What is a Retinal Specialist?

A retinal specialist is an ophthalmologist who has specific education and training to become a ‘subspecialist’ in the retina, a practice called “vitreoretinal medicine.”

As an ophthalmologist they can detect and treat ALL eye diseases, however, they have chosen to focus on this very important part of the eye.

Everyone should know what the retina is, as it’s so important to the most wonderful sense, your eyesight.

The retina is the part of your eye that captures light, and through a series of complex electrical signals which are sent to your brain, creates images. And that’s how we see the world.

Simple right? Well, it is certainly not that simple. It takes years of study to fully comprehend the intricate workings of the retina and the eye.

Retinal specialists have extensive education and training before they can practice vitreoretinal medicine.

This includes:

  • Medical school – 4 years
  • Internship – 1 year
  • Ophthalmology residency – 3 years
  • Retina-Vitreous fellowship – 2 years

After all this training they are now able to treat both surgically and medically vitreoretinal diseases.

Retina, the key to healthy vision

One of the leading causes of blindness in America is due to retinal problems. So, this subspecialty of ophthalmology is very important to the visual health of millions. Ophthalmologists devote their lives to treating, preventing, and curing blinding eye diseases.

They need all this training because the surgical procedures they perform are the most delicate surgeries in the world. Working very small spaces of the eye cavity they operate on tissue thinner than a butterfly’s wing.

The field of retinal medicine has advanced greatly. Retinal specialists now have to highly innovative tools equipment and treatments to manage conditions that were once caused blindness including age-related macular degeneration and diabetic retinopathy.

The Vitreous Body and Vitrectomy

The practice is called vitreoretinal medicine in reference to the vitreous body or vitreous humor, the clear gel that fills the hollow space (vitreous cavity) between the lens and the retina. The vitreous cavity makes up about two-thirds of the volume of the eye giving your eye its round shape.

This is an important part of retinal medicine as the retina is behind the vitreous body. A surgical procedure called a “vitrectomy” may be done by a specialist to:

  • Provide better access to the retina by removing the vitreous humor
  • Address abnormal pulling (traction) by the vitreous causing retinal detachment and other retina issues.
  • Treat hazy vision caused by clouding (vision-blocking vitreous opacity)
  • Diagnose severe eye infections
  • Place a therapeutic device in the eye such as drug-delivery devices or a glaucoma drainage device

How does a retinal specialist do a Vitrectomy?

Your retinal specialist uses small instruments to cut the vitreous humor and suction it out to allow for repairs. The vitreous gel will then be replaced with a saline solution or other material after the surgery to help hold the retina in position. As time goes on the natural fluids from your eye will replace the temporary fillers.

The procedure is not painful, your eye may be a little sore after, but over-the-counter pain relievers can be enough.

Eye diseases vitreoretinal medicine treats

Diabetic Retinopathy

Diabetes affects the body’s ability to regulate blood glucose levels. Uncontrolled blood sugars affect the circulatory system all over our bodies and cause significant damage. Our smallest vessels are at the highest risk for this damage, which is especially true for the vessels in the retina.

Damage to the capillaries (small blood vessels) causes fluids to leak and become blocked, which can lead to detachment of the retina.

Diabetic Retinopathy is one of the leading causes of blindness in the United States. It is a progressive disease, the longer a patient has uncontrolled blood sugars the higher their risk is for diabetic retinopathy. Patients with diabetes should be checked yearly with a comprehensive diabetic eye exam.

Macular Degeneration

Macular Degeneration or age-related macular degeneration (AMD) is a disease that destroys your sharp central vision. The macula is the portion of your retina that has a very high concentration of cones, light-sensitive cells responsible for detailed sharp central vision. AMD is a leading cause of vision loss in Americans 60 and older.

There are two types Macular Degeneration, wet and dry

Wet macular degeneration happens when abnormal blood vessels grow under the macula and leak blood and fluid causing cells in the macula to die. Blurred vision is a common early symptom.

Dry AMD happens when the light-sensitive cells in the macula slowly break down gradually causing you to lose your central vision. A common early symptom is straight lines appear crooked.

Regular comprehensive eye exams can detect macular degeneration before the disease causes vision loss.

Retinal Vascular Disease

Retinal vein occlusion (RVO) is the second most common retinal disease after diabetic retinopathy. It is like a stroke in the eye. The word “occlude” means to stop up or obstruct. Conditions such as high blood pressure, high cholesterol, and diabetes can cause atherosclerosis (thickening of the artery walls).

With RVO the main vein in the retina which takes blood back to the heart from the eye is blocked, causing the walls of the vein to leak blood and fluid into the retina. When this fluid collects in the macula vision becomes blurry without treatment you can quickly lose much of your central vision.

Retinal vein occlusion requires prompt diagnosis and treatment. If untreated patients may end up with a scar in the center of the retina resulting in a dark spot in the center of their vision. This can make it impossible to do things such as read a book or drive a car.

Intraocular Inflammation (Uveitis)

Uveitis is an inflammation that affects the inside of the eye. This condition can cause a range of eye problems depending on the part of the eye that is most affected.

Uveitis is inflammation of the luvia, a structure that has three different segments in your eye. The Iris, the colored part of the eye, the ciliary body, which is the muscle, and the choroid, a pigmented inner woven layer of blood vessels that lies behind the retina.

Uveitis may have a multitude of causes. It can occur as a result of infection, injury, or an autoimmune or inflammatory disease. Often a cause can’t be identified. Uveitis symptoms are variable ranging from redness and pain, inability to tolerate bright light, and decreased vision.

Uveitis can be serious, leading to permanent vision loss. Early diagnosis and treatment are important to prevent complications and preserve your vision.

 Intraocular Tumors

This is cancer that affects the eye. There are two kinds of tumors of the eye. Primary tumors that involve the eye such as ocular melanoma and an ocular lymphoma and secondary tumors that can resolve from metastasis of tumors elsewhere in the body, which are the most common. Ocular tumors can be benign (it can grow but not spread) or malignant (it can grow and spread). These cancers need to be found early to have effective treatment.

Retinal Tears and Detachment

Retinal detachment begins with a retinal tear, which is followed by a small detachment that progressively increases in size as the retina detached from the wall of the eye. The retina then loses function and you lose part of your vision.

What causes this is as we age the vitreous body becomes more liquid. In a healthy gel state, the vitreous is loosely attached to the retina, so when the eye moves the vitreous moves away from the retina. When more liquid, the vitreous can and tear the retina, allowing fluid to pass through the tear and lift the retina off the back of the eye.

When should you see a Retinal Specialist?

It’s important to pay attention to any changes in your vision and find care quickly. Seek immediate medical attention if you see any of these warning signs of potentially serious retinal disease. See an ophthalmologist who is a retinal specialist or who can exam you and refer you to a specialist if needed.

Some of the retinal diseases mentioned here and others share some common signs and symptoms. Watch for these signs of retinal disease:

  • You see floating specks or cobwebs
  • Blurred or distorted vision (straight lines may look wavy)
  • Trouble with the side vision
  • Lost vision

Risk factors

Risk factors for retinal diseases might include:

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

Schedule a comprehensive eye exam

If you don’t have an eye doctor, contact Arizona Retinal Specialists. We can certainly help preserve or improve your vision. Call us at 623-474-3937 (EYES) to schedule a comprehensive eye exam at a location near you. Don’t delay as early diagnosis can save you from eye disease.


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