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What is retina?

The retina is the nerve layer that lines the back of the eye, senses light, and creates impulses that travel through the optic nerve to the brain.

There is a small area, called the macula, in the retina that contains special light-sensitive cells

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What are the symptoms of retinal disease?

Flashes

Floaters

Sudden loss of vision

Distortion of vision

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What is vitreous?

Vitreous is a thick transparent gel like substance that fills the eyeball between the lens and retina .It contains 99% of water and rest is a mixture of collagens, proteins, salts and glucose.

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Do I require dilatation of eyes for retinal checkup?

Yes. For retina checkup, the pupil are dilated(expanded) with the help of drops which are instilled in both eyes. The drops are put every 15 mins for up to 5-6 times and it takes about 45 to 90 minutes to achieve the full effect. It’s after this the retina specialist examines your retina, this test is also known as fundus examination.

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Can I drive after retina checkup?

No. Due to dilatation. Person experience blurring of vision and its not safe to drive.

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I have diabetes, should I consult a retina specialist?

Definitely. Diabetes affects the microvasculature. Therefore it is important to check your retina.

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When should I see a retina specialist?

Common symptoms of retinal disease are sudden loss of vision, distorted vision, floaters and flashes, peripheral shadows. Apart from this individuals who have DM,HT, high myopia should undergo retina checkup every 6-12 months. Anyone more than 40 years should get a retinal check up every year.

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What are floaters?

Floaters are dark spots, thread or cob web like structures moving in the line of vision.

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What to do if I have floaters and flashes?

Mostly floaters are harmless, but are warning signs to get eye check up. In DM and HTN can be due to blood in eye. After PVD chance of retinal break is there. So we should not avoid floaters.

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Will floaters disappear?

They will gradually disappear and diminish over years.

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What are the common causes of floaters?

Age, Diabetes are common causes of floaters.

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What is retinal detachment?

It is a condition in which part of the retina is lifted or pulled from its normal position, and causes vision loss. If not treated leads to blindness. Therefore, retinal detachment is always considered an emergency

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What are the causes of retinal detachment?

Retinal holes, retinal breaks, or retinal tears, and liquefaction of the vitreous humor. injury to the eye can cause retinal detachment

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What precautions to be taken to prevent retinal detachment?

If u have sudden flashes or floaters consult your ophthalmologist immediately. I f you are have high myopia or if you have a family history of retinal problems be sure to have your eye examined regularly. Always wear safety eyewear during sports and other hazardous activities

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Does RD occur in both eyes?

Detachment is more likely to occur if the other eye has the condition (such as lattice degeneration) associated with retinal detachment in the first eye. If only one eye suffers a serious injury or requires eye surgery then, of course, the chance of detachment in the other eye is less.

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What are the risk factors for a retinal detachment(RD)?

Retinal detachment(RD) can happen to anyone at any age, however it is more common over the age of 40. It is commonly seen in people who had cataract surgery, myopia, eye injury, family history of RD, had RD in other eyes.

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What is treatment of retinal detachment?

Treatment depends on configuration of retinal detachment multiple options like pneumatic retinopexy, scleral buckling, vitrectomy are available but type of RD and associated pathology decide the choice of surgery.

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How long does it take for a detached retina to heal?

Improvement starts in 2 weeks after surgery. Retina may continue to heal for a year or more and it may take months to stabilise after surgery.

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What is diabetic retinopathy?

It is a condition where high blood sugar levels damage the retinal blood vessels and cause leakage of fluid and blood in the retina.

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Who is at risk of diabetic retinopathy?

Juvenile diabetes – more than five years

Adult onset diabetes – more than 10 years.

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What is the treatment of diabetic retinopathy?

First advice is to control the blood sugar level.

Treatment depends on stages of diabetic retinopathy.

Initial stages may require regular retina checkup and good Blood sugar controlled.

In advance case retina laser is done to prevent bleed from new vessels.

More advance cases with persistent bleed and retinal detachment may need retina surgery.

Diabetic macular oedema may require Intravitreal injection (injection in the eye) and lasers.

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How to prevent diabetic retinopathy?

Keeping your blood sugar and blood pressure under control can help prevent diabetic retinopathy Even controlled diabetes can lead to diabetic retinopathy, so you should have your eyes examined once a year.

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How diabetes affects retina?

Diabetes affects the background retina and the macula. Background retinopathy – can be non-proliferative (NPDR) and proliferative (PDR). This may or may not be associated with diabetic maculopathy

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What are the symptoms of diabetic retinopathy?

If the macula is affected, blurring of vision occurs. If the macula is not affected the patient will have no symptoms.

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What is non proliferative diabetic retinopathy?

In this type, retinal blood vessels leak causing oedema and hemorrhage.

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What is proliferative diabetic retinopathy?

In this type abnormal blood vessels are formed over the retina which causes hemorrhage and retinal detachment.

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Is diabetic retinopathy curable?

It is not possible to reverse the damage that has occurred unless it is detected in a very early stage. Treatment can slow the progression of vision loss.

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How frequently eye checkup should be done for diabetic retinopathy?

It is advisable to get your eyes checked once in a year

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How is diabetic retinopathy diagnosed?

By dilated fundus (retina) examination.

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What happens when diabetic retinopathy is not treated?

It would result in blindness.

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When to screen for retinopathy when a diabetic woman gets pregnant?

Screening should start from the first trimester since progression is very fast in pregnant woman

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Should people with diabetic retinopathy change their diet?

A very well-balanced diet and certain food guidelines are recommended for people with diabetic retinopathy. Sugars and fats, which increase blood sugar levels, must be avoided.

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What is macular edema?

Macular edema is a complication of non - proliferative as well as proliferative diabetic retinopathy (and of other diseases, particularly vein occlusions). It is a swelling of the macula (the central area of the retina) caused by leakage of fluid and blood through the walls of dilated blood vessels. Macular edema is the most common cause of vision loss.

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What is pathological myopia?

When an eye has myopia greater than 8 diopters, the problem is known as pathological or high myopia. Degenerative myopia, also called malignant progressive myopia, causes progressive stretching and gradual damage of the retina, choroid, vitreous, sclera, and optic nerve. This type of myopia needs regular clinical evaluation. At this time, the progression of this eye disease cannot be stopped. However, some complications of degenerative myopia such as retinal detachment, macular edema, and glaucoma, can be treated.

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What are the retinal complications in high myopia?

Peripheral retinal degenerations

Retinal tear

Retinal holes

Retinal detachment

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When to follow up?

If you are asymptomatic follow up every 6 months. The symptoms of a PVD and retinal detachment are

flashing lights

a recent onset, increase or change in your floaters

a curtain effect coming down, up or across your vision.

It’s important if you notice any of these symptoms or any new symptoms that you have in your eyes checked immediately by an eye specialist.

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What is lattice degeneration?

It is the peripheral thinning of retina in high myopia. . It can cause holes and tears of the retina causing retinal detachment.

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What are the symptoms of lattice degeneration?

Lattice degeneration ismostly asymptomatic. But if the patient sees any flashes or floaters it may be a warning sign of a tear or hole which has to be treated immediately to prevent retinal detachment.

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Is treatment required for lattice degeneration?

If you are asymptomatic both eyes, there is no family history of retinal detachment they need not be treated. But if there is a development of tear, laser is adviced.

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Can high BP affect retina?

Uncontrolled high blood pressure can damage the retinal vessels causing hypertension retinopathy. It causes edema, hemorrhages, occlusion of the retinal vessels leading to permanent retinal damage and vision loss. Hence it is prudent to keep your blood pressure under control and check your eyes yearly.

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What is the treatment for hypertension retinopathy?

Controlling high blood pressure prevents changes in the blood vessels of the eye, as well as in other organs like the heart, kidneys and brain. Therefore, controlling high blood pressure is the only treatment for hypertensive retinopathy. The patient needs to follow a healthy lifestyle and adhere to the appropriate medical drug treatment .

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What is age related macular degeneration (ARMD)?

It is the degenerative condition of the retina in which the central area of the retina responsible for central vision, the macula is affected

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Will both eyes be affected?

Yes

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What are the symptoms of ARMD?

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What are the symptoms of ARMD?
p>Appearance of blurry spot, distortion of images, seeing wavy lines, sudden loss of central vision. If any of the above symptoms are present consult your ophthalmologist immediately

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Is ARMD curable?

No, but treatment can slow or even stop the progression of the wet form, so the earlier you're diagnosed, better the improvement .

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What is the treatment for ARMD ?

For dry armd- vitamin supplements

Wet armd- photodynamic therapy and intravitreal injections

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What is a macular hole?

A hole develops in the macula, due to the vitreous gel inside the eye pulling on the retina. This vitreous gel tends to shrink as we get older causing traction. In most cases, macular holes can be surgically repaired, providing they are treated early.

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How a macular hole treated?

Surgery is the treatment for macular hole. It is better to get operated within six months of it being found. The longer a hole is left, it is difficult. To successfully close the hole. In most cases, surgery will stop the vision problems getting worse. Most people will notice some improvement in vision, and more than 50% of cases will gain sufficient vision to allow driving and reading. It is difficult to restore perfect vision

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What is retinal vein occlusion?

Retinal vein occlusion, is a blockage in the veins of the retina. There are two main types: branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). A blockage in both is thought to be caused by pressure on the vein from outside The most common cause of these is high blood pressure.

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What are the symptoms of retinal vein occlusion?

Patients with both branch and central retinal vein occlusions usually describe a sudden painless loss of vision in one eye that may affect near and distance vision... it is very important to be checked immediately.

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What is the treatment for retinal vein occlusion?

Treatment used in retinal vein occlusions. These include

Intravitreal injection

Laser photocoagulation

Vitrectomy surgery

Choice of treatment depends on clinical findings.

Branch retinal vein occlusions usually occur in people over 50 years old and are more common in people with high blood pressure (hypertension. Central retinal vein occlusions also occur in the same age group and are associated with high blood pressure, smoking, and glaucoma.

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What is OCT?

Optical coherence tomography is a non-invasive diagnostic test used for imaging of retina. it helps in early detection of any disease. It is used to diagnose macular disorders like ARMD, macular edema, macular hole, CSR.

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What is FFA?

Fundus Fluorescein angiography is a procedure to examine the tiny blood vessels in the eye.A dye called fluorescein is injected in your arm and serial photographs of eyes are taken. Dye highlight the blood vessel in the back of eye.

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What is ocular migraine?

Visual problems associated with migraines are known as ophthalmic migraines, or ocular migraines, changes also may take place in blood flow to the area of the brain responsible for vision (visual cortex or occipital lobe).

Resulting ophthalmic or ocular migraines commonly can produce visual symptoms even without a headache.

Resulting ophthalmic or ocular migraines commonly can produce visual symptoms even without a headache.

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What are symptoms of ocular migraine?

Typically you will see a small, enlarging blind spot (scotoma) in your central vision with bright, flickering lights (scintillations) or a shimmering zig-zag line (metamorphopsia) inside the blind spot.

The blind spot usually enlarges and may move across your field of vision. This entire migraine phenomenon may end in only a few minutes, but usually lasts as long as about 20-30 minutes.

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What is the treatment for ocular migraine?

They cause no permanent visual or brain damage and do not require treatment.Still, always consult your eye doctor when you have unusual vision symptoms, because it’s possible that you have another condition requiring treatment, such as a detached retina, which should be checked out immediately

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What is night blindness?

Blindness refers to difficulty seeing at night or in poor or dim lighting situations. The main indication of night blindness is difficulty seeing well in dark or dim lighting, especially when transitioning from a brighter to a lower light environment, like walking from outside into a dimly lit room.

Many experience difficulty driving at night, particularly with the glare of the streetlights or the headlights from oncoming traffic

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What are the causes of night blindness?

Night blindness is a condition that can be present from birth, or caused by a disease, injury or even a vitamin deficiency.

Retinitis Pigmentosa – a genetic condition in which the pigmented cells in the retina break down causing a loss of peripheral vision and night blindness.

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Is nightblindness is hereditary?

Yes. Nightblindness due to retinitis pigmentosa are hereditary in nature.

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How RP IS DIAGNOSED?

Dilated fundus examination and ERG (signals from retina are recorded) is done to confirm RP.

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What is the Treatment for RP?

Vision loss due to RP is irreversible .

Low vision aids and visual rehabilitation are advised by the specialist.