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Symptoms

Symptoms of retinal disease

img_symptomsSome symptoms of retinal problems are common to various retinal diseases. This means that, before you are diagnosed, a particular symptom does not necessarily point to a specific retinal disease. Your retina specialist will be able to determine which retinal condition you are experiencing. It’s important to know that changes in vision in one eye may go unnoticed if the other eye has good vision and compensates for the eye with retinal challenges. That is just one reason both eyes need to be tested separately to detect any changes or issues.

Understanding retinal disease

The retina is a thin sheet of nerve tissue lining the back wall of the eye. It is the part of the eye that senses light, thereby enabling you to see. Every eye contains something called vitreous gel (also known as vitreous humor), a clear gel consisting primarily of water, that fills most of the inside of the eyeball. One of the main functions of this gel is to allow the eyeball to maintain its round shape without collapsing. Vitreous gel also helps hold the retina in place against the interior wall of the eyeball.

Floaters and flashes

Floaters are small moving spots in a person’s vision caused by shadows cast onto the retina. These shadows are created by cells or other material causing opacities (blockages of light) within the vitreous gel. Although these objects look to you like they are in front of your eye, in fact they are floating inside it. Floaters can have different shapes, such as dots, circles, or cobwebs. Floaters often develop later in life when the vitreous gel begins to shrink and to pull away from the back of the eye wall. This problem is called a posterior vitreous separation.

Continued shrinkage of the vitreous gel can cause a tugging or traction on the retina that produces intermittent flashes of light. A flash is a similar sensation to having been bumped in the eye and seeing “stars.” Any patient with a sudden new onset of floaters or flashes of light should have their retinas examined to determine what is causing these problems.

In some patients, continued pulling of the vitreous gel can damage the retina, producing problems such as a retinal tear or retinal detachment.

If the retina tears, fluid can seep behind the retina through the opening caused by the tear. The gradual accumulation of fluid can cause a more dramatic separation of the retina from the eye wall, which is called retinal detachment.

Diabetic retinopathy is a serious eye disease that can occur in people with diabetes.Patients with elevated blood glucose for prolonged periods of time often develop damage to the retinal blood vessels that supply blood to the retina. The damage to these vessels can cause abnormal bleeding in the eye, swelling of the retina, poor blood flow to the retina, and retinal scars.

Abnormal bleeding, called vitreous hemorrhage, occurs in the central cavity of the eye and can cause floaters and flashes. Although vitreous hemorrhage is often caused by advanced diabetic retinopathy, other retinal conditions that can lead to vitreous hemorrhage as well.

A thorough retinal examination should be undertaken to determine the cause of any new floaters or flashes, and to ensure that the correct treatment and management takes place.

Metamorphopsia (distortion of vision)

The macula is the center of the retina and is responsible for our fine vision, which we used to read and recognize faces. Many conditions affect the macula, such as age-related macular degeneration, diabetic macular edema, macular hole, and macular pucker.

Very often, the earliest symptom produced by these conditions is a distortion of the vision, rather than visual loss. For example, a telephone pole might look curved or bowed rather than straight. A retinal specialist should evaluate new onset metamorphopsia as soon as possible. One can test themselves for metamorphopsia by using an Amsler grid at home.

Decreased central or peripheral vision

Any sudden drop in a patient’s visual ability may be a symptom of any number of retinal diseases. If the disease process is located in the central portion of the retina, the patient will notice an inability to use the eye for reading or other detail-oriented tasks.

If the retinal pathology is in the corner of the retina, a patient will experience a gray or black “veil,” or curtain, obscuring any portion of the side vision. This symptom is especially significant if the area of peripheral vision loss appears to be moving towards the center, because it may be a sign of retinal detachment.

Prompt retinal evaluation is recommended.