Understanding Retinal Conditions: Causes, Symptoms, and Treatment Options
The eye can be compared to a camera with many delicate parts, each needing to function perfectly to allow an image to be captured. The retina acts like the film in a camera. It is a thin structure measuring less than 0.5mm in thickness which lines the inside of the eyeball.
The retina has millions of different cells, all working in harmony to capture light rays and convert them into electrical signals ready to be sent to the brain for processing. A healthy retina is therefore crucial for good sight.
Many conditions can affect the retina, ranging from structural issues such as retinal detachment, macular holes, and epiretinal membranes, to systemic conditions like diabetes and hypertension. Early recognition of problems is key, because the earlier they are caught, usually the better the visual outcome.
In this article, we’ll cover key retinal conditions – such as floaters, retinal holes, and retinal detachment, along with their diagnosis, available treatment options, and practical advice for living with retinal disorders.
What Is the Retina and Why Is It Important?
When viewed under a microscope, the retina is made up of millions of cells in a layered meshwork each with a different role to ensure it functions perfectly. Light enters through the front of the eye, passes through the lens and the vitreous cavity, and finally reaches the retina at the back.
This is where the crucial process of generating electrical signals occurs. Once formed, these signals travel through the optic nerve where they are transmitted rapidly to the visual cortex of the brain for processing, allowing us to perceive images.
At the centre of the retina is an area known as the macula – a region often mentioned in connection with diseases such as macular degeneration and macular holes. The macula is responsible for fine central and colour vision. People with a poorly functioning macula can report central visual defects such as reduced vision and distortion. In severe macular disease, vision can be reduced to near blindness.
Common Retinal Symptoms
The main symptoms which suggest a problem with the retina are as follows: reduced vision, distorted vision, areas of missing vision, peripheral shadows, flashing lights and floaters. Many of these symptoms are often non-specific, and therefore any new symptoms and visual changes should be promptly assessed by a consultant ophthalmologist who specializes in retinal surgery.
Early assessment is strongly recommended because the earlier identification of a problem usually results in better long-term vision. For instance, a retinal detachment identified and treated on the first day can often have a final vision which is the same as it was before the retinal detachment occurred. In contrast, waiting and diagnosing a retinal detachment after a couple of weeks can sometimes result in irreversible loss of sight, leaving the affected eye able to see only hand movements and unable to read letters again.
Risk factors vary depending on the retinal condition, but individuals who are shortsighted (myopic) generally have a higher risk of developing problems such as retinal detachment.
Floaters
Floaters are a common visual occurrence, describing the sensation of seeing small things drifting across the field of vision. Different people describe floaters differently: some mention seeing lots of tiny flies, whereas others refer to their floaters like a net curtain.
There are many possible causes of floaters, some more serious than others. Firstly, it is quite normal to develop floaters as the vitreous jelly inside the eye changes with age, typically in one’s 50s. However, in short-sighted (myopic) patients, these vitreous floaters can occur in younger life.
Floaters can also result from retinal tears or bleeding within the eye – both potentially serious events that may precede a retinal detachment, which is a sight-threatening emergency. More rarely, floaters can be a sign of inflammatory eye disease (known as uveitis) or very rarely, some cancers.
Diagnosis and Treatment of Floaters
Because it’s difficult to determine the cause of floaters without specialist assessment, it’s strongly advised to visit the London Lauriston Clinic and consult a retina specialist for a thorough examination. A comprehensive eye examination, including a dilated examination of the retina, is essential to rule out any concerning causes.
Floaters may also appear alongside other symptoms such as flashing lights, reduced vision or distorted vision. If these occur, prompt eye assessment is crucial.
Retinal Hole (Retinal Tear)
A retinal hole is a small break in the light-sensitive tissue at the back of the eye. It often develops when the clear gel inside the eye (the vitreous) pulls on the retina as it naturally shrinks with age.
It is more common with age, in people who are nearsighted (require glasses for distance), after eye injuries or surgeries, and in those with a family history of retinal problems.
Some people have no symptoms, while others may suddenly notice new floaters, flashes of light, or a dark shadow in their vision.
If left untreated, a retinal hole or tear can allow fluid to collect under the retina, causing it to lift away from the back of the eye. This condition, called retinal detachment, can lead to permanent vision loss if not treated promptly.
Diagnosis and Treatment of a Retinal Hole
An eye specialist can check the back of your eye with drops that make the pupil bigger, this is called a dilated eye exam, to see if there are any retinal holes or tears. Early detection is vital, as a simple laser procedure can often prevent retinal detachment.
Seek immediate medical attention from an ophthalmologist at the London Lauriston Clinic if you experience sudden floaters, flashes of light, or a dark shadow across your vision.
Retinal Detachment
Retinal detachment happens when the retina, the light-sensitive layer at the back of the eye, separates from the wall of the eye. It often starts with a retinal hole or tear that lets fluid slip underneath.
There are three main types:
- Rhegmatogenous: caused by a tear or hole.
- Tractional: from scar tissue pulling on the retina, often linked to diabetes.
- Exudative: from fluid buildup due to inflammation or other diseases.
Retinal detachment can result from untreated retinal holes or tears, eye injury, severe nearsightedness, previous eye surgery, or diabetic eye disease.
Common symptoms include new floaters, flashes of light, a dark curtain or shadow across vision, and sudden changes in sight.
Diagnosis and Treatment of Retinal Detachment
Once the retina detaches and affects the central vision, the light-sensing cells can stop working and die. The longer it stays detached, the greater the risk of permanent vision loss.
Retinal detachment is an emergency – prompt retinal detachment treatment is essential to save sight and prevent permanent vision loss.
How Retinal Problems Are Diagnosed
You can’t examine your own retina at home as you would your skin, which is why only an eye specialist using a specialised microscope can properly assess it.
For these reasons, it is important to have a regular (ideally yearly) eye check with an expert at a trusted health clinic, such as the London Lauriston Clinic. This can be with an optician or with a retinal specialist depending on your preference.
Regular monitoring is important, as early detection of problems often leads to better long-term visual outcomes. In addition to routine check-ups, any new symptoms such as floaters, flashing lights, shadows in the vision, or reduced or distorted vision may indicate a retinal problem and should therefore be promptly assessed by a specialist.
Treatment Options
There are many retinal conditions, each requiring a different approach to treatment.
In general, retinal diseases are either managed with laser, surgery, or eye injections. Patients with floaters can choose to undergo laser or retinal surgery to help improve their symptoms. Conditions such as retinal detachment and macular hole usually require surgery, with significantly better outcomes when diagnosed and treated early.
Retinal specialists also provide expertise in conditions such as age-related macular degeneration and diabetic retinopathy, which are commonly treated with intraocular injections.
Living With Retina Conditions
Retinal conditions can cause severe visual loss or even be asymptomatic. For those with visual loss, the central or peripheral vision might be affected, depending on the location of the problem.
Some retinal diseases can impact your ability to drive, in line with UK DVLA standards. The first step is to identify any retinal condition and then determine how it might affect a person in day-to-day life, as well as whether the condition is progressive or requires monitoring.
As retinal specialists, we provide expert advice on lifestyle adjustments, driving safety, and whether vitamin supplements may support your specific condition and overall eye health. Maintaining regular communication with your eye specialist ensures you receive timely care and know where to turn in an emergency.
When to See a Specialist
If you experience sudden floaters, flashes of light, blurred or distorted vision, or a dark shadow in your sight, it’s essential to seek urgent evaluation by a retina specialist. Early diagnosis greatly increases the chance of preserving vision.
For expert diagnosis, personalised treatment, and ongoing eye health monitoring, visit the London Lauriston Clinic, a trusted health clinic in London offering specialist care for retinal conditions, from floaters and retinal holes to complex detachments.
This article was written by Miss Anna Grabowska and Mr James Neffendorf, consultant ophthalmologists and vitreoretinal surgeons at London Lauriston Clinic.
