Retina

The retina is the light-sensitive layer at the back of the eye. It gives no warning when it starts to fail, which is why retinal disease is found by looking, not by waiting for symptoms.

What we treat

Diabetic retinopathy

Diabetes damages the small blood vessels of the retina. They leak, close off, and in later stages new fragile vessels grow where they should not. Early retinopathy produces no symptoms at all, which is why screening is scheduled rather than prompted by how the eyes feel.

Macular conditions

The macula is the small central part of the retina responsible for fine detail: reading, faces, screens. Fluid collecting here, or age-related degeneration, blurs or distorts the centre of vision while the edges stay clear.

Retinal tears and detachment

A sudden shower of floaters, flashes of light, or a shadow spreading across part of your vision needs same-day assessment. A detaching retina is one of the few true emergencies in eye care, and the outcome depends heavily on how quickly it is treated.

Screening intervals for diabetes

The American Academy of Ophthalmology’s Preferred Practice Pattern sets these out clearly:

• Type 1 diabetes: annual screening beginning five years after the onset of the disease.
• Type 2 diabetes: screening promptly at the time of diagnosis, then at least yearly thereafter.

The difference reflects how each condition is found. Type 2 is often present for years before it is diagnosed, so retinopathy can already be established on the day you are told you have diabetes. Where retinopathy is detected at any stage, referral to an ophthalmologist is indicated.

What the examination involves

1. Drops to widen the pupilThey take about twenty minutes to work and leave vision blurry and light-sensitive for a few hours, so arrange not to drive yourself home.
2. Retinal imagingA photograph of the back of the eye. The record matters as much as the image. Next year’s comparison is what reveals change.
3. Examination of the retinaIncluding the peripheral retina, where tears most often begin.

Treatments

Depending on what is found, treatment may involve laser to seal leaking or abnormal vessels, intravitreal injections to reduce fluid and suppress abnormal vessel growth, or surgical repair for a detachment. All of them work considerably better when started early, which is the entire argument for screening.