What Causes Macular Edema?

There are certain eye conditions that we hear about relatively often. Cataracts, for example, or even glaucoma. As retinal specialists, we diagnose and treat more obscure problems, such as macular edema. Here, we discuss what this condition is, what causes it, and what we may do to protect eye health.

The macula is the central part of the retina, the thin layer of tissue that sits at the back of the eye. When light enters the front of the eye, it passes through the lens and the vitreous and lands on the retina. The retina processes light and delivers signals to the brain via the optic nerve. The brain processes these signals and forms an image. As the center of the retina, the macula processes finer vision, that which we use to read, write, and perform up-close tasks. Macular edema is the thickening or swelling of the macula that requires treatment so that vision is not disrupted or lost.

Why Macular Edema Develops

Macular edema results from damaged blood vessels the retina. Damaged blood vessels can leak blood, fluids, and small amounts of fat. These can accumulate on the macula, causing thickening or swelling. Studies suggest that damaged blood vessels are a common side effect of diabetes. Macular edema is often considered a complication of diabetic retinopathy. However, other factors may contribute to this condition, including:

  • Age-related macular degeneration
  • Blockages in the small veins in the retina
  • Inflammation of the uvea, a middle-eye structure
  • Genetic disorders such as retinitis pigmentosa
  • Side effects of certain medications

A history of eye surgery is not considered a direct cause of macular edema but it could be a factor that increases a person’s risk of blood vessel damage in the retina. For example, the blood vessels in the retina may be more sensitive after cataract surgery, increasing the risk of fluid leakage onto the macula.

Treatments for Macular Edema

At this time, macular edema is not a curable condition. Doctors provide care to manage swelling in the macula and protect long-term vision. A retinal specialist may reduce the thickness of the macula by injecting medication into this part of the eye. Alternatively, laser treatment may be administered to seal off leaking blood vessels. Treatments for macular edema to not reverse vision loss that has occurred. However, they can stabilize the condition to prevent worsening.

If you are experiencing symptoms of a retinal disorder, it is important to consult with a specialist. We are proud to serve physicians and patients in Edina, Minneapolis, St. Cloud, and various other Minnesota cities. To locate an office near you, call (800) VRS-2500.

What is Macular Pucker and What Would One Do About This Condition?

Here is an interesting detail about being a retinal specialist: you diagnose and treat conditions that many people have never heard of. If you’ve heard the term “macular pucker” before, you are among a very, very small group. For the most part, one only becomes familiar with this problem if they or someone they love is diagnosed with it. Here, we discuss what macular pucker is, who may develop it, and what we do about it when we find it.

Macular pucker is an eye disease that develops in the macula. The macula is the central part of the retina, which sits at the back of the eye. The macula is responsible for forming central vision. A macular pucker, as it may sound, involves bulging or wrinkling in this part of the retina. Normally, the macula lies flat. This position is necessary for normal function. A wrinkle or bulge will interrupt the clarity of central vision. People with macular pucker may experience cloudiness, a graying of their central field of vision, or blank spots in central vision. In some cases, no symptoms develop. Macular pucker may affect any person. However, studies indicate that there are certain people who have a higher risk of developing this condition.

People with Retinal Conditions

Eye conditions that affect the retina may increase the risk for macular pucker. Common retinal conditions include:

  • A torn or detached retina
  • Posterior vitreous detachment
  • Damaged or abnormal blood vessels in the retina
  • Swelling in the eye, increased intraocular pressure
  • Injury to the eye
  • Inflammation in the eye

Older Adults

Macular pucker is more commonly found in older adults. This could be because, as we age, the vitreous fluid that fills the center of the eye shrinks. The vitreous is normally gel-like and viscous. With age, it becomes more fluid, which could cause it to separate from the retina. Tiny fibers in the vitreous can tug on the retina, resulting in tears or other damage. Where there is damage, there will be scar tissue, and scar tissue could lead to macular pucker. The American Society of Retina Specialists reports that 2% of adults aged 50 and over show signs of macular pucker. Approximately 20% of adults aged 75 and older show signs of the condition.

VitreoRetinal Surgery, PA provides services to diagnose and treat conditions like macular pucker, macular holes, and several other problems. We are honored to accept referrals from physicians in our area and are committed to helping each patient address their eye health needs. To schedule a visit with us, call (800) VRS-2500.

Common Retinal Conditions that Can be Misdiagnosed

Medical misdiagnoses are difficult to understand. Doctors do their best to arrive at accurate conclusions about patients’ health based on available data. However, because there are innumerable medical conditions, and many of them mimic one another, even highly trained and experienced healthcare providers and sophisticated diagnostic equipment could overlook the correct issue. One of the best ways we have of reducing misdiagnoses in medicine at large and, for us, within the field of retina care, is to educate patients. The team at VitreoRetinal Surgery, PA is consistently armed with the most up-to-date information regarding retinal conditions. We share this information with patients to ensure they can make confident decisions about their care.

Three Commonly Misdiagnosed Retinal Conditions

Macular Hole

We receive numerous referrals from other doctors and appreciate the opportunity to provide advanced care for their patients. Sometimes, patients come to us believing they have a macular hole. This misdiagnosis isn’t too far off-base. What we often find is that a macular hole diagnosis is actually a lamellar macular hole. The difference relates to severity, with the lamellar macular hole being less severe.

A macular hole affects all layers of the retina, while a lamellar macular hole affects only one or a few.

A macular hole must be surgically corrected, while a lamellar macular hole typically does not require surgical intervention.

Central Retinal Vein Occlusion

Central retinal vein occlusion is a condition in which small blot hemorrhages may be scattered throughout all four quadrants of the eye. This same clinical data characterizes diabetic retinopathy. Additionally, both conditions can cause macular edema that is visually significant during an eye exam. A retina specialist may differentiate the two by the presence of disc edema and venous tortuosity (twisting of one or more veins) in the eye, which indicates the occlusion of the central retinal vein.

Retinoschisis

Like central retinal vein occlusion, peripheral retinoschisis shares similar indications with another condition. In this instance, it is that peripheral retinoschisis gets misdiagnosed as retinal detachment. In either condition, the retina may be elevated. A specialist looks for finite details such as white dots on the retina and a particular shape and thickness of this part of the eye to reach an accurate diagnosis. The distinction is critical because retinal detachment requires prompt surgical intervention to prevent vision loss, whereas peripheral retinoschisis does not.

The differences between retinal conditions often come down to the tiniest details. The objective of any comprehensive eye exam is not to create doubt in a patient’s mind that their referring doctor “got it wrong.” Our goal is to continue providing second-opinions as requested by referring physicians so patients receive the best possible care.

We proudly serve areas in and around Minneapolis, St. Cloud, Hermantown, Edina, St. Paul, and more. To locate an office near you, call (800) VRS-2500.

Frequently Asked Questions about Eye Floaters

When we reach a certain age, we may begin to notice objects drifting across our field of vision. These are phenomena called floaters. If you have noticed these objects and have attempted to look at them, you know they cannot be pinned down visually. Trying to look at a floater is the fastest way to get it to disappear, it seems. Because floaters are a common symptom experienced by most adults, we receive a lot of questions about this visual disturbance. Here, we answer some of the most common.

What is an eye floater?

Floaters are not imaginary objects floating through vision. They are small clumps of protein that have formed inside the eye. As light passes through the eye, these clumps may cast shadows on the retina. These appear as small blobs, cobwebs, hair, black dots, or worm-like shapes. As the eyes shift around, floaters move. They are most obvious when you are observing a uniform background such as the sky.

Why do floaters occur?

We get floaters as we get older because the vitreous humor, the gel-like fluid that fills the center of the eye, loses density. The liquid becomes watery and clumps of protein float through it. Protein clumps become visible as they cast shadows on the back of the eye. While age is the most common factor that contributes to floaters, they may also stem from inflammation, infection, an eye injury, or a retinal tear.

Should I be concerned about eye floaters?

Most people over the age of 40 will experience the occasional object floating around their field of vision. The change in the vitreous humor is a natural occurrence that is usually not a cause for concern. However, floaters are sometimes indicative of a retinal tear, a condition that can be very serious. A retinal tear may occur if the shrinking vitreous tugs on the retina so much that this structure begins to separate from the back of the eye. If the retina tears and begins to detach, floaters may coincide with shadowing coming over vision as well as streaks of light passing through the field of vision. These symptoms require prompt medical attention.

Floaters may go away on their own over time. However, it is wise to schedule a retinal exam if floaters develop to ensure that this important part of the eye is healthy and intact. VitreoRetinal Surgery, PA is proud to serve patients in several Minnesota cities, including St. Cloud, Minneapolis, and Duluth. To find an office near you, call (800) VRS-2500.

Macula | Blaine, MN

How Age-Related Macular Edema Affects Vision

Age-related macular degeneration (AMD) describes the damage that occurs in the macula, the part of the eye in which central vision is formed. This common condition is the leading cause of vision loss in older adults. Although total blindness is not typically caused by AMD, people with this condition may suffer a diminished quality of life. For this reason, it is important to know how age-related macular edema may appear and what to do if it does.

What Is the Macula?

The macula is a part of the retina that is positioned at the center of the back of the eye. It is the part of the retina where, when light lands, transports electrical messages to the brain to form central vision, that which is straight ahead of the eyes. When the macula is damaged, light processing in this area is interrupted, causing the decrease or loss of central vision.

Symptoms of AMD

Damage to the macula does not cause vision loss right away. Milder symptoms often occur first. These include:

  • Sensitivity to glare
  • Fuzzy, blurry, or shadowing in the central vision
  • Difficulty seeing or reading in low-light
  • Distortion or blurring of straight lines

As the disease worsens, symptoms become more noticeable. When the disease reaches an advanced stage, everyday tasks can become a challenge due to the marked decrease in the central area of vision. Sufferers have a difficult time reading road signs, seeing objects up close, watching television, driving, and performing work or chores. Being able to see clearly only in peripheral vision, sufferers can become limited in how they engage in life.

Treating AMD

A board-certified ophthalmologist can diagnose AMD during a comprehensive eye exam and discussion of visual symptoms. The early diagnosis of age-related macular edema is imperative to the most successful management of the condition. Doctors use medications or laser therapy to slow the progression of this disease but cannot correct the damage that has occurred.

If you exhibit symptoms of macular degeneration, a thorough eye exam is needed to discover the cause of visual impairment. Our specialists have years of experience treating age-related macular degeneration and can administer care to help preserve your vision for the foreseeable future.

VitreoRetinal Surgery, PA proudly serves patients in several Minnesota cities. To locate an office near you, call (800) VRS-2500.

Vitreo Retinal Surgery

Causes of Blurry Peripheral Vision

Our peripheral vision is our ability to see objects that are to the side of the face without turning our head. It is an expansion of our central vision and necessary for us to engage in life as fully and safely as possible. Sudden peripheral vision loss may feel like tunnel vision, where everything to the side is dark and everything in the central field is quite clear. There are reasons why peripheral vision loss may occur. With prompt attention for this visual disruption, a retinal specialist can identify the cause and, optimally, administer treatment that might restore at least some degree of visual clarity.

Retinal Detachment and Tears

Blurry side vision is one of the primary symptoms of a torn or detached retina. Additional symptoms include sudden spots, flashes, floaters, or a shadow obscuring part of the field of vision. Retinal detachment requires prompt treatment to prevent complete vision loss.

Glaucoma

This progressive eye disease involves elevated pressure within the eye. Persistent pressure on the optic nerve can lead to irreversible damage and vision loss. Because damage occurs slowly, patients have a chance to receive care that can preserve as much visual clarity as possible.

Retinitis Pigmentosa

Retinitis pigmentosa affects the light-sensitivity of the retina, the part of the eye that transfers light to the brain via the optic nerve. The intense sensitivity of the retina leads to gradual degeneration of this part of the eye. Retinitis pigmentosa is a rare eye disorder that cannot be cured but may be managed with appropriate care from a retina specialist.

A Note About Peripheral Vision Loss

Peripheral vision loss may occur suddenly or gradually. People with glaucoma, for instance, are more likely to notice very subtle changes over time. Regardless of the speed of darkening in the peripheral view, it is beneficial to schedule a comprehensive eye exam right away. A board-certified ophthalmologist or retina specialist can determine the cause of visual changes and provide appropriate care.
In the case of sudden peripheral vision loss, floaters, or flashes, emergency medical attention is needed right away.

Contact Our Retinal Care Specialists

We are proud to serve patients from multiple Minnesota cities, including St. Cloud, St. Paul, Minnesota, and more. To locate an office near you, call (800) VRS-2500.

Discussing Diabetic Eye Disease

This month is when we turn our attention to diabetic eye disease awareness. A chronic health condition related to the body’s ability to use insulin and glucose efficiently, diabetes affects many systems. The effects of diabetes on eye health is one of several important matters for people with this medical problem. The retinal specialists in our practice encourage all diabetic patients to obtain a thorough ophthalmic exam every year, as well as prompt care for any changes in vision.

Common Types of Diabetic Eye Disease

Diabetes is an influencing factor on the development of potentially serious eye diseases including glaucoma and cataracts. Some of the common problems that we help patients address include:

  • Diabetic retinopathy. Retinopathy is the term that we use to describe damage to the retina, tissue at the back of the eye. The retina has a rich blood supply from tiny blood vessels. These can be damaged over time due to the effects of diabetes, which causes them to leak blood and fluid into the retina. When fluid builds up here, the retina swells. As a result, vision can become cloudy. Diabetic retinopathy cannot be cured. It requires ongoing management to preserve vision.
  • Diabetic macular edema. This condition is a complication of untreated diabetic retinopathy. The macula is at the center of the retina. Fluid accumulation on this tissue affects some of the most detailed vision abilities. Treatment is designed to stop or, optimally, reverse vision loss.

Can Diabetic Eye Disease be Avoided?

If you have diabetes, this is an important question to ask. It is questions like these that are at the heart of events like Diabetes Eye Disease Awareness Month.

Some of the tips provided by eye health experts include:

  • Keep a close watch on cholesterol levels and blood pressure, as these factors also influence eye disease risk. Both can be managed with diet and exercise. If needed, a doctor may prescribe medication to keep levels under control.
  • Undergo a dilated eye exam every year. Some people with diabetes may be advised to maintain more than one exam a year. Each dilated eye exam observes the retina, macula, and optic nerve for signs of damage in supporting blood vessels. The sooner that abnormalities are found, the more effective treatment will be.
  • Pregnant women diagnosed with gestational diabetes are encouraged to protect eye health by following a low-sugar, high-fiber diet.

To see a retinal specialist in Minnesota, call (800) VRS-2500. VitreoRetinal Surgery, PA has offices in Minneapolis, Plymouth, Edina, and other cities.

Cloudy Vision or Blurry Vision? There is a Difference!

When a person doesn’t see as well as they used to, the common ways they describe their vision are “blurry” and “cloudy.” Often, the terms are used interchangeably, at least by patients. Doctors know that there are unique differences between cloudy vision and blurry vision. They also know that the causes of either blurriness or cloudiness can vary widely. Because your doctor relies somewhat on your description of what you are experiencing, it is important to know how to accurately describe your situation. Here, we’ll provide some assistance.

What is blurry vision?

When you look through a camera lens to snap a photo, there may be an instant during which objects are out of focus. Using an old-school camera, one could manually alter the focus of objects in their frame. The out-of-focus sensation is what we describe as blurry. Objects may be blurry when you look straight at them or when they sit to one side or the other of your peripheral vision.

Blurry vision may be a sign of:

  • Infection
  • Retinopathy
  • Nearsightedness, farsightedness, or astigmatism
  • Age-related macular degeneration
  • Cataracts
  • Injury or abrasion to the cornea
  • Corneal scarring
  • Optic neuritis

What is cloudy vision?

Just like a cloudy day, cloudy vision feels as though you are looking through fog or a dirty window. When vision is cloudy, there may be an urge to blink or wipe the eyes to remove the “film.” When a person develops cloudy vision, they may also experience additional symptoms, such as:

  • Double vision
  • Halos or glare around lights
  • Poor night vision
  • Light sensitivity
  • Dry or watery eyes
  • Cloudy vision may be a sign of:
  • Cataracts
  • Macular degeneration
  • Inflammation or infection
  • Dirty or damaged contact lenses

Both cloudy and blurry vision may be caused by potentially serious eye conditions. If either symptom persists or becomes severe very quickly, a comprehensive eye exam should be scheduled right away.

VitreoRetinal Surgery, PA proudly serves multiple Minnesota cities with friendly, experienced care. To schedule a consultation with one of our retina specialists, call (800) VRS-2500 to find an office near you.

Retinopathy of Prematurity: What You Need to Know

Several serious eye conditions may affect a person. However, what we tend to limit our attention to are issues such as visual clarity. An eye exam revolving around this can fall short in the needed accuracy for the average person, let alone a patient who has a higher risk for potentially serious conditions such as retinopathy. Furthermore, rarely do we hear of the risks a child, even a newborn, may face. At Vitreo Retinal Surgery, PA, we know what these risks are and we know how to address them.

What is Retinopathy of Prematurity?

Retinopathy is a term we use to describe damage to the retina. The retina is a small structure that sits next to the optic nerve at the back of the eye. Light lands on the retina and the retina transfers light to the optic nerve, sending it to the brain for interpretation. Usually, retinopathy occurs in older individuals with chronic health problems like diabetes. Another circumstance in which retinopathy may occur, though, is when an infant is born prematurely.

Retinopathy of prematurity (ROP) is generally limited to a small number of infants born before 31 weeks gestational age and who weight less than 3 ½ pounds. In this situation, the infant should undergo a retinal screening exam to assess their risk for retinopathy. Due to the risk of permanent blindness, patients are treated conscientiously by a retinal specialist. Our practice is served by highly trained physicians, including a Pediatric Vitreoretinal Surgeon, to meet the unique needs of our patients.

What is the ROP Screening Like?

The initial screening to asses for Retinopathy of prematurity may be scheduled for four to six weeks of age. The test is performed with dilation, which “opens” the pupils so the doctor can visualize all important structures from the front to the back of the eye. Dilation is achieved with painless eye drops. Looking through a special instrument that does not touch the infant’s eye, the doctor evaluates the blood vessels that have developed around the retina and throughout the eye. Insufficient blood vessel development can indicate retinopathy.

Depending on the findings of the initial evaluation, subsequent screenings may be scheduled every week or two. If the first screening indicates a high risk or the confirmed presence of ROP, treatment options may be discussed immediately. Common treatment options include laser therapy of the periphery blood vessels of the retina, an injection of Intravitreal Anti-VEGF to target abnormal blood vessels, or vitrectomy surgery to remove scar tissue and repair a retinal detachment.

Our team understands the enormous amount of stress that can occur in the event of premature birth and subsequent health concerns. We pride ourselves on providing compassionate care to the patient and their family in every instance. To learn more about retinopathy of prematurity and how it can be treated, call (800) 877-2500 to locate a Minnesota office near you.

What is Retinal Laser Photocoagulation?

Most people are only vaguely familiar with the various tests and treatments that may be performed on the eyes. For many, nothing more than an annual vision exam takes place until they encounter a problem such as one of the various eye diseases. In our Minnesota offices, we specialize in the diagnosis and treatment of diseases and conditions that affect the retina. Retinal laser photocoagulation is a technique that may be advisable in several scenarios.

Retinal laser photocoagulation is a procedure that is performed in the office using a local anesthetic to numb the eyes. The laser device emits light that gets absorbed into a local area of ocular tissue, where it causes the formation of scar tissue. The scar tissue can seal a retinal tear to keep the retina from detaching. The technique can also destroy or seal leaking blood vessels to preserve sight and protect the integrity of the retina. In this instance, photocoagulation may also slow the growth of abnormal blood vessels in the eye.

Some of the common conditions for which retinal laser photocoagulation may be used include retinal tears, macular edema, diabetic retinopathy, and retinal vein occlusion. The benefit of undergoing this procedure is that the risk of further vision loss is decreased.

What Is Retinal Photocoagulation Like?

We understand that the necessity for any eye procedure can feel unnerving. Retinal procedures are performed after the eye has been numbed with eye drops or another type of local anesthesia. Eye drops to dilate the pupil are also administered. Because dilation takes time to wear off, patients need to have a loved one bring them to their appointment and drive them home. Once the procedure begins, it is typically over within 15 to 20 minutes. A contact lens may be inserted over the front of the eye. This can help focus the laser. The doctor directs the point of light from the laser to targeted areas. Here, tissue sustains minor burns; not enough to affect vision but enough stimulate the formation of necessary scar tissue.

During the procedure, slight pinprick sensations may be felt as laser light touches tissue at the back of the eye. Bright flashes of light may also be noticed. Because only local anesthesia is used, patients can talk with their doctor throughout their procedure and let them know if they become uncomfortable.

After retinal laser photocoagulation, vision will be slightly blurry and the eyes will be extra sensitive until the pupils return to normal. The treated eye may feel mildly sore for a few days. For a short time, certain activities may need to be avoided, such as strenuous exercise. Thorough post-treatment care instructions are provided to facilitate optimal healing.

We proudly provide retinal care to patients in areas including St. Paul, Duluth, Minneapolis, Oakdale, and more. To locate a retina specialist near you, call (800) VRS-2500.