Retinal Conditions

Diabetic Retinopathy & Macular Degeneration

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Diabetic Retinopathy

Diabetes can affect the blood vessels in the retina, causing them to become either blocked or leaky, which can cause loss of vision in some cases.

The risk of this damage increases with:

  • Increased duration of diabetes
  • Higher average blood sugar levels (poor diabetic control)
  • High blood pressure and cholesterol
  • Smoking

People with diabetes should have their eyes checked regularly by an eye care professional with experience in this area, as early detection and appropriate treatment can prevent vision loss.  They should also minimise their risk by having regular visits with their General Practitioner, to monitor and minimise the above risk factors.

Macular Degeneration

The macula is the central area of the retina, the thin layer of tissue at the back of the eye with the light sensitive cells essential for our vision.  The macula is the specialised area in the central retina that is responsible for our detailed, fine central vision for tasks including reading.

Macular degeneration is a group of conditions that cause damage to this area, resulting in loss of detailed vision, but in which peripheral or side vision generally remains preserved.  It is a leading cause of blindness in Australia.

The main risk factor for Macular Degeneration is age.  Other risk factors include family history of Macular Degeneration, smoking, high blood pressure and cholesterol.

There are two main types of macular degeneration – wet and dry.  In Dry MD, the retina and underlying tissues gradually show signs of wear and tear, resulting in vision deterioration that is usually slowly progressive.  There is no currently available treatment, but research is continuing.

In Wet MD, abnormal blood vessels form under the retina that can leak fluid and bleed, which distorts vision and damages the light sensitive cells of the macular region.  Untreated, Wet MD often results in a rapid deterioration in central vision.  Unlike Dry MD, however, treatment is often possible.  Usually this involves a series of injections to stop the leakage from the abnormal vessels.

Ophthalmologists are well trained in detecting and treating macular degeneration, giving the best chance of preserving vision.

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Symptoms of floaters (small dark shadows that appear to float in your vision) and flashes of light with no apparent source can result from degeneration of the vitreous, which is the jelly-like substance in the back part of the eye, just in front of the retina.  The vitreous is clear and quite solid when we are young, but begins to break down as we get older, forming liquid pockets within it.  Sometimes as it breaks down, small clumps of connective tissue can cast shadows on the retina, causing floaters.

Often, the vitreous degenerates to the point that it ‘collapses’ on itself.  When this happens, the thicker outer part of the vitreous can peel away from the retina (known as a ‘vitreous detachment’), as the liquid pockets move behind the main part of the vitreous.  In most cases, this causes no problems (other than the nuisance value of the floaters).  In a small number of patients, the vitreous may tear a small hole in the retina as it peels away.  When this occurs, fluid can seep through the hole and under the retina, resulting in a ‘retinal detachment’, which can cause loss of vision.

Prompt detection and treatment of a retinal tear can prevent progression to a retinal detachment.  Treatment usually involves application of laser around the tear, to prevent fluid from spreading under the retina.  Therefore, anyone with the following symptoms should have their eyes examined promptly by an eye care professional:

  • New onset of flashing lights, especially if accompanied by new floaters
  • A sudden increase in the number of floaters seen in your vision
  • A dark shadow or curtain in your peripheral, or side vision. This can be a sign of a detachment developing, and is an urgent problem, as it can cause permanent reduction if the detachment spreads to the central vision, even if subsequent surgical repair is successful.
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