The retina is the light-sensitive area at the back of the eye. The most sensitive part of the retina is the macula. The macula controls our central and fine detail vision so we can read words in a book for example.
The Macular Society website has more information on their page: What is the macula?
Medical retina is the area of eye care that manages and treats conditions of the retina.
How do I know if I need to see a medical retina specialist?
If your eyesight has got worse or changed, make an appointment at your local opticians. An optometrist at your opticians will make an assessment and decide if further tests are needed. If you do need to have further tests, a referral will be made to your local hospital eye service.
Who will I see?
Services are led by specialist consultants who are experts in medical retina. The consultants are supported by a team of specialist ophthalmologists, specialist nurses, optometrists, ophthalmic technicians, photographers, and non-medical injectors. Members of the team work together to provide the best care for patients through accurate assessment, diagnosis, and treatment. The Macular Society has this Who’s who in eye care section where you can read about the different eye care professionals you may see, and who can help.
Vitreoretinal surgery
Vitreoretinal surgery is the name given to any operation that treats problems with the eye’s retina, macula or vitreous which is the jelly inside the eye.
Some of the conditions of the retina detailed above, including retinal detachment and retinal tear, may require a vitrectomy. This when the vitreous is removed from the back of the eye and replaced with another substance – such as gas, clear silicone, air, or saline. This helps your eye keep its shape until your body begins producing the vitreous again.
Vitrectomies can be a way to take a biopsy of a tumour in the eye and are sometimes used to treat cataracts and dislocated lenses. An eye surgeon may use a vitrectomy to place a device or a drug-delivery system into the eye.
Some medical retina conditions are listed below:
This is complication of diabetes where blood vessels bleed and leak fluid into the retina. Over time, a persistently high blood sugar level can damage the blood vessels in three main stages:
- background retinopathy – tiny bulges develop in the blood vessels, which may bleed slightly but do not usually affect your vision
- pre-proliferative retinopathy – more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye
- proliferative retinopathy – scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina. This can result in some loss of vision
You will not usually notice diabetic retinopathy in the early stages, as it does not tend to have any obvious symptoms until it is more advanced. However, early signs of the condition can be picked up by taking photographs of the eyes during diabetic eye screening (see below). The main treatment for more advanced diabetic retinopathy is laser treatment.
An oedema is a swelling caused by a build-up of fluid. Macular oedema starts with leakage of fluid and blood in the macula which blurs the vision. Long term macular oedema can cause scarring of the macula which leads to permanent loss of central vision.
Like wet AMD, diabetic macular oedema can be treated with anti-VEGF drugs. VEGF, or vascular endothelial growth factor, is a substance that stimulates the growth of blood vessels. Anti-VEGF drugs treat diabetic macular oedema by stopping the leakage of fluid from the abnormal blood vessels. The drugs need to be delivered to the back of the eye by an injection.
This screening is done to monitor diabetic related changes in the eye. Such problems can lead to permanent sight loss if they are not treated early. If you have diabetes and are 12 years old or older, you will get a letter asking you to have your eyes checked once a year. There may be more than one place in your local area that offers this screening service, so choose the one most convenient for you. The letter will tell you how to book your screening appointment and give you more information about screening and the importance of attending regularly.
At your screening appointment, you will have your eyesight tested for your general level of vision, and eye drops will be put into your eyes to dilate your pupils so that the photographer can get good, clear images of your retina. These eye drops blur the vision for a few hours so you must not drive to your appointment. Pictures are taken of the back of the eye using a machine called a retinal camera. These are then sent to be assessed and you will get a letter in the post in a few weeks with your results.
This video shows what a typical screening appointment looks like:
This is a rare condition that might occur following an eye operation, procedures, or an injury to the eye. It is an inflammation of the inner eye, usually caused by an infection.
The Moorfields Eye Hospital has more information about endophthalmitis on its website.
This is when a thin layer of wrinkled scar tissue forms on the retina. Most epiretinal membranes happen when the vitreous (the jelly inside the eye) pulls away from the retina. This wrinkling of the retina can then cause distortion and blurring of your vision. Follow the links below for more information:
Retinal dystrophies are inherited (genetic) conditions that affect the cells in the retina (the back of the eye). Over time, the cells are damaged and stop working. The most common retinal dystrophy is Retinitis Pigmentosa. With this disorder, the first symptom is often trouble seeing at night (called night blindness) and over time this progresses to losing your peripheral vision and can advance to affect your central vision.
Watch this video about living with retinitis pigmentosa and getting a guide dog:
And this one detailing John’s story:
And Dave’s story:
Other retinal dystrophies can affect different parts of the eye. Follow the links below for more information:
This is a small tear that opens in the macula that affects your central vision but does not cause total blindness. It can be repaired with surgery. Follow the links below for more information:
Melanoma is cancer that develops from pigment-producing cells called melanocytes.
Most develop in the skin, but they can also appear in other parts of the body, including the eye.
Eye melanoma occurs when the pigment-producing cells in the eyes divide and multiply too fast, then produce a lump of tissue known as a tumour.
Treatment for melanoma of the eye depends on the size and location of the tumour.
Retinal detachment is when the retina completely pulls away from the back of the eye. It usually happens either due to trauma or the vitreous (the jelly inside the eye) pulling at the retina causing it to come away. Retinal detachment is usually treated with surgery. See vitreoretinal surgery further down this page.
A retinal tear may be treated with a laser to prevent it becoming a retinal detachment. The treatment, called laser retinopexy, forms scar tissue around the tear. This acts like a barrier to prevent the retina from detaching.
Follow the links below for more information:
There is also a video of Hilary telling her story of living with retinal detachment and getting a guide dog:
A retinal tear can happen when the retina remains attached to the back of the eye but the part that is torn may pull away. This is not as serious as a retinal detachment, however if you have a retinal tear, you may need treatment to prevent retinal detachment.
A retinal vein occlusion (RVO) is when a vein in the retina gets blocked and causes blood and other fluids to leak into the retina. This causes damage to the retina that can affect vision. There are two types of vein occlusions, branch and central, with the latter being the more serious.
RVOs can be treated with anti-VEGF drugs. VEGF, or vascular endothelial growth factor, is a substance that stimulates the growth of blood vessels. Anti-VEGF drugs can treat this condition by stopping the leakage of fluid from the abnormal blood vessels. The drugs need to be delivered to the back of the eye, and this is currently done by injection into the eye.
Follow the links below for more information:
Uveitis is inflammation of the layers of the eye called the uvea. There are three types of uveitis:
- Anterior or iritis. This starts quickly and affects the front of the eye. It can cause redness and pain and is the most common type of uveitis.
- Intermediate uveitis affects the middle layers of the eye. It can cause floaters and blurred vision.
- Posterior uveitis affects the back of the eye. It can cause changes and blurring of vision.
Uveitis is usually treated with steroid eye drops. For intermediate or posterior uveitis, steroid injections may be needed if the eye drops don’t work. Sometimes, you need immunosuppression for persistent uveitis.
Follow the links below for more information: