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Vitreoretinal Meaning

The term "vitreoretinal" describes the interaction of the retina and vitreous humour in the eye. A gel-like material called vitreous humour fills the gap between the lens and the retina.

Vitreoretinal Diseases

This can involve a variety of retinal conditions, including macular degeneration, diabetic retinopathy, retinal tears, retinal detachments, and other vitreoretinal illnesses.

Anatomy of the Eye

Eyes are round. The retina is a light-sensitive layer behind the eye. The cornea and lens focus light on the retina. The optic nerve sends the retina's image to the brain. The brain and sight create images.

Anatomy of the Eye

Our eyesight blurs if the cornea scars or the lens becomes clouded, like in a cataract. Vision can also be impaired by retinal diseases such age-related macular degeneration, macular hole, and others.

  • 01 What is the Retina ?

    The retina in the back of the eye is thin. It converts light entering the eye into brain-understandable information like a screen. We need it to see and understand our surroundings.

  • 02 What is the Macula ?

    The macula, located at the retina's centre, is tiny but sensitive. It provides clear, centred vision. When we direct our attention to something, like when reading, driving, or identifying faces, the macula aids us in seeing it clearly. It plays a vital role in our ability to see fine details and colours accurately.

  • 03 What is the Vitreous ?

    The term "vitreous" describes the gel-like material that fills the area inside the eye that is located between the lens and the retina. It looks like jelly because it is transparent and clear. The retina is supported by the vitreous, which also aids in maintaining the shape of the eye. Additionally, it aids in light transmission to the retina, which helps us see.

  • 04 What is the Crystalline lens?

    The crystalline lens, behind the iris, is clear and flexible. It's similar to a magnifying glass or camera lens. The crystalline lens focuses light onto the retina, which is light-sensitive. The lens changes shape to concentrate light, letting us see objects at different distances. Our near- and far-sightedness depend on it.

Retinopathy: Diabetic Retinopathy

Retinopathy is a disease or condition that affects the light-sensitive tissue at the back of the eye i.e. retina.

Whereas, diabetic retinopathy is a complication of diabetes that can result in blindness.

Symptoms, causes, and treatment of Diabetic Retinopathy.

Proliferative Retinopathy

You must have read about the Diabetic Retinopathy with the above link. If not, then please go through it.

As this is the advance stage of the diabetic retinopathy. It arises when the retina has to undergo consistent damages.

  • 01 Causes of Proliferative Retinopathy

    Diabetes-related long-term damage to the blood vessels in the retina results in proliferative retinopathy. The body attempts to develop new blood vessels to replace the injured ones when the retina's blood supply is disrupted.. Further, the problems arises as these new blood vessels are abnormal and fragile.

  • 02 What are the symptoms?

    There is no specific symptom for proliferative retinopathy. Just like the diabetic retinopathy, you must seek immediate medical attention from an eye care professional; if you feel vision loss, floaters and flashes, impaired colour vision, dark or empty areas in vision.

  • 03 Treatment Options

    • Laser surgery (pan retinal photocoagulation / PRP / green laser) During scatter laser therapy, your eye doctor will use a specialized laser to make a number of tiny burns in the retina's periphery.

      These laser burns have the goal of constricting the abnormal blood vessels that have multiplied as a result of diabetic retinopathy. The treatment seeks to stop additional bleeding and lower the risk of consequences by focusing on specific veins.

    • Vitrectomy When there has been a severe retinal hemorrhage, a vitrectomy procedure may be used as a surgical treatment. In a vitrectomy, the accumulated blood in the eye's center is removed. Throughout this procedure, local anesthetic is given.

      To begin the operation, your doctor will first create a few very small incisions in your eye. A little tool removes blood-stained vitreous gel through these incisions. Saline (salt) replaces the gel after removal.

    • Anti-vascular endothelial growth factor (Anti-VEGF) Injections The anti-growth factor medicine known as Avastin (Bevacizumab) is administered intravitreally. By reducing macular edema and limiting the growth of new blood vessels, Avastin can help with improving vision and preserving the health of the retina.

    The primary objective of treatment is often to reduce the progression of diabetic retinopathy. Therefore, thorough diabetes management is necessary to lower the risk of additional eye damage.

    For preventing diabetic retinopathy and preserving eyesight, comprehensive diabetes management is crucial, along with specialized therapies like Avastin injections.

Age-Related Macular Degeneration (ARMD/AMD)

A common cause of vision loss and blindness is age-related macular degeneration (AMD). It is a retinal eye condition marked by the slow degradation of central vision while peripheral vision is largely unaffected.

Age-Related Macular Degeneration (AMD)

This degenerative disorder gradually damages the macula, which is in charge of crisp detail and colour vision. As a result, simple tasks like reading, writing, driving, identifying people, and carrying out daily activities can become difficult.

  • 01 Types of ARMD

    AMD is divided into two types: dry (Atrophic) AMD and wet (Exudative) AMD, and it mainly affects people over the age of 50 years.

    The more common kind of AMD, known as dry AMD, is defined by a slow build-up of drusen, yellow deposits behind the retina.

    Although less frequent, wet AMD is characterized by the development of aberrant blood vessels behind the macula, which can cause fluid leakage and eventual blindness.

  • 02 Symptoms of ARMD

    It's crucial to remember that in the majority of AMD instances, side vision, which is governed by peripheral vision, is relatively unaffected. The following distortions, you can feel:

    • Straight lines or faces appearing wavy
    • Doorways seeming crooked
    • Objects appearing smaller or far away
    • General decrease in central vision
    • A central blurry or blind spot
  • 03 Treatment of ARMD

    Treatment of dry AMD: Although there isn't a treatment for dry AMD yet, there are a number of ways to control the illness and stop it from getting worse.

    The following are the ways to opt:

    • Nutritional Supplements: Vitamins C and E, zinc, copper, lutein, and zeaxanthin can reduce the risk of severe AMD. Talk to your eye doctor before using supplements.
    • Lifestyle Changes: eating a healthy diet, maintaining healthy weight, and avoiding smoking can improve the health of retina conditions.
    • Low vision aids: Low vision aids can help with severe dry AMD. Magnifiers, telescopic lenses, and other assistive devices improve vision and daily life.

    Treatment of wet AMD: Wet AMD treatment slows disease progression, prevents vision loss, and improves vision if possible. Common wet AMD treatments include these:

    • Anti-vascular endothelial growth factor (Anti-VEGF) Injections: As explained above these injections can be directly injected in the eye.
    • Photodynamic Therapy (PDT): Verteporfin, a light-sensitive dye, is injected into an arm vein. By projecting a low-energy laser into the eye, the dye closes aberrant blood vessels. Anti-VEGF injections currently replace PDT.
    • Combination Therapy: Anti-VEGF injections with photodynamic therapy may treat wet AMD. The treating ophthalmologist and patient features may warrant this strategy.
    • Laser photocoagulation: A high-energy laser seals macula blood vessels in this older technique. Due to the risk of tissue damage, this procedure is rarely done anymore.
    • Surgical intervention: Vitrectomy or retinal translocation may be explored for severe wet AMD with substantial scarring or hemorrhage. These operations remove blood vessels and scar tissue or relocate the macula for better vision. Surgical interventions may not be appropriate for all patients.

    Remember, just like all other diseases, wet AMD also needs to be examined and treated at the early stage. For this, everyone must take appointments with an ophthalmologist for regular check-up.

Retinal Detachments

When the retina detaches, it separates from the back wall of the eye and is removed from its blood supply and source of nutrition. The retina will degenerate and lose its ability to function if it remains detached. Central vision will be lost if the macula remains detached.

Retinal Detachments
  • 01 What are the types of Retinal Detachments?

    • Rhegmatogenous retinal detachment (most common): A retinal break or tear allows the liquid vitreous, which fills the eyeball, to pass through and elevate the retina. This separation is most common.
    • Exudative retinal detachment: This detachment is due to leakage of fluid from under the retina. The fluid is called exudate. Tumors and inflammatory disorders can create exudative detachments.
    • Traction retinal detachments (TRD): This type of detachment is due to pulling on the retina usually from fibro-vascular tissue within the vitreous cavity. Proliferative diabetic retinopathy (PDR) is the most common cause of traction retinal detachments.
  • 02 What are the causes?

    Overall retinal detachment is uncommon, affecting only about one in ten thousand people. However certain groups are at increased risk:

    • Short-sighted (myopic) people
    • Previous cataract surgery (particularly if it was complicated)
    • Previous history of eye injury
    • Patients with a family history of retinal detachment
  • 03 Symptoms of Retinal Detachment

    • Flashes of light ("lightning bolts" or sudden arcs of light lasting a split second)
    • New floaters, particularly a shower of new floaters all at once.
    • A shadow or curtain in the peripheral vision that is constantly present.
  • 04 How can it be treated?

    The condition of the retina can be remedied. In 9 out of 10 patients, surgery successfully reattaches the retina in a single procedure. However, this means that occasionally some patients will need additional surgery. It can be treated with the following methods:

    • Scleral Buckle Surgery: A silicone "scleral buckle" is stretched around the eye to support and shape the wall. The buckle helps reconnect the separated retina to the eye wall. The surgeon may remove fluid or blood under the retina during surgery.
    • Vitrectomy: It removes the vitreous gel and replaces it with a gas or oil bubble. The surgeon delicately extracts gel from the vitreous cavity using small cuts in the eye. The bubble then presses the retina against the eye wall, helping it stick back together. The bubble vanishes on its own or during a follow-up surgery.
    • Pneumatic Retinopexy: Fixes some retinal detachments. Injecting a tiny gas bubble into the vitreous cavity pushes on the detached retina and maintains it in place. The patient's head is positioned to keep the gas bubble from separating. Scar tissue fills the eye tear or hole using laser or cryotherapy (freezing). The gas bubble slowly sinks.
    • Laser or Cryotherapy: Laser or cryotherapy can treat retinal tears or minor detachments. These procedures scar the retinal tear. Closing the hole prevents fluid from entering the retinal space.

    The patient's eye health, retinal detachment location, size, and spread determine treatment. Your eye doctor or retina expert will assess your case and recommend a treatment.

  • 05 What is it like to have a gas bubble in the eye?

    The vision is blurred if there is a gas bubble in the eye, rather like having your eyes open under water. As the gas bubble gets smaller patients notice its edge as wobbly line in the upper field of vision. This will then drop across the field of vision, the bubble then being seen as a round blob before it disappears.

  • 06 Will my vision get back to normal?

    Central (reading) and peripheral vision must be considered. Retinal detachment surgery restores peripheral vision. How much central, or reading, vision returns depends on whether and how long the macula was detached before surgery (a "macular –off" detachment).

    A "macular-on" separation before surgery is good news and should restore central vision. The macula may not fully recover if it was detached for more than a few days before surgery.

  • 07 Risk of retinal detachment in your other eye

    If you have had a retinal detachment in one eye, then there is a small risk of developing retinal detachment in the other eye. We will carefully examine your fellow eye.

Flashes, Floaters & PVD (Posterior Vitreous Detachment)

Flashes, floaters, and PVD are vitreoretinal issues that can impair vision.

Flashes and Floaters
  • Flashes: Brief flashes or flickering sensations arise in the peripheral vision. They may appear spontaneously or with eye movement like camera flashes. The vitreous gel inside the eye pulls on the retina, activating it and causing flashes.

  • Floaters: Small specks, spots, or cobweb-like forms drift across the field of vision. They may appear black or transparent and move when focused on. Tiny clumps of vitreous gel or cells produce shadows on the retina, causing floaters. Floaters are safe, but a sudden rise or commencement of many floaters, especially with flashes, may suggest a retinal rupture or detachment.

  • PVD (Posterior Vitreous Detachment): The vitreous gel inside the eye separates from the retina. As we age, the vitreous gel liquefies and pulls away from the retina, creating PVD. This is normal. Due to retinal stimulation, PVDs may cause floaters and flashes.

  • 01 What is the treatment of Floaters and flashes?

    The cause determines floater and flash treatment. Most flashes and floaters are harmless, but an ophthalmologist should check for retinal damage. Most floaters dissolve over time and become less irritating.

Lattice Degeneration

Lattice degeneration thins and weakens the peripheral retina, which can produce a retinal tear.

Lattice Degenerations

A sac loosely linked to the retina holds the clear, gel-like vitreous, which fills the eye. The vitreous fluidifies and sometimes separates from the retina as one ages. The sac pulls on the retina in lattice degeneration. This straining weakens the retina and causes white, crisscrossing "lattice" lesions.

  • 01 Causes of Lattice Degeneration

    Lattice degeneration causes are unknown. It may be inherited and linked to aging. Lattice degeneration is more common in patients with a family history of myopia.

  • 02 What are the symptoms?

    Lattice degeneration often causes no symptoms or vision issues. However, frequent symptoms include:

    • Floaters: Small specks or cobweb-like objects floating in vision.
    • Flashes of light: Brief flashes in peripheral eyesight.
  • 03 How to treat Lattice Degeneration?

    Lattice degeneration without consequences seldom needs treatment. However, regular eye exams are necessary to monitor and diagnose issues.

    It can cause retinal tears or separation, requiring therapy. Complication therapy options include:

    • Laser photocoagulation creates tiny burns around lattice degradation. Scarring and strengthening the fragile retina reduces the likelihood of retinal tears or detachment.
    • Lattice degeneration may be treated using cryotherapy. Cold temperatures strengthen the retina by forming scar tissue around lattice degradation.

Retinal Vein Occlusions (CRVO/BRVO)

Retinal Vein Occlusions (CRVO/BRVO)

Retinal vein occlusions obstruct retinal veins. Retinal veins return retinal blood to the heart for recirculation. A blocked vein produces retinal blood and fluid leaks. This occlusion can induce retinal hemorrhages, edema, and ischemia (lack of oxygen).

  • 01 Types of RVO

    There are two types of retinal vein occlusions:

    • Central Retinal Vein Occlusion (CRVO) Occurs when the main retinal vein is blocked. This results in poor blood flow throughout the entire retina and can cause severe visual loss, particularly in older people.
    • Branch Retinal Vein Occlusion (BRVO) Occurs when a smaller branch of the main retinal vein is blocked. This results in damage to the area of the retina drained by this branch. Visual loss varies but is not as severe as with a central retinal vein occlusion.
  • 02 What are the symptoms?

    • Retinal vein blockage causes blurred vision. The macula-the retina's core visual area-collects extra fluid from the blocked vein.
    • Retinal vein blockage can cause floaters. They're floating "spots
    • CRVOs can cause eye pain. Neo-vascular glaucoma causes this.
  • 03 What are the treatment options?

    The Ophthalmologist will discuss the different treatment options available. Treatments may include:

    • Lifestyle and dietary modification
    • Laser treatment
    • Antihypertensive medication
    • Intravitreal injections of anti-VEGF ( avastin/Lucentis) or steroids
    • Vitrectomy surgery
  • 04 Best Eye Hospital for Vitreoretinal Service in Delhi

    Save Sight Centre is accredited by NABH for providing the best eye care solutions. More than 1,25,000 patients have trusted in us and daily it’s increasing. We have the best eye surgeons. There are specialists for Vitreoretinal services.

    You can trust us and book your appointment with the professional doctors.