Retina

The Northeast Florida Macular Degeneration and Diabetes Eye Institute

Dr. Pecoraro and his partners have established the first full-time center in Clay County dedicated to diseases of the retina. In the Institute, patient care is focused around management of complex eye diseases such as macular degeneration and diabetic retinopathy. Along with our highly trained staff, this specialty center offers the latest in diagnostic testing and treatment.

Please take some time to review the information provided for you on this page including the video animations of various eye diseases and their management.

Cystoid Macular Edema (CME):

Cystoid Macular Edema (CME) is a condition in which the macula develops microscopic swelling which can blur the central vision. CME most commonly develops following intraocular surgery but may be associated with a variety of vascular conditions such as macular degeneration, diabetic retinopathy or vascular occlusion. Treatments for CME depend on its cause. CME may be treated with medicated eye drops, injected medication, laser treatments, and surgery.

Diabetic Retinopathy:

Diabetic retinopathy is a potentially blinding complication of diabetes that can damage the retina. This disease affects half of all Americans diagnosed with diabetes. Diabetic retinopathy occurs when tiny retinal blood vessels become damaged and begin to leak fluid or blood resulting in blurred vision. Some patients may develop poor retinal circulation leading to abnormal blood vessel formation which can cause intraocular bleeding or retinal detachment. Diabetic retinopathy that is detected and treated early has the best prognosis. Careful blood glucose control is important. The doctors at Clay Eye Physicians and Surgeons will work closely with your doctor to manage and monitor your diabetes.

Epiretinal Membranes (Macular Puckers):

An epiretinal membrane, commonly called a macular pucker, is a thin film-like covering that can develop over the central retina known as the macula. This area of the retina is responsible for your clear central vision. Epiretinal membranes may lead to blurry or distorted vision. Some epiretinal membranes require vitrectomy surgery with removal of the membrane for improvement of vision.

Flashes and Floaters – Posterior Vitreous Detachments:

Flashes of light and floaters in the field of vision occur in healthy people, but may also be a sign of serious problems. If flashes occur suddenly, it may be a sign that the retina is torn. In this case, you should contact your doctor immediately. Floaters, usually due to a posterior vitreous detachment, are caused by particles that are floating in the vitreous gel and cast shadows on the retina. Floaters may naturally appear with increasing age. However, if floaters occur suddenly, it may be a sign that the retina is torn. You should contact your doctor immediately if you experience such sudden symptoms.

Macular Degeneration:

Macular degeneration is one of the most common eye diseases treated by the doctors at Clay Eye Physicians and Surgeons. Macular degeneration is associated with aging. It can destroy sharp central vision and is the leading cause of legal blindness among people over the age of 50 in the western world. In some individuals, tiny dot-like deposits, known as drusen, slowly accumulate beneath the macula. While these deposits usually do not cause visual loss directly, they indicate that a person is at risk for developing further problems with the macula. Atrophic or thin areas can develop in the macula which can lead to visual loss in the “dry” form of macular degeneration. In some patients, abnormal blood vessels may develop under the macula leading to the “wet” form of macular degeneration. If these vessels can be identified at an early stage, it may be possible to seal them with an injection of new medications developed for wet macular degeneration or other treatments. If you notice any new distortion or visual changes, it is critical to contact your eye care provider immediately.

Macular Holes:

Macular holes are just that, holes in the macula. The macula is the central portion of the retina that is responsible for seeing fine details clearly. Macular holes involve cellophane-like wrinkling of the macula. If the wrinkling is especially severe, it can stretch the macula and cause a hole to form. Many macular holes are treatable with vitrectomy surgery.

Retinal Tears and Detachment:

Retinal Detachment Fleming Island Retinal tears and detachment occur when the vitreous, a clear jelly-like substance that fills the eye, pulls from the retina and causes the retina to tear. The liquid that passes through the tear and settles under the retina results in separation of the retina from the back wall of the eye. The condition is termed a retinal detachment. An untreated detached retina usually causes blindness.

You should contact your doctor as soon as you develop the symptoms of retinal detachment. Symptoms include seeing flashing lights, new floaters, or a gray curtain move across your field of vision.

Retinal vascular diseases are common in people with high blood pressure, diabetes, and other factors that cause vascular disease throughout the body such as increasing age, high cholesterol, smoking, and hypertension. Retinal vascular diseases include retinal arterial macro aneurysm, retinal branch, and central artery and vein occlusion, diabetic retinopathy, and ocular ischemic syndrome. In simple terms, these are conditions that can restrict the blood flow throughout your eye structures and lead to vision loss or blindness. As a patient of Clay Eye Physicians and Surgeons, you will benefit from our doctor’s expertise and from our state-of-the-art diagnostic capabilities. Our doctors can help manage your eye condition, and we will work closely with your primary care physician as well.

Treatments

Avastin/Lucentis/Steroid Injections

Avastin, Lucentis, and steroids are all treatment options for age-related macular degeneration and retinal vascular diseases (blood vessel blockages including diabetic retinopathy). These agents work to block the growth of new blood vessels that may leak and contribute to vision problems. They are injectable medications that block the effects of Vascular Endothelial Growth Factor (VEGF) which is responsible for the growth of new blood vessels in the eye. VEGF is implicated in the development and progression of wet macular degeneration, diabetic retinopathy, and macular edema. VEGF promotes the growth of new abnormal blood vessels and increases the permeability of existing vessels leading to leakage. By blocking VEGF, Avastin and Lucentis can, in some cases, improve outcomes in patients with a broad variety of retinal and macular diseases.

Laser Treatment for Diabetic Retinopathy

Depending on the type of retinopathy you have, your doctor may recommend laser treatment. Laser treatment can be used to help reduce the swelling in your retina caused by leaky blood vessels. It can also be used to treat a more aggressive form of retinopathy, called “proliferative,” which can lead to bleeding into your eye, retinal detachments, and loss of vision.

Laser Surgery for Retinal Tears

Once a retinal tear or hole is identified and determined to be threatening to your vision, it is important to have it repaired prior to it progressing to a retinal detachment. A laser beam is focused on the area surrounding the tear, and small microbursts of the laser are emitted sealing off the tear to prevent it from spreading.