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«Uveitis Uveitis The uvea is the middle layer in the eye sandwiched between the retina (innermost layer) and the sclera (outermost layer). The uvea ...»

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Uveitis

Uveitis

The uvea is the middle layer in the eye sandwiched between the retina (innermost layer) and the sclera

(outermost layer). The uvea contains many blood vessels that carry blood to and from the eye. Uveitis is

inflammation of the uvea. Since the uvea nourishes many important parts of the eye, uveitis can damage

your sight.

Symptoms can include pain, “floaters,” blurriness, light sensitivity, and redness. Uveitis may develop

suddenly with redness and pain or with just a blurring of vision.

Causes of this condition include viruses like mumps, shingles, or herpes simplex; eye injuries; fungi or parasites; autoimmune diseases; and others. In most cases, the cause is unknown.

Uveitis is diagnosed by an examination of the eye. In addition, your ophthalmologist (Eye M.D.) may order blood tests, skin tests, or x-rays and also will want information about your overall health.

There are different types of uveitis:

Iritis With iritis, the uvea is inflamed near the front of the eye in the iris. Iritis has a sudden onset and may last up to eight weeks.

Cyclitis Cyclitis affects the muscle that focuses the lens in the middle part of the eye. It develops suddenly and lasts for several months.

Choroiditis This is an inflammation in the back of the eye. It can develop more slowly than the other forms of uveitis and last longer, although this is variable.

Because uveitis is a serious condition that can cause permanent damage to the eye, it needs to be treated as soon as possible. Eyedrops and pupil dilators reduce inflammation and pain. For more severe inflammation, oral medications or injections may be necessary. If uveitis is associated with other conditions like glaucoma or retinal damage, surgery may be required.

If you have a “red eye” that does not clear up quickly, ocular pain, or other significant symptoms, see your ophthalmologist as soon as possible.

]] file:///C|/Documents%20and%20Settings/Det/My%20Documents/M...tamadeeh/PatientResources/Retina_and_Vitreous/Uveitis.html1/8/2008 10:29:04 AM Stargardt's Disease Stargardt's Disease Stargardt’s disease is an inherited disease that affects the retina, the layer of light-sensitive cells lining the back of the eye. It usually becomes apparent between the ages of eight and 14. Boys and girls are equally susceptible and more than one child in a family can have it.

Stargardt’s disease begins with slightly blurry vision that gradually gets worse. By the late 20s, corrected vision is typically about 20/200, the level labeled legally blind. Remaining vision is good enough for most people to live fairly normal lives, though they will not drive, or read without using magnification devices.

A buildup of lipofuscin (fatty substance) in retinal cells is thought to cause Stargardt’s disease. The buildup typically happens in the central retina, or macula, where it resembles beaten bronze. Or it can occur in the side retina where it causes small white flecks. This form is called fundus flavimaculatus.

Angiography, a special photograph of the retina, may aid in the diagnosis. Although no specific medical or surgical treatment is available, eyeglasses and magnification help affected people adapt to the disease.

]] file:///C|/Documents%20and%20Settings/Det/My%20Documents/M...atientResources/Retina_and_Vitreous/StargardtsDisease.html1/8/2008 10:29:04 AM Retinoschisis Retinoschisis Retinoschisis is a genetic eye disease that splits the retina, the light-sensitive layer of cells lining the back of the eye. It occurs in two forms, one affecting young children, the other affecting older adults.

Both forms usually affect both eyes, though one eye may be worse than the other.

Because the disease is inherited on the X chromosome, childhood retinoschisis occurs in boys more than girls. It is usually detected because of poor vision.

Retinoschisis has different affects on the eye and vision depending on the location of the split. If the split retina involves the peripheral (side) retina, peripheral vision is lost. Retinal detachment is another risk associated with retinoschisis. More commonly, retinoschisis affects the macula, the area of the retina responsible for central vision. If the split retina is in this location, one loses central vision.

Peripheral retinoschisis is more common in adults and is usually caused by aging. In this case, it usually does not affect vision, but it can cause a retinal detachment. If detected early, a retinal detachment can be treated with surgery or laser therapy.

]] file:///C|/Documents%20and%20Settings/Det/My%20Documents/M...eh/PatientResources/Retina_and_Vitreous/Retinoschisis.html1/8/2008 10:29:04 AM Retinal Side Effects From Systemic Medication Retinal Side Effects From Systemic Medication The retina is a layer of light-sensing cells that line the back of the eye. As light rays enter your eye, the retina converts the rays into signals that are sent through the optic nerve to your brain, where they are recognized as images.

Certain systemic medications, which affect the entire body rather than one specific location, can sometimes affect the retina and lead to vision loss. If you are taking any of the medications below to treat other conditions, be sure to tell your ophthalmologist (Eye M.D.) so that your eyes can be examined frequently to check for potential damage and vision loss. Other drugs not listed can also have ocular side effects.





hydroxychloroquine, an antimalarial drug commonly used in the treatment of systemic lupus q erythematosus and rheumatoid arthritis;

niacin, also known as nicotinic acid or vitamin B3, used as both a vitamin supplement and a lipidq <

–  –  –

amitriptyline and imipramine, used to treat depression, sleep disorders, and neuropathic pain;

q corticosteroids, used to treat inflammatory disorders and for adrenal insufficiency;

q

–  –  –

Caught early, it is possible to prevent damage and perhaps even to reverse it, depending on the drug and on the particular case. It is not common for eyes to be damaged by these medications, so it is important to continue to take all medications that have been prescribed for you unless your doctor tells you to discontinue them.

]] file:///C|/Documents%20and%20Settings/Det/My%20Documents/...nd_Vitreous/RetinalSideEffectsFromSystemicMedication.html1/8/2008 10:29:04 AM Proliferative Diabetic Retinopathy Proliferative Diabetic Retinopathy Proliferative diabetic retinopathy (PDR) is a complication of diabetes caused by changes in the blood vessels of the eye. If you have diabetes, your body does not use and store sugar properly. High blood sugar levels create changes in the veins, arteries, and capillaries that carry blood throughout the body.

This includes the tiny blood vessels in the retina, the light-sensitive nerve layer that lines the back of the eye.

In PDR, the retinal blood vessels are so damaged they close off. In response, the retina grows new, fragile blood vessels. Unfortunately, these new blood vessels are abnormal and grow on the surface of the retina, so they do not resupply the retina with blood.

Occasionally, these new blood vessels bleed and cause a vitreous hemorrhage. Blood in the vitreous, the clear gel-like substance that fills the inside of the eye, blocks light rays from reaching the retina. A small amount of blood will cause dark floaters, while a large hemorrhage might block all vision, leaving only light and dark perception.

The new blood vessels can also cause scar tissue to grow. The scar tissue shrinks, wrinkling and pulling on the retina and distorting vision. If the pulling is severe, the macula may detach from its normal position and cause vision loss.

Laser surgery may be used to shrink the abnormal blood vessels and reduce the risk of bleeding. The body will usually absorb blood from a vitreous hemorrhage, but that can take days, months, or even years. If the vitreous hemorrhage does not clear within a reasonable time, or if a retinal detachment is detected, an operation called a vitrectomy can be performed. During a vitrectomy, the eye surgeon removes the hemorrhage and any scar tissue that has developed, and performs laser treatment to prevent new abnormal vessel growth.

People with PDR sometimes have no symptoms until it is too late to treat them. The retina may be badly injured before there is any change in vision. There is considerable evidence to suggest that rigorous control of blood sugar decreases the chance of developing serious proliferative diabetic retinopathy.

Because PDR often has no symptoms, if you have any form of diabetes you should have your eyes examined regularly by an ophthalmologist (Eye M.D.).

]] file:///C|/Documents%20and%20Settings/Det/My%20Documents/M.../Retina_and_Vitreous/ProliferativeDiabeticRetinopathy.html1/8/2008 10:29:04 AM Retinopathy of Prematurity Retinopathy of Prematurity Retinopathy of Prematurity (ROP) damages premature babies’ retinas, the layer of light-sensitive cells lining the back of the eye. ROP usually occurs in both eyes, though one may be more severely affected.

The last 12 weeks of a full-term pregnancy are an especially active time for the growth of the eye. When a baby is born prematurely, blood vessels are not ready to supply blood to the retina. At birth, abnormal new blood vessels form and cause scarring or detachment of the retina. The condition is especially common in very small babies. It is more likely to occur in babies weighing one or two pounds than in babies weighing three pounds or more.

Despite improved medical care, the disease is becoming more common because smaller and sicker infants are surviving. Supplemental oxygen given to premature babies may be part of the cause of ROP, but it is not the only factor as was once thought.

In severe cases, the retina may be extremely scarred and detached. Many cases get better without treatment and only a small number of children go blind. Cryotherapy (freezing) or laser treatments can prevent progression of the disease.

Children with ROP are more likely to develop nearsightedness and amblyopia (lazy eye). Eyeglasses, patching, and eye muscle surgery can help these associated problems. Follow-up examinations of severely affected children should continue periodically.

]] file:///C|/Documents%20and%20Settings/Det/My%20Documents/.../titamadeeh/PatientResources/Retina_and_Vitreous/ROP.html1/8/2008 10:29:04 AM Retinoblastoma Retinoblastoma Retinoblastoma, a malignant tumor that grows in the retina, the layer of light-sensing cells in the back of the eye, can destroy a child’s vision and be fatal. Retinoblastoma can occur in one or both eyes, and usually develops in the first year or two of life. It affects children of all races, and occurs in boys and girls equally.

The most common sign is a change in the color of the pupil, which can appear white in reflected light.

This phenomenon is referred to as a cat’s eye reflex. Sometimes the affected eye will cross or turn outward. Retinoblastoma can be hereditary and is more likely to develop in children with a family history of the disease.

With early diagnosis, retinoblastoma treatment is remarkably effective. More than 90% of children survive and many eyes are saved with a combination of medications, radiation therapy, and heat, freezing, or laser treatments. In severe cases, the affected eye is removed.

If a child has had retinoblastoma, there is an increased chance for a second cancer to develop. Children with retinoblastoma should have regular examinations by an ophthalmologist (Eye M.D.) and a pediatric oncologist.

]] file:///C|/Documents%20and%20Settings/Det/My%20Documents/.../PatientResources/Retina_and_Vitreous/Retinoblastoma.html1/8/2008 10:29:04 AM Retinitis Pigmentosa Retinitis Pigmentosa Retinitis pigmentosa (RP) describes a group of related diseases that tend to run in families and cause a slow but progressive loss of vision. RP affects the rods and cones of the retina, the light-sensitive nerve layer at the back of the eye, and results in a decline in vision in both eyes. RP usually affects both eyes equally, with severity ranging from no visual problems in some families to blindness at an early age in others. RP gets its name from the fact that one of the symptoms is a clumping of the retinal pigment that can be seen during an eye exam.

The earliest symptom of retinitis pigmentosa, usually noticed in childhood, is night blindness or difficulty with night vision. People with normal vision adjust to the dark quickly, but people with night blindness adjust very slowly or not at all. A loss of side vision, known as “tunnel vision,” is also common as RP progresses. Unfortunately, the combination of night blindness and the loss of peripheral vision can be severe and can lead to legal blindness in many people.

While there is a pattern of inheritance for RP, 40% of RP patients have no known previous family history. Learning more about RP in your family can help you and your ophthalmologist predict how RP will affect you.

Usher’s syndrome, a condition that causes both deafness and blindness, is a form of RP. The incidence of Usher’s syndrome is difficult to determine, but surveys of patients suggest up to 10% of RP patients are deaf. The incidence of Usher’s syndrome is three cases per 100,000. It is the most frequent cause of combined deafness and blindness in adults.

Considerable research is being done to find the hereditary cause of RP. As hereditary defects are discovered, it may be possible to develop treatments to prevent progression of the disease. While developments are on the horizon, particularly in the area of genetic research, there is currently no cure for retinitis pigmentosa.

Nutritional supplements may be of benefit in RP. It has been reported that vitamin A can slow the progression of RP. Large doses of vitamin A are harmful to the body, and supplements of vitamin E alone may make RP worse. Vitamin E is not harmful if taken along with vitamin A or in the presence of a normal diet. Your ophthalmologist (Eye M.D.) can advise you about the risks and benefits of vitamin A and about how much you can safely take.

Despite visual impairment, people with RP can maintain active and rewarding lives through the wide variety of rehabilitative services that are available today. Until there is a cure, periodic examinations by your ophthalmologist will keep you informed of legitimate scientific discoveries as they develop.



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