Macular Edema: Macular edema is swelling in part of the retina (the light-sensitive layer of tissue at the back of your eye). People with macular edema may have blurry vision, but treatment can help reduce the swelling and prevent vision loss. The macula is surrounded by many tiny blood vessels, anything affecting them, such as a medical condition affecting blood vessels elsewhere in the body or an abnormal condition originating in the eye, can cause macular edema. Retinal blood vessel obstruction, eye inflammation, diabetes, and age-related macular degeneration have all been associated with macular edema. The macula may also be affected by swelling following cataract extraction, though typically this resolves itself naturally. Treatment seeks to remedy the underlying cause of the edema. Eyedrops, injections of cortisone around the eye or laser surgery can be used to treat a macular edema. Recovery depends on the severity of the condition causing the edema.
Retinal Tear / Detachments: In general, retinal detachments are classified based on the cause of the detachment: rhegmatogenous, tractional, or exudative. Rhegmatogenous retinal detachments are the most common type. They are caused by holes or tears in the retina that allows fluid to pass through and collect underneath the retina, detaching it from its underlying blood supply. Retinal tears can develop when the vitreous gel separates from the retina as part of aging or in patients with abnormal thinning in the peripheral retina (lattice degeneration) or occasionally from trauma. Retinal tears often present with acute onset of flashes and floaters. Untreated retinal tears may progress to a retinal detachment. Tractional retinal detachments are caused by scar tissue that grows over the retina and pulls the retina off the back wall of the eye. This type of retinal detachment may occur from diabetes or other conditions. Exudative retinal detachments form when fluid leaks out of blood vessels and accumulates under the retina. This type of retinal detachment is uncommon and can occur in eyes with abnormal inflammation, tumors, or excessive leakage from abnormal blood vessels. The goal of treatment is to reattach the retina to the back wall of the eye and seal the tears or holes that caused the retinal detachment. Several methods can be used to repair a retinal detachment:
Scleral buckle: In this surgery, a silicone band is placed outside the eye wall of the eye near the retinal tear in order to close the tear. The tear is treated with a freezing probe to induce controlled scarring around the tear and permanently seal it. A small gas bubble may be placed in the eye to help seal the retinal break.
Vitrectomy: In this surgery, three small incisions are made in the white part of the eye and fine instruments are used to remove the vitreous gel that fills the eye and drain the fluid from under the retina. The surgeon may then use a laser or a freezing probe to seal the retinal breaks. The eye is then filled with a gas bubble or silicone oil to hold the retina in place while it heals.
Laser: When a retinal tear is not associated with a detachment or the retinal detachment is small, laser may be used to wall off the detachment to prevent it from spreading. Based on the characteristics of the detachment, a retina specialist can determine which approach is most appropriate. In general, retinal detachment repairs succeed in about 90% of the time, though sometimes more than one procedure is required to successfully put the retina back into place. The visual results depend on each patient’s preoperative vision and other factors that differ between individual patients. In general, when the center of the retina has not detached before surgery, the post-operative vision tends to be similar to the pre-operative vision. If the central retina is detached prior to surgery, successful re-attachment often leads to vision improvement, though some degree of permanent vision loss may occur.