Retinal diseases vary widely, but most of them cause visual symptoms. Retinal diseases can affect any part of your retina, a thin layer of tissue on the inside back wall of the eye.

The retina contains millions of light-sensitive cells, called rods and cones, and other nerve cells that receive and organize visual information. The retina sends this information to the brain through the optic nerve, enabling you to see.

Treatment is available for some retinal diseases. Depending on your condition, treatment goals may be to stop or slow the disease. This may help preserve, improve or restore your vision. Untreated, some retinal diseases can cause severe vision loss or blindness.

Types

Common retinal diseases and conditions include:

  • Retinal tear. A retinal tear occurs when the clear, gel-like substance in the center of your eye, called vitreous, shrinks and tugs on the thin layer of tissue lining the back of your eye, called the retina. This can cause a tear in the retinal tissue. It’s often accompanied by the sudden onset of symptoms such as floaters and flashing lights.
  • Retinal detachment. A retinal detachment is defined by the presence of fluid under the retina. This usually occurs when fluid passes through a retinal tear, causing the retina to lift away from the underlying tissue layers.
  • Diabetic retinopathy. If you have diabetes, the tiny blood vessels in the back of your eye can deteriorate and leak fluid into and under the retina. This causes the retina to swell, which may blur or distort your vision. Or you may develop new, irregular capillaries that break and bleed. This also worsens your vision.
  • Epiretinal membrane. Epiretinal membrane is a delicate tissue-like scar or membrane that looks like crinkled cellophane lying on top of the retina. This membrane pulls up on the retina, which distorts your vision. Objects may appear blurred or crooked.
  • Macular hole. A macular hole is a small defect in the center of the retina at the back of the eye, called the macula. The hole may develop from atypical traction between the retina and the vitreous, or it may follow an injury to the eye.
  • Macular degeneration. In macular degeneration, the center of the retina begins to deteriorate. This causes symptoms such as blurred central vision or a blind spot in the center of the visual field. There are two types — wet macular degeneration and dry macular degeneration. Many people will first have the dry form, which can progress to the wet form in one or both eyes.
  • Retinitis pigmentosa. Retinitis pigmentosa is an inherited degenerative disease. It slowly affects the retina and causes loss of night and side vision.

Many retinal diseases share some common symptoms. These may include:

  • Seeing floating specks or cobwebs.
  • Blurred or distorted vision in which straight lines can look wavy.
  • Defects in the side vision.
  • Vision loss.

You may need to try looking with each eye alone to notice these changes.

When to see a doctor

It’s important to pay attention to any changes in your vision and find care quickly. Seek immediate medical attention if you suddenly have floaters, flashes or reduced vision. These are warning signs of potentially serious retinal disease.

Risk factors for retinal diseases might include:

  • Aging.
  • Smoking.
  • Being obese.
  • Having diabetes or other diseases.
  • Eye trauma.
  • A family history of retinal diseases.

To make a diagnosis, an ophthalmologist performs a thorough eye exam and looks for irregularities anywhere in the eye.

The following tests may be done to find the location and extent of the disease:

  • Amsler grid test. An eye professional may use an Amsler grid to test the clarity of your central vision. You’ll be asked if the lines of the grid seem faded, broken or distorted. Noting where the distortion is on the grid can help to understand the extent of retinal damage. If you have macular degeneration, you may be asked to use this test to self-monitor your condition at home.
  • Optical coherence tomography (OCT). This test is an excellent technique for capturing precise images of the retina. This can help diagnose epiretinal membranes, macular holes and macular swelling, called edema. It also can monitor the extent of age-related wet macular degeneration and how it’s responding to treatment.
  • Fundus autofluorescence (FAF). FAF may be used to determine the stage of retinal diseases, including macular degeneration. FAF highlights a retinal pigment, called lipofuscin, that increases with retinal damage or dysfunction.
  • Fluorescein angiography. This test uses a dye that causes blood vessels in the retina to stand out under a special light. This helps to exactly identify closed blood vessels, leaking blood vessels, new irregular blood vessels and subtle changes in the back of the eye.
  • Indocyanine green angiography. This test uses a dye that lights up when exposed to infrared light. The resulting images show retinal blood vessels and the deeper, harder-to-see blood vessels behind the retina in a tissue called the choroid.
  • Ultrasound. This test uses high-frequency sound waves, called ultrasonography, to help view the retina and other structures in the eye. It also can identify certain tissue characteristics that can help in the diagnosis and treatment of eye tumors.
  • CT and MRI. In rare instances, these imaging methods can be used to help evaluate eye injuries or tumors.

The main goals of treatment are to stop or slow disease progression and preserve, improve or restore your vision. In many cases, damage that has already happened can’t be reversed, making early detection important. Your eye doctor will work with you to decide on the best treatment.

Treatment of retinal disease may be complex and sometimes urgent. Options include:

  • Using a laser. Laser surgery can repair a retinal tear or hole. Your surgeon uses a laser to heat small pinpoints on the retina. This creates scarring that usually binds the retina to the underlying tissue. Immediate laser treatment of a new retinal tear can decrease the chance of it causing a retinal detachment.
  • Shrinking irregular blood vessels. Your eye doctor may use a technique called scatter laser photocoagulation to shrink irregular new blood vessels that are bleeding or threatening to bleed into the eye. This treatment may help people with diabetic retinopathy. Extensive use of this treatment may cause the loss of some side (peripheral) or night vision.
  • Freezing. In this process, called cryopexy (KRY-o-pek-see), your surgeon applies a freezing probe to the outside wall of the eye to treat a retinal tear. Intense cold reaches the inside of the eye and freezes the retina. The treated area will later scar and secure the retina to the eye wall.
  • Injecting air or gas into your eye. This technique, called pneumatic retinopexy (RET-ih-no-pek-see), is used to help repair certain types of retinal detachment. It can be used in combination with cryopexy or laser photocoagulation.
  • Indenting the surface of your eye. This surgery, called scleral (SKLAIR-ul) buckling, is used to repair a retinal detachment. Your surgeon sews a small piece of silicone material to the outside eye surface, called the sclera. This indents the sclera and relieves some of the force caused by the vitreous tugging on the retina and reattaches the retina. This technique may be used with other treatments.
  • Evacuating and replacing the fluid in the eye. In this procedure, called vitrectomy (vih-TREK-tuh-me), your surgeon removes the gel-like fluid that fills the inside of your eye, called the vitreous. Air, gas or liquid is then injected into the space.

    Vitrectomy may be used if bleeding or inflammation clouds the vitreous and blocks the surgeon’s view of the retina. This technique may be part of the treatment for people with a retinal tear, diabetic retinopathy, a macular hole, epiretinal membrane, an infection, eye trauma or a retinal detachment.

  • Injecting medicine into the eye. Your eye doctor may suggest injecting medicine into the vitreous in the eye. This technique may be effective in treating people with wet macular degeneration, diabetic retinopathy or broken blood vessels within the eye.
  • Implanting a retinal prosthesis. People who have severe vision loss or blindness owing to certain inherited retinal disease may need surgery. A tiny electrode chip is implanted in the retina that receives input from a video camera on a pair of eyeglasses. The electrode picks up and relays visual information that the damaged retina can no longer process.
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  5. Have AMD? Save your sight with an Amsler grid. American Academy of Ophthalmology. https://www.aao.org/eye-health/tips-prevention/facts-about-amsler-grid-daily-vision-test. Accessed Dec. 21, 2023.
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