What is a Retinal Specialist?

Retina specialists are specialized eye doctors who treat only diseases of the retina.  Ophthalmology is a specialty of medicine/surgery dealing with the diseases of the eye and the surrounding tissues, including the eye lids, eye muscles, eye orbit/socket, optic nerve and the optic tracks as they run from the back of the eye to their final destination in the occipital lobe, in the back of the brain.  Because of the many different aspects necessary for the proper function of the eye, ophthalmology has been divided into a number of subspecialties.  One of these is the specialty of retina.

 

The Retinal Specialist

The retinal specialist focuses his work on the retina, which is the sensory portion of the eye, the vasculature which supports the retina, and out of necessity, the vitreous which is the jelly material that fills the central cavity of the eye.  The retinal specialist is most often called upon when vision can no longer be improved after appropriate glasses have been prescribed and/or cataract surgery to determine the cause of the persistent decreased vision, or if there is any abnormality noted in the back of the eye on routine eye examination.

 

When Would a Retinal Specialist be Consulted?

Any condition in which there is decreased vision, which can not be explained by a condition involving the eye lids, cornea, and/or lens, could involve a consultation with a retinal specialist.    Conditions resulting in the clouding of   the vitreous can include vitreous degeneration, bleeding, inflammation/infection, and cancer.  If the center of the back of the eye (the macular) is involved, the most common major problem is macular degeneration. Other macular problems include  hereditary conditions, or the result of a number inflammatory conditions or infections, such as Histoplasmosis, Toxoplasmosis, AIDS, etc.  These conditions may also affect the peripheral retina.  Other conditions which can affect the macula include vitreo-macular traction syndrome, pseudophakic macular edema, macular pucker and macular hole.

Peripheral retinal conditions which would involve a retinal specialist include retinal tears and/or retinal detachments, diabetic retinopathy, hypertensive retinopathy, and tumors (both primary and metastatic), to mention just a few.

Vascular lesions include both arterial and venous occlusive disease, which may be either central or branch, and vascular anomalies.

Ocular trauma often falls into the realm of the retina specialist because there is usually bleeding into the eye with retinal damage.  This type of retinal damage may include giant retinal tears, retinal dialysis, macular swelling, and retinal hemorrhage.  Also when eye trauma occurs there may be a rupture of the globe and/or a foreign body within the eye.

How Do I Find a Retinal Specialist?

Retinal specialists can be located though the Yellow Pages, but it would be best to ask your current eye doctor for a referral.  In that way, you would be referred to a retinal specialist who has a good relationship with your doctor, and together they can best coordinate your care and follow-up.

Macular Degeneration: Who’s at Risk?

Risk factors for developing macular degeneration include both environmental and hereditary components.  The actual cause of this disease is not known, but is multi-factorial.

Age-related macular degeneration (aka ARMD) is the most common cause of blindness in the United States of adults, particularly those approaching the age of retirement.   Until relatively recently, the actual cause was not entirely known, and it still is not fully understood.

Hereditary/genetic factors which are uncontrollable

  • Age is the number one risk factor to consider when discussing ARMD.  It is the most common cause of blindness in those over the age of 60, and affects one third of adults over the age of 70.
  • Gender is a factor in that females are more likely to be affected, but this is most likely due to their longer life expectancy.
  • Those with a family history of macular degeneration are at greater risk, especially if the relative is in the immediately family.
  • Caucasians are more at risk than any other races, most likely due to genetic background and pigmentation.
  • Light colored eyes have an increased risk of developing macular degeneration because the lesser amount of pigment in the eye exposes it to greater damage from UV radiation.
  • The presence of the disease in one eye increases the likelihood of getting the similar condition in the fellow eye.

Risks factors which are controllable:

  • Smoking increases the chances of developing macular degeneration by a factor of 2 to 5 times.  It is most likely associated with a decrease in oxygen made available to retinal tissue which has a high oxygen demand.
  • Prolonged exposure of ultra-violet and blue light damages retinal tissue directly and leads the production of metabolic byproducts which are detrimental to eye function and lead to macular degeneration.
  • Diets high in fat and cholesterol, and low in antioxidants and nutrients have a higher risk in developing macular degeneration.  Fats and cholesterol ultimately affect blood vessels and flow, and nutrients and antioxidants are important for retinal tissue function and the removal of free radicals detrimental to cell metabolism.
  • Obesity is a risk factor in that an individual with a body mass index (BMI) greater than 30 is 2.5 times more likely to have macular degeneration.
  • Individuals with high blood pressure have an increased risk for macular degeneration due of its effect on the blood vessels, in that there is narrowing and therefore, less circulation to the retina.
  • Exercise improves cardiovascular health, therefore improves eye circulation, and is felt to decrease the risk for macular degeneration.

What Should I Do If I am at High Risk for Macular Degeneration?

If you have determined that you are at an increased risk for age-related macular degeneration, it would be important to first get a complete eye exam to include a thorough retinal evaluation.  This would determine if you are truly at high risk and should take appropriate steps in changing your life style and be placed on nutritional supplements with high antioxidant content.  You may also be advised as to how to monitor yourself in order to detect the onset of the more sight threatening form of macular degeneration, which is more successfully treated in its early stage.

To get a thorough eye exam, you should contact you local ophthalmologist/retinal specialist.