Dr Mavrikakis - Posterior Segment
The eye is filled with a clear jelly substance called the vitreous. Light passes through the vitreous to focus on the retina, the inner lining of the eye. When the vitreous comes away from the retina this is called posterior vitreous detachment (PVD).
CAUSES:The vitreous is made from water and collagen and has a stiff, jelly like concistency. As we get older the vitreous becomes more watery and can not keep its usual shape. As a result it starts moving away from the retina.
SYMPTOMS of a vitreous detachment could be floaters, flashes of light and or a cobweb effect. If you experience any of these symptoms you need to have your eyes examined by an ophthalmologists within 24 hours because these may be an indication of a more serious problem such as a retinal tear or retinal detachment.
A retinal detachment is a very serious problem that usually causes blindness unless treated. The appearance of flashing lights, floating objects, or a gray curtain moving across the field of vision are all indications of a retinal detachment. If any of these occur, see Dr Mavrikakis right away. As one gets older, the vitreous (the clear, gel-like substance that fills the inside of the eye) tends to shrink slightly and take on a more watery consistency. Sometimes as the vitreous shrinks, it exerts enough force on the retina to make it tear.
Diabetics cannot use or store sugar properly due to lack of endogenous insulin. High blood sugar can damage the blood vessels of the retina (inner lining of the eye) and when they are damaged, they can leak fluid or bleed. This causes the retina to swell and form deposits leading to diabetic retinopathy.
Types of Diabetic Retinopathy
Non proliferative Diabetic Retinopathy
This early stage of the disease is characterized by leakage of fluid, lipids and blood into the retina causing swelling and deposit formation
In this later stage, new blood vessels grow on the surface of the retina. These new blood vessels can lead to serious vision problems because they can break and bleed into the vitreous (vitreous hemorrhage), the clear, jelly-like substance that fills the center of the eye. Proliferative retinopathy is a much more serious form of the disease and can lead to blindness.
Important diagnostic tests in diabetic retinopathy
Fundus fluorescein Angiography
Treatment of Diabetic Retinopathy
Pan Retinal Laser Photocoagulation (PRP)
Treatment of Wet Macular Degeneration
Avastin (Bevacizumab) An unapproved form of Lucentis, is considerably less expensive and appears to produce similar results in macular degeneration treatment. Avastin is administered through monthly injections into the eye.
Visudyne drug treatment (Photodynamic Therapy or PDT). Visudyne was the first drug therapy approved for treatment of the wet form of macular degeneration. It is only for those patients who have new blood vessel growth (neovascularization) under the retina in a well defined, distinctive pattern known as "predominantly classic."
The macula is the part of the retina responsible for acute central vision, the vision you use for reading, watching television, and recognizing faces. A macular hole is a small, round opening in the macula. The hole causes a blind spot or blurred area directly in the center of your vision.
The retina is a layer of light-sensing cells lining the back of your eye. As light rays enter your eye, the retina converts the rays into signals that are sent through the optic nerve to your brain, where they are recognized as images.
Symptoms, which can be mild or severe and affect one or both eyes, may include:
If your symptoms are mild, no treatment may be necessary. Updating your eyeglass prescription or wearing bifocals may improve your vision sufficiently. If you have more severe symptoms that interfere with your daily routine, Dr Mavrikakis may recommend vitrectomy surgery to peel and remove the abnormal scar tissue. During this procedure, Dr Mavrikakis uses tiny instruments to remove the wrinkled tissue.
Macular edema is the swelling of the macula, the small area of the retina responsible for central vision. The edema is caused by fluid leaking from retinal blood vessels. Central vision, used for reading and other close, detail work, is affected.
The most common symptom of macular edema is blurred or distorted vision.
Intraocular Foreign Bodies and Sharp Trauma
Sports Eye Injuries
Cataract surgery is extremely safe and effective. However occasionally complications occur and it is the skills of the vitreoretinal surgeon which are called to remedy the situation. It is important to realize that these complications are rare but the vitreoretinal surgeon encounters them from time to time due to the high volume of cataract operations being performed.