Q & A on Retina Problems and Retinal Disease

Q: I had detached retinas in both eyes. I regained sight in my right eye but not in my left eye. I was wondering if there are any new procedures to help me. I have a lot of trouble with glare, and my left eye lid has begun to droop (congenital ptosis). I was told that it would not be a good idea to get an eye transplant, but I feel that there must be something that can be done. If you have any information for me I would really appreciate it. — C.T., New Mexico

A: Longstanding retinal detachments are typically not reparable, even with the newer techniques of retina surgery. There is no such thing as an eye transplant, only a cornea transplant, and this wouldn't help the retinal detachment. Tinted contact lenses or dark glasses can sometimes help the glare. — Dr. Slonim

[Read more about retinal detachment.]

Q: In 1972 I was accidentally shot in my left eye with a BB. Cataracts formed in the eye, and in 1976-77 were removed. Would a lens transplant help get my vision back? As of now I can see maybe 5 percent of light. The last time I went to an eye doctor, he said I also had a detached retina in the left eye. Since I don't use the left eye, is there any need to reattach the retina? — G.G., Arkansas

A: If the retinal detachment is the cause of the decreased vision (as I expect it probably is), then a lens implant will not help the vision. Retinal detachment surgery 28 years after the injury will probably not be successful. — Dr. Slonim

Q: How does diabetes affect your eyes? — L.L., Connecticut

A: Diabetes causes problems in the retina with what are collectively called microvascular abnormalities. The small blood vessels develop microaneurysms and leak blood. New blood vessel growth (neovascularization) occurs. Unfortunately, these blood vessels are weak and also leak. These leaks (hemorrhages) can cause irreversible damage to the retina, with subsequent vision loss.

Patients with controlled diabetes do better than those with uncontrolled diabetes. However, even the diabetic who is under perfect control can still develop diabetic retinopathy — hence, the need for yearly retinal exams. — Dr. Slonim

[Read more about diabetic retinopathy.]

Q: I had a retinal detachment some years ago that was mended with a "buckle." Now my vision is blurry sometimes, good other times. I also have allergies. What do you think causes the blurriness? — H.L., Arizona

A: It could be a number of things. Need some background and medical/surgery history. Could be a cataract. After all, you did have a scleral buckle in the past. — Dr. Slonim

Q: My eye doctor said I have a nebus and is sending me to a specialist. What is a nebus? — J.A., Florida

A: Probably nevus, which is the same as a pigmented freckle. Typically seen on the retina. The specialist will just offer an opinion or possibly photograph it to follow it in the future (a picture is worth a thousand words).

Just like any pigmented freckle on the skin, we watch pigmented retinal nevi to make sure they don't change their characteristics (e.g., size, shape, elevation, etc.) — Dr. Slonim
 

Q: I was born deaf due to maternal rubella. I was told that my iris color has flaked off because of the disease. I would like to know more information on that. — C.E.M., Georgia

A: Typically rubella causes a retinitis (inflammation of the retina) with a "salt-and-pepper" appearance in the retina, which represents a mottling of the retinal pigment epithelium (pigmented layer below the retina). This condition may not affect vision at all. I am unaware of iris color changes as a result of rubella. — Dr. Slonim

Older people are more likely to develop macular holes, which form in the inner back portion of the eye (retina) in the macula, where fine focusing occurs. It's unclear why macular holes develop, but they may result from vascular disease or shrinkage of the eye's interior gel-like substance (vitreous) that continuously pulls away from and stresses the retina.

Q: Can age cause your eye to have a hole in it behind the cornea? — Laura, Alabama

A: The hole "behind the cornea" is the pupil, which is an opening in the iris that allows light to pass through to the retina. Retinal holes are possible and occur with a greater frequency as we get older. Small holes in the macula (area of central vision) can seriously affect one's central vision while the peripheral portion of the retina remains intact and normal. — Dr. Slonim

Q: I have an eye disease called juvenile X-linked retinoschisis, plus congenital horizontal nystagmus. Could you give me any information on it? — R.R., Ontario, Canada

A: Retinoschisis is a splitting of the internal layers of the retina. The disease juvenile X-linked retinoschisis refers to a condition that is hereditary and usually presents with decreased vision during the first decade of life. Frequently the splitting of the retinal layers occurs in the central retina (foveal area) and also in the periphery.

A nystagmus is a rhythmic (sometimes jerky) movement of the eyes. Congenital horizontal nystagmus refers to a movement which is in the horizontal plane (to the left and right) that is present at birth or found very early in life. — Dr. Slonim

Q: My left eye is seeing straight lines as wavy. The vision in that eye also tends to have blind spots come in and out, like things are morphing. What is this condition, and is there a treatment for it? — R.Z., California

A: If straight lines are wavy, then you need to see an ophthalmologist (probably a retinal specialist) to rule out a problem in your macula or other ocular structures. — Dr. Slonim