Retina and Vitreous Service

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What is the macula?

The macula is the part of the retina or nerve tissue in the back of the eye that is responsible for our central fine vision. It is what allows us to see and decipher words on the page of a book or to make out the details on something smaller or a longer distance away.

What is a macular pucker and how can it affect my vision?

A macular pucker (epiretinal membrane) is a growth of clear tissue over the macula. Many of these membranes are found during examinations and do not produce any problems in asymptomatic patients. Some epiretinal membranes can contract on the surface of the macula, causing distortion in the retina and adversely affecting central vision.

What is a macular hole and how can it affect my vision?

A macular hole is a partial (lamellar) or full thickness loss of tissue in the central retina. It can lead to a progressive and permanent loss of a patient’s central vision, ultimately leading to a central black area blocking sight.

More information on macular degeneration

What is retinal detachment?

Comparable to the film in a camera, the retina is responsible for “creating” the images that we see. It is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain.

retinal detachment

When the retina detaches, it is lifted or pulled from its normal position. It separates from the back wall of the eye and is no longer connected to the layer of cells known as the retinal pigment epithelium. These cells are critical for the health of the retina. When detached, the retina degenerates and loses its ability to function. The center of the retina is called the macula, which is the only part of the eye capable of facilitating fine, detailed vision such as reading a recognizing faces. An untreated retinal detachment will spread to the macula. A detached macula can cause central vision loss.

In cases where small or large areas of the retina are torn, these tears or breaks can lead to retinal detachment if left untreated. If not promptly treated, a retinal detachment can cause permanent vision loss.

What are the retinal veins?

The retina is a very thin sheet of nerve tissue that lines the inside of the back of the eye. The macula, the central part of the retina, is responsible for our central vision. Much like other parts of the body, the retina and macula have arteries and veins.

  • Arteries transport oxygenated blood to the retina from the heart.
  • Veins transport blood without oxygen from the retina back to the heart.
  • Several small veins drain blood into the larger Branch Retinal Veins.
  • Four Branch Retinal Veins form the single Central Retinal Vein.
  • Proper functioning of the retinal veins is crucial for appropriate delivery of oxygen to the retinal tissue.

What is retinal vein occlusion?

A retinal vein occlusion (RVO) is a blockage of blood flow in one of the retinal veins. It can occur in either a branch retinal vein (branch retinal vein occlusion, BRVO) or in the central retinal vein (central retinal vein occlusion, CRVO). The occlusion causes bleeding in either one section of the retina (BRVO) or throughout the retina (CRVO) and can also produce swelling of the macula (macular edema). The region of the retina in which the blockage occurs will be deprived of oxygen (ischemia).

In severe vein occlusions, this oxygen deprivation can occur in the macula (macular ischemia). If a significant amount of ischemia occurs, new blood vessels may begin to grow on top of the retina (neovascularization).

Retinal vein occlusion is a major cause of vision loss in the United States and is more common in patients 65 years of age and older. BRVO is slightly more common than CRVO.

For more information on the importance of retinal health, visit our page on diabetic retinopathy.

Dr. Jeffery Stephens and Dr. Niraj Shah are fellowship-trained retinal surgeons. They specializes in caring for problems of the vitreous cavity and retina, including premature retinopathy, diabetic retinopathy, detached retinas, and macular degeneration.

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