Eye Conditions
Vitreous Hemorrhage Treatment
The vitreous is the gel-like substance that makes up approximately two-thirds of the eye's volume and is located in between the lens in the front of the eye and the retina in the back of the eye. In normal, healthy vitreous gel, there are no blood vessels, but diseases such as diabetic retinopathy can lead to the development of new blood vessels which can grow into the vitreous gel. These blood vessels are often fragile and susceptible to leaking blood and fluids.
A vitreous hemorrhage occurs when one of these blood vessels ruptures and causes bleeding within the vitreous gel, causing visual symptoms. Normal blood vessels may also rupture, although less common, as a result of force from a retinal tear or detachment. Patients with vitreous hemorrhage usually notice a sudden, significant increase in the number and size of floaters blocking their vision. Severe bleeding can also cause vision to appear blurry, cloudy or hazy.
When symptoms occur, it is important for patients to seek prompt medical attention. Your doctor will examine your eye along with your medical history to determine the cause of the hemorrhage and then recommend an appropriate treatment. Treatment for a vitreous hemorrhage may include vitrectomy, cryotherapy, laser photocoagulation, or intravitreal injections.
Macular Hole Treatment
The macula is a small spot in the center of the retina that focuses light at a sharp point and allows us to see objects in detail. This is especially useful for reading, driving and other everyday activities that require clear vision. A macular hole often develops as part of the natural aging process, when the vitreous gel thins and separates from the macula. This can pull on the macula and cause a hole to form. Macular holes can also develop from injury, inflammation, retinal detachment or other eye diseases.
In its early stages, a macular hole may cause a small blurry or distorted area in the center of vision. As the hole grows over time, central vision progressively worsens, and peripheral vision may also be affected. There are three different stages of macular holes, including foveal detachments, partial-thickness holes and full-thickness holes. Each stage can progress to the next if left untreated.
Most macular holes can be successfully treated through vitrectomy, a surgical procedure to remove the vitreous gel and stop it from pulling on the retina. The doctor then inserts a mixture of air and gas into the area to keep its shape. Vitrectomy is performed on an outpatient basis under local anesthesia and is considered a safe and effective treatment for a macular hole.
Macular Pucker Treatment
An epiretinal membrane, also called a macular pucker, is a thin layer of tissue that forms over the macula, the area of the retina that gives us clear central and reading vision.
Epiretinal membranes often develop on their own as a part of the natural aging process. Particles that have drifted into the vitreous (the gel that fills the eye) settle onto the macula and begin to obscure vision. Membranes may also result from eye conditions or diseases such as diabetic retinopathy, retinal detachment, inflammation, injury or vascular conditions. These are called secondary epiretinal membranes, whereas spontaneously formed membranes are called idiopathic.
Many epiretinal membranes do not disrupt vision. Thicker membranes, however, can create wrinkles or puckers in the macula, and small blurry or distorted areas in the center of vision may appear. Vision loss increases as the membrane thickens. Peripheral vision is not affected, however, and there is no risk of blindness.
While some epiretinal membranes heal on their own, surgery is recommended for those that do not. Vitrectomy is performed as an outpatient procedure with local anesthesia. During the procedure, the vitreous gel is removed, a saline solution fills the eye and then the membrane is lifted from the macula. There is no non-surgical alternative to treat epiretinal membranes.
Central Serous Chorioretinopathy
Central serous chorioretinopathy (CSC) is a retinal condition that involves a buildup of fluid in the choroid, the membrane located behind the retina. As fluid accumulates, it can seep in between the layers of the retina and cause them to separate, leaving patients with blurred vision or poor night vision. This condition is most common in men between the ages of 20 and 50 years old, although women can also be affected.
Although the cause of this condition is unknown, it is believed that patients who acquire this disease have likely been exposed to certain treatments or medical problems that triggered CSC. Possible triggers may include steroid medication, pregnancy, antibiotics, nasal allergies, asthma and high blood pressure.
Patients with CSC may experience blurred or dimmed vision, blind spots, distorted shapes and a decrease in visual sharpness. This can greatly interfere with reading, driving and other normal activities, and may affect a patient's quality of life throughout the duration of the condition.
Most cases of CSC go away on their own within a few months, but patients should be monitored closely to ensure that the condition improves and no complications develop. If needed, laser treatment may be used to speed the healing process.
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