Retinal Examination
How is retinal examination performed?
Some of the retinal diseases require urgent treatment. If there is a sudden change in the course of an ongoing retinal disease, you have to apply to the hospital as soon as possible since it is critical for your eye health. It is not necessary to book an appointment in this case. Patients who are followed up in the retinal unit should spare at least half an hour for the examination. A part of this period is spent during the examination, while most of the time is spent, waiting for the dilation of the pupils after an eye drop is applied to the patient. Some pupils take longer to dilate than others. In addition to the retinal examination, if the diagnostic tests are required (such as ultrasound, fundus angiography, retinal thickness analyzer), the examination period will be longer. In summary, the examination in the retinal unit may take longer than expected. Patience is essential for achieving a healthier outcome. The procedure followed during the examination in the retinal unit is as follows;
- Evaluation of visual acuity
- Anterior segment examination in biomicroscope
- Eye pressure
- Dilation of Pupil by Eyedrops
- Retinal examination
During the retinal examination, you will feel a very intense beam of light, your patience, tolerance and communication with the doctor will facilitate the examination and provide a healthier assessment. The most frequently followed patients in this unit;
- Diabetic retinopathy, maculopathy
- Retinal detachment
- Eye traumas
- Macular hole
- Macular degeneration
- Vascular diseases of the retina; retinal vein-artery occlusions
Diabetes and Retina
Does Every Diabetes Patient has Poor Vision?
There are a number of factors that accelerate retinal damage in diabetics; For example, smoking, pregnancy, anemia, coexistence of kidney disease, high cholesterol, hypertension may cause damage to the eye. 90% of the patients with a history of 15-20 years of diabetes, also have retinal disorders. High blood pressure for a prolonged amount of time, negatively affects eye vessels. New vessel formations occur in the retina and fluid leaks out of these newly formed vessels. As a result of the leakage from these newly formed blood vessels, retina swells up. Since there is also oily content along with the leaking fluid, it causes the formation of a layer called exudate in the retina and decrease vision quality. Vision quality might not have been affected at the time of diagnosis, if the disorder is diagnosed prior to the formation of new blood vessels. However, this period progresses very rapidly and may turn into a dangerous variation in the future, which might cause a sudden decrease in vision quality.
How does Diabetes Cause Blindness?
Diabetes harms the small vessels of the retina. As a result of damage to the vessels, fluid leakage occurs. This fluid leaking out of the vessel causes edema in the visual center. Loss of vision may occur as a result of bleeding inside the eye. Wrinkles occur in the retina, which can pull the retina and cause retinal detachment and tears. Visual loss may develop in the visual center due to malnutrition.
Can Diabetes be Controlled?
Regular check-ups, even if the patient is not suffering from an apparent visual problem is essential. Early diagnosis and treatment made in time provides the best results.
- Good control of diabetes, regulation of hypertension, reduction of fat in blood, severely control the eye problems related to diabetes.
- In the follow-up of the patients, it is useful to take the fundus photographs. Eye angiography may also be required in some cases.
Why is Angiography of Fundus Fluorescence Applied?
Angiography is a simple and helpful diagnostic tool in a short time. With this test, your doctor will gain insight into the blood circulation of your eye and the structural changes in certain tissues of the eye, especially the retina. Angiography can also be used in diseases affecting the vessels of the retina (such as vascular blockages, diabetes) and age-related macular degeneration, congenital structural diseases of the retina, and tumors.
Retinal Tears and Detachment
What Causes Retinal Tears or Holes?
The retina is in contact with the vitreous gel covering the inside of the eye. In a healthy eye, the vitreous gel is homogeneous, firm, supports the retina, and pushes the retina into the outer fold tissues of the eye, such as the lower choroid and sclera. This viscous consistency and homogeneous structure of the vitreous gel may be impaired in some special cases. Disorders such as high myopia, eye trauma, intraocular inflammation facilitate the transition of vitreous gel to liquid consistency. The transition to liquid consistency causes the vitreous to lose its supporting property. It starts to leave the surface where it is attached to the retina. During this separation, it retracts the retina, and, in some cases, it causes tearing. The penetration of the vitreous into the ruptured area causes retinal detachment.
Why Immediate Intervention is Critical for Retinal Detachment?
Retinal detachment is a disorder that can lead to blindness. Tearing off the retina from the adherent layer will disrupt nutrient supply to cells, resulting in cell death. Retinal detachment can progress to the macula, causing loss of central vision. Even if the retina is successfully attached through surgery, cell death caused by late intervention cannot be countered. In such a case, it is impossible to regain the old vision quality, even after a perfect operation.
Conditions Requiring Treatment in Patients with Retinal Degeneration;
- Presence of retinal detachment in the other eye
- Family history of retinal detachment
- Coexistence of other diseases at risk of retinal detachment
- Tear in the retinal thinning area
- Having eye surgery planned
- Having a profession with a high risk of eye or head trauma.
Diabetes and age-related macular degeneration are diseases that affect the retinal layer. They are the most common cause of vision loss in older ages. The reason why this disorder causes loss of sight is as a result of the development of new vessel formations in the retinal layer containing the visual center. Newly formed vessels are not as strong as the existing original vascular structure and cannot carry out their tasks ideally. As a result, fluid leaks out of these vessels and bleeding occurs. Retinal edema develops as a result of the exudate of the fluid in the retina, which results in sight loss. This vision loss might be permanent if it is acted upon too late. The formation of new vessels in the retina may cause blindness. There are some treatment methods to prevent this condition. The aim of the treatment is to choose the most effective and the least risky method first. Recent studies have shown the effectiveness of Injection Therapy in retinal diseases. Injection therapy is a method applied by injecting a drug that prevents the formation of new vessels into the intraocular fluid. It has been shown that this drug has no toxic effect on the retina. It is a valuable method in patients with diabetes and age-related macular degeneration (yellow spot disease), which a large portion of patients have benefitted from.
Macular Degeneration
Macular Degeneration:
Retina is the name of the nerve layer that covers the back of the eye. This nerve layer is very thin and provides a healthy perception of the image. The degree of visual impairment in retinal diseases varies according to the location of the damage. The visual center of the eye is usually damaged due to aging.
What is Age-Related Macular Degeneration?
Age-related macular degeneration is one of the most common causes of vision loss in patients over 60 years of age. This disease is a disease of the nerve layer at the back of the eye that holds the VISION CENTER. Damage in this area, including the visual center, affects life negatively. This disorder is most common in:
- People from White Ethnicities
- Elderly
- Smokers
- Hypertension Patients
- Overweight/Obese Individuals
- People with High Blood Fat Levels
- Those Who are More Exposed to the Sunlight
- Individuals with a Family History of Macular Degeneration
- People with Blue Eyes
- Women
What are the symptoms of age-related macular degeneration?
The region of the retina, called the macula, is the central area that allows us to see the objects in detail. If the macular function is lost, the central vision will be affected, initially distant and nearby objects are seen as curved, a black focus occurs in the center of the visual field, while at the same time the vision is impaired in the dark. Therefore, the person’s daily life is greatly affected by damage to the macula, and activities such as driving and reading cannot be done. Although macular degeneration affects the central part of the nerve layer called the retina, it only reduces central vision but does not affect the peripheral vision. For example; Despite the outer part of the watch can be seen around the clock, the watch itself cannot be seen and the time cannot be read. Because the central vision is impaired, the surrounding areas outside the center can be seen as unaffected. Macular degeneration itself does not cause complete visual loss. However, there may be a significant decrease in vision.