotherapy (Freezing): The doctor places a cold probe on the eye’s outside wall. This chills the area to form a scar, which binds the retina to the eye wall. It often works together with other procedures.
Pneumatic Retinopexy (Air or Gas Repair): In this technique, the doctor injects a bubble of air or gas into the eye. The bubble pushes the retina into place and helps it heal. Laser or freezing treatments might also be used to secure the retina.
Scleral buckling: The doctor sews a small piece of silicone onto the outside of the eye (the sclera). This pushes the wall of the eye inward, lessening tension and helping the retina reattach. Sometimes doctors use it along with other treatments.
Vitrectomy: In this surgery, the doctor removes the gel filling the inside of the eye (the vitreous). The space is then replaced with air, gas, or fluid. This method helps if blood or swelling blocks the doctor’s view or if the retina is very damaged.
Medicines Injected Into the Eye: Some patients need medicine put directly into the vitreous. These drugs can manage swelling, bleeding, or vision loss due to wet macular degeneration or diabetic retinopathy.
Retinal Implants: For those with severe, genetic retinal disease, a doctor can place a tiny electronic device in the retina. It picks up signals from a camera worn in glasses, helping send some vision information to the brain.

Comparison of Common Retinal Treatments

Treatment	Main Use	Key Benefit	Side Effects / Risks
Laser treatment	Tears, diabetic retinopathy	Secures retina, shrinks vessels	May reduce side or night vision
Freezing (Cryopexy)	Retinal tears	Forms healing scar	Swelling, risk of infection
Pneumatic retinopexy	Detachment	Minimally invasive	Bubble may affect vision for days
Scleral buckling	Detachment	Strong repair	Discomfort, need for surgery
Vitrectomy	Bleeding, major detachment	Restores view of retina	Long recovery, risk of cataracts
Injections	Swelling, abnormal blood vessels	Directly treats problem	Rare risk of infection
Retinal implant	Inherited severe vision loss	Restores some vision	Surgical risks, learning curve

Some treatments take place in a doctor’s office, while others require a hospital or surgical center. Doctors choose the treatment based on the stage of the disease and the person’s overall health.

Adjusting to Vision Changes and Finding Support

Vision loss related to retinal diseases can change daily life and simple tasks. People may struggle with reading, seeing faces, or driving safely.

For those also dealing with conditions like diabetes, high blood pressure, cataracts, or glaucoma, coping can be more challenging. Blurred vision is common and may add stress.

Ways to Manage Vision Changes:

Review Glasses or Contact Prescriptions: A visit to the eye doctor can confirm if glasses or contacts are still effective. Updated prescriptions or stronger lenses can sometimes help. If improvement is low, seeing a low-vision specialist is the next step.
Try Magnifiers for Daily Tasks: Hand-held or wearable magnifying devices can make reading and sewing easier. Closed-circuit television systems that display text on a screen may be useful for some.
Adjust Computer and Device Settings: Increase font size and adjust contrast on screens. Adding speech output or screen reading software can be helpful, especially for people with blurred vision or trouble focusing.
Use Electronic or Voice-Controlled Tools: Devices such as talking clocks, calculators, and large-print books support those with poor eyesight. Many smartphones and tablets have apps and voice features to help with reading and communication.
Select Home Appliances for Low Vision: Appliances with large numbers or buttons are easier to use. Watching TV on a big, high-definition screen or sitting closer can help people see details better.
Improve Home Lighting: Bright, even lighting may make reading and moving around the house safer. It can help prevent falls and make tasks less frustrating.

Transportation Considerations:
Driving with vision problems always requires caution. People should check with their doctor before continuing to drive, especially at night, in bad weather, or heavy traffic.

Many use local buses, shuttle services, ride-share apps, or ask friends and family to help with travel.

Emotional and Social Support:
Vision changes can cause worry, sadness, or stress, particularly in people also dealing with diabetes, high blood pressure, or chronic eye health issues.

Support is important. Talking to a counselor or joining a support group can help people adjust. Spending time with family and friends offers comfort.

Helpful Tools	Example Uses
Magnifiers	Reading, sewing
Screen readers	Computer and phone use
Large-print appliances	Easier phone calls and timekeeping
Bright lighting	Reading, walking inside safely
Ride-shares	Safe travel

Taking practical steps, asking for help, and using technology can help people keep their independence and handle daily life confidently.

Getting Ready for Your Eye Visit

Steps You Can Take Before Your Eye Exam

Before meeting with an eye doctor, such as an optometrist or ophthalmologist, you can make a short to-do list to feel more prepared and make the visit smoother:

Ask About Preparation: Call the eye clinic and ask if you should do anything special to get ready for your appointment.
Write Down Symptoms: Make a list of all vision changes or problems you have noticed. Even symptoms that seem small or unrelated to your eyes should be included.
Medication Information: Prepare a list of every medicine, vitamin, and supplement you take. Include the names and the amounts you use each day.
Bring a Helper: Plan to have a family member or a friend go with you. Most eye exams for retinal problems include dilating eye drops that make your eyes sensitive to light and blurry for a while. It may not be safe to drive yourself home.
Prepare Questions: Write down any questions you want to ask the doctor. Examples can include:
- How serious is my eye condition?
- Will I lose more vision?
- What treatment options are available?
- Should I take supplements?
- What symptoms should I look out for?
- What lifestyle changes can help me?
- Can I use low-vision aids?
- Is it okay for me to drive?

Having your thoughts and questions organized can help you remember everything during your visit.

What Your Eye Doctor Will Want to Know

During your exam, the ophthalmologist or optometrist will need certain details to understand your eye health better. Be ready to talk about:

When Your Symptoms Started: Your doctor will ask when you first noticed any problems with your vision.
Which Eye is Affected: Be prepared to explain if one or both eyes are having trouble.
Type of Vision Trouble: The eye specialist may ask whether you have trouble with things up close, far away, or both.
Lifestyle and Health: They may ask about smoking, since this can affect your eyes.
Medical Background: Expect questions about other health problems like high blood pressure, cholesterol, or diabetes.
Family and Injury History: Your eye doctor might ask if anyone in your family has had eye diseases or if you have hurt your eye in the past.

Below is a checklist you can review before your appointment:

When did my symptoms begin?
Is one or both of my eyes affected?
Do I notice problems up close, at a distance, or both?
Have I ever smoked, and how much?
Do I have any other health conditions?
Has anyone in my family had retina problems?
Did I ever injure my eyes?

Remember to bring any glasses, contact lenses, or eye medicine you use to the appointment. Having all your information ready can help the doctor give better care.

Retinal Diseases – Diagnosis and Treatment