Treatments for Retinal Disease
Eye Injections for retinal disease
We perform eye injections for a number of retinal disease including Age Related Macular Degeneration, Diabetic Retinopathy and Retinal Vein Occlusion. Several of the medications, termed anti-VEGF agents, work by causing abnormal blood vessels to shrink and regress or by reducing abnormal leakiness of blood vessels. Examples include Avastin, Lucentis and Eylea. Other medicines injected into the eye include steroids, which work by reducing inflammation in the eye.
Having an eye injection is usually not as bad as it sounds. We numb the eye with anaesthetics first and clean the eye with an antiseptic. The antiseptic can feel like having shampoo in the eye, which is often the most uncomfortable part of the procedure. Once the eye is numb, the injection with a very small needle through the white part of the eye usually produces minor discomfort.
After the eye injection, the eye may be red from irritation or a limited amount of blood that accumulates near the injection site like a bruise. This can be very minor or very noticeable. It will fade over a week or two. The eye may be irritated and scratchy for the first day, but usually is much improved by the day after the procedure. If the eye becomes more painful or the vision becomes more blurry following the day of the injections you should call the office and may need to be evaluated. Very rarely, vision threatening issues such as severe infection can occur and requires prompt evaluation and treatment.
Laser Surgery for retinal disease
A number of laser procedures are used in treatment of retinal disorders. Lasers can be used for conditions such as Age Related Macular Degeneration, Diabetic Retinopathy, Retinal Vein Occlusion as well as to treat retinal tears.
Laser procedures are usually performed in the office. Most laser procedures are painless or only minimally uncomfortable. Occasionally the laser procedure can be more uncomfortable. Sometimes an injection of an anesthetic is used to make the eye comfortable for the procedure.
Sometimes a laser procedure will be done in one visit, other times it may be performed over several visits.
Vitrectomy Surgery for retinal disease
The primary surgery used in the treatment of retinal disease is vitrectomy. In this procedure, the gel from the center of the eye is removed and replaced with saline (salt water). Once the gel is removed, natural saline fluid that is continuously being made inside the eye takes the place of the gel. Sometimes a temporary gas bubble is placed into the eye at the end of surgery. Rarely a silicone oil is place into the eye that helps to hold the retina in place. Silicone oil is often removed with and additional surgery 3 to 6 months later.
Vitrectomy surgery is utilized for a large number of retinal disorders. For example, blood and scar tissue can be removed from patients with advanced diabetic eye disease. Other disorders treated with vitectomy include removal of epiretinal membranes, closure of macular holes and treatment of retinal detachments.
Vitrectomy surgeries are currently performed at Ashland Community Hospital, where the very specialized equipment needed for this type of surgery is located. Several clinic appointments are required after surgery and these are usually performed at the Medical Eye Center. You will need to take eye drops for a month or more after surgery. If a bubble is placed in your eye during the surgery, you may need to position face down for part of the day for the first week or so after the surgery. Because severe pressure problems can occur if you travel to higher altitude with a bubble in the eye, you must not fly in an airplane or drive to higher altitude without specific instructions from your surgeon. Once the bubble is gone, no altitude restrictions apply.
If you require vitrectomy surgery, your surgeon will give you more information about what to expect.