Retina
The retina is like the film of the camera which sends the image to the brain for processing. A damaged retina can lead to significant visual disturbances many of which may become permanent if not treated in time. The retinal diseases are some of the most common causes of a permanent loss of vision in many patients, if not treated on time.
Retina Treatment at Prakash hospital in Sarguja
Prakash hospital is 1st in sarguja district to provide treatment of retinal diseases. Equipped with latest and advanced technology and tools for early diagnosis and management of retinal diseases, Prakash hospital provides management strategies at par with the best institutes of India. Our wide range of services includes retina care, ROP screening and diagnosis,macular degeneration and diabetic retinopathy management with the help of laser, anti-VEGF injections and other management options at an affordable cost in sarguja.
With best retina specialist in sarguja and world class infrastructure and best grade machines, Prakash hospital is amongst the best hospitals for diabetic retinopathy treatment.
Hand-in-hand diabetes control treatment by our experienced specialist physician is done at the center.
Problems Associated with Retina
There are four main types of disorders which are related to the retina:
- Diabetic Retinopathy – It is one of the most common issues associated with people having diabetes. In Diabetic Retinopathy disease, the high blood sugar levels cause damage to the blood vessels of the retina and damage it. In the advanced stages, it can lead to blindness.
- Retinopathy of Prematurity – RoP is mainly caused due to the retinal blood vessels developing abnormally and affects prematurely born babies. It can also lead to retinal detachment and blindness.
- Age-Related Macular Degeneration – The damage of Macula can cause AMD which can lead to a permanent vision loss.
- Retinal Detachment – It is mainly the detachment of the retina from the layer underneath. If it is not taken care of properly, there is a chance of a permanent vision loss.
Diabetic Retinopathy
Symptoms: If you have Diabetic Retinopathy, you may observe:
COMPLETE DIABETIC RETINOPATHY MANAGEMENT
Advanced Technology & Diagnostic Tools
Treatment Options
Restore your vision & improve your health with the most modern diabetic retinopathy management options available today.
1. Retinal Laser / Green Laser
Retinal Laser / Green Laser is a very effective management tool treatment option in diabetic retinopathy. It is helpful in treating leaking blood vessels and prevent further progression of the disease to the unaffected / healthy areas of retina.
2. Anti VEGF Molecules
Anti VEGF drugs block VEGF action and slow down the damage being caused by neovascularisation, further slowing down the vision loss and also improving it in early cases. Topical anesthetic eye drops are instilled and AntiVEGF drug is injected into the eye. It is a painless daycare procedure and one may resume his routine activities from the very next.
COMMON QUESTIONS ABOUT DIABETIC RETINOPATHY
Unpredictable blood sugar levels and long-term diabetes increase the risk of this disease. Most people may not develop diabetic retinopathy until quite late of having diabetic. Nevertheless, all diabetic patients should get there retina check-up done every yearly / as per suggested by there retina consultants.
With the availability of modern treatment options along with good systemic control and compliance, diabetic retinopathy can be manage very well and visual loss can be prevented. Early diagnosis and management plays an important role.
Yes. This is the most important sign of retinopathy for diabetics. In the early stages, the bleeding is in the form of small aneurysms. As diabetic retinopathy progresses, it leads to formation of abnormal new blood vessels which cause repetitive bleeding inside the eye.
The only way to monitor diabetic retinopathy getting it diagnosed early and managed by experts before it induces vision loss or blindness. So, if you have diabetes, then make sure you get your eyes checked for diabetic retinopathy at least once a year / as per suggested by your retina consultant.
Retinopathy Of Prematurity
Retinopathy of Prematurity (RoP) is a disease of the retina affecting prematurely born babies. In neonates in whom retinal vascularization is incomplete, abnormal proliferation of immature retinal blood vessels develops due to relative lack of oxygen following the withdrawal of therapeutic oxygen. The abnormal new blood vessels that grow are fragile and prone to leakage. It can result in significant damage to the retina including the formation of scar tissue and retinal detachment.
Types
Retinopathy of Prematurity is graded according to its severity: Stage I through “Plus” disease (+).
- Stage 1: Demarcation line
- Stage 2: Ridge
- Stage 3: Ridge with the extraretinal fibrovascular proliferation
- Stage 4: Retinal detachment “Plus” disease (+)
Diagnosis
Diagnosis is done during an ophthalmological examination either before the infant leaves the hospital or within 4 weeks of birth. Screening is recommended for all premature and low-birthweight babies, especially those receiving supplemental oxygen.
Risk Factors
The primary risk factor is premature birth. The condition is most common in infants with a birth weight of less than 2 Kg (~2.75 lbs) and gestational age of fewer than 34 weeks.
ROP is commonly seen in low-birthweight infants, premature infants, and those who received oxygen therapy. It is occasionally seen in full-term neonates.
What can you do to reduce risk?
The best way to reduce the risk of ROP is to prevent premature birth through prenatal care and educating expecting mothers about factors that can influence a baby’s health in utero. If a child is born prematurely, close monitoring of oxygen levels and appearance of the retinal blood vessels is essential. To prevent ROP, pediatricians attempt to balance the amount of supplemental oxygen the infant is receiving with the appearance of the blood vessels. Oxygen is necessary, but too much can be damaging.
Treatment
Currently, treatment relies on the destruction of the areas of the retina that are without blood vessels. It becomes necessary only if the disease has reached a specific, well-defined stage, as the milder forms often regress spontaneously. By destroying the retina, the stimulus for the growth of the abnormal blood vessels is removed. The destruction is achieved by cryotherapy (literally freezing the retina, using a small pulse) or photocoagulation with laser energy. Rarely, surgery is undertaken in an attempt to remove the scar tissue.
Macular Degeneration (AMD)
What is Macular Degeneration (AMD)?
AMD is a common eye disease mostly seen in people over the age of 50 years that gradually destroys sharp, central vision. In some cases, AMD advances so slowly that people notice little change in their vision. At this stage, it may be detected on routine retina check-up. But in others, the disease progresses faster and may lead to a loss of vision in one or both eyes. AMD usually involves both eyes, although one may be affected long before the other. AMD causes no pain and almost never leads to total blindness.
How does AMD lead to vision loss?
AMD is of two types:
- Dry AMD: More common type. 90 percent of all people with AMD have this type. There is a slow atrophy of macula, leading to a gradual loss of central vision.
- Wet AMD: Although only 10 percent of all people with AMD have this type, it accounts for 90 percent of all blindness from the disease.
As dry AMD worsens, the formation of abnormal, fragile blood vessels causes “wet” AMD. These new blood vessels often leak blood and fluid under the macula. This causes rapid damage to the macula that can lead to the loss of central vision in a short period.
Who is at risk of developing it?
At the moment the exact cause for AMD is not known. However, there are some risk factors, which have been identified.
- Age: AMD is an age-related condition, so growing older makes the disease more likely.
- Gender: Women are more affected than men
- Genetics: There appear to be a number of genes, which can be passed through families which may have an impact on whether someone develops AMD, or not
- Smoking: A definite risk factor. Stopping smoking can reduce the risk of macular degeneration
- Sunlight: Blue rays of sunlight may accelerate macular degeneration. It is a good idea to wear sunglasses with UV filters to protect the eyes during outdoor activities
- Nutrition: Research suggests that supplementation with antioxidants like Vitamin C and E, and minerals like zinc and selenium can help protect against macular degeneration.
SYMPTOMS -The symptoms may not be noticeable in early Dry AMD if only one eye is affected, to begin with. In the early stages your central vision may be blurred or distorted, with objects looking an unusual size or shape and straight lines appearing wavy or fuzzy (Metamorphopsia). This may happen quickly or develop over several months. People with the advanced stage will often notice a black patch or dark spot in the centre of their sight. This makes reading, writing and recognizing small objects or faces very difficult.
There may be a sudden painless loss of central vision when wet AMD develops.
Can AMD be detected in time?
AMD is a slowly progressing disease is detected mostly on a routine ophthalmological evaluation. The comprehensive eye exam includes:
Visual Acuity Test
- Dilated Eye Exam to examine your retina and optic nerve for signs of AMD and other eye problems
- Amsler Grid: The pattern of the grid resembles a checkerboard. You will cover one eye and stare at a black dot in the center of the grid. While staring at the dot, you may notice that the straight lines in the pattern appear wavy. You may notice that some of the lines are missing. These may be signs of AMD.
- Optical Coherence Tomography: This gives the cross-sectional image of macula identifying the exact location of the choroidal neovascular membrane beneath the macula.
Can AMD be prevented in time?
AMD cannot be prevented. Early detection is essential to prevent severe visual loss. Protecting your eyes from the sun, eating a well-balanced diet with plenty of fresh fruits and vegetables and stopping smoking may all help to delay the progress of AMD.
Can AMD be treated in time?
Dry AMD: Once dry AMD reaches the advanced stage, no form of treatment can prevent vision loss. However, treatment can delay and possibly prevent early dry AMD from progressing to the advanced stage, in which vision loss occurs. Nutrition and antioxidants- The role of antioxidants is not clear, but supplementation with Lutein, zeaxanthin, Vitamin C and E and other minerals has shown a beneficial effect in slowing the progression of the disease. Quit smoking.
- Wet AMD: Wet AMD can be treated with laser surgery, photodynamic therapy, and injections into the eye. None of these treatments is a cure for wet AMD. Each treatment may slow the rate of vision decline or stop further vision loss, but the disease and loss of vision may progress despite treatment.
- Injections (Anti VEGF therapy): Wet AMD can now be treated with a new drug that is injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with Wet AMD and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of the growth factor. You will need multiple injections, usually given about six weeks apart. The eye is numbed before each injection. After the injection, you will remain in the doctor’s office for a while, and your eye will be monitored. As with photodynamic therapy, the main benefit for patients treated with the drug is to slow vision loss from AMD.
Retinal Detachment & Its Treatment
A retinal detachment occurs when the retina is pulled away from its normal position in the back of the eye. The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. Retinal detachment can cause permanent vision loss if not treated in time.
What are its symptoms?
- Flashes of Light (Photopsia): mostly experienced in the temporal (outside away from the nose) part of the vision
- Floaters: black cobweb-like spots moving in front of the eye
- A curtain-like shadow coming in the field of vision
- Sudden Vision Loss when macula is detached
Who is at risk for Retinal Detachment?
A retinal detachment can occur at any age, but it is more common in people over the age of 40. Common risk factors for developing RD are:
- High Myopia, especially more than 5 Dioptre, after cataract surgery
- Retinal detachment in the other eye
- Family history of RD
- Presence of other eye diseases such as retinoschisis, degenerative myopia, or lattice degeneration
- Following an eye injury
What are the treatment options?
Retinal hole or breaks are treated with laser photocoagulation or cryopexy (a freeze treatment) as the outdoor procedure. During laser treatment, dot-like burns are placed around the hole to “weld” the retina. In Cryopexy the area around the hole is frozen, and it helps reattach the retina. Retinal detachments are treated with surgery viz scleral buckling and complex vitreoretinal surgery involving the use of Silicon oil or gases.
- In scleral bucking, a silicone band is placed anchored with stitches around the eyeball to gently push the wall of the eye against the detached retina.
- In vitrectomy, the surgeon makes tiny incisions in the sclera (white portion of the eye). Vitrectomy instruments are placed inside the eye to take out the vitreous gel, and it is replaced with silicone oil or gases to push the retina in place. Laser or cryopexy is done around the breaks to seal it.