Other Conditions

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Other Conditions

At Retina Consultants of Charleston, we treat multiple vitreoretinal diseases, including those affecting the retina, macula, vitreous, and optic nerve. These include:

Uveitis

With uveitis, inflammation targets the healthy tissue inside the uvea, the eye’s middle layer between the retina and the sclera, the white part. Uveitis can be serious, and may progress to eye damage or vision loss. But the earlier you’re diagnosed, the greater your chances for preserving your vision.

How Is Uveitis Classified?

There are four different uveitis subtypes, defined by the inflammation’s location:

• Anterior uveitis, the most common type, affects the eye’s front portion.
• Intermediate uveitis affects the eye’s peripheral (side) retina and the vitreous, the clear, jelly-like gel comprising most of the eye’s volume.
• Posterior uveitis targets the eye’s back portion, and specifically, the choroid, tissue connecting the sclera and the retina.
• Panuveitis may affect the entire eye.

Uveitis Causes And Risk Factors

Immunity is closely associated with uveitis, which develops as a response to disease, infection, injury, or toxins. While there is usually no cause known, potential risk factors include:

• Previous eye damage or injuries
• Complications from eye surgery
• Underlying autoimmune illnesses
• Bacterial, parasitic, and viral eye infections
• Inflammatory disorders
• Family history
• Smoking

Uveitis Symptoms

Symptoms can develop in one or two eyes, gradually or quickly, and may occur once or in stages. Uveitis can permanently impact vision, so alert your ophthalmologist as soon as these symptoms appear:

• Eye redness
• Floaters
• Blurriness
• Eye pain
• Light sensitivity
• Decreased vision or loss

Lattice Degeneration

As the retina enables us to see images, any damage is a major health threat. Lattice degeneration affects the retina’s peripheral (side) portions, with the tissue thinning, forming a lattice-like pattern. This may cause retinal tears, breaks, holes, and detachment. A common condition, it targets about 8-10 percent of the general population. There is no lattice degeneration prevention or cure.

Lattice Degeneration Causes And Risk Factors

While no cause is known, lattice degeneration may be associated with low or inadequate blood flow to the eyes. Risk factors may include nearsightedness (myopia), and having a family history, although it’s not passed down from parents. If this condition occurs in one eye, you’re more likely to develop it in the other.

Lattice Degeneration Signs And Symptoms

While there are no symptoms, this condition may (rarely) progress into a retinal tear or detachment, requiring immediate ophthalmic treatment. The most common symptoms include:

• Blurred vision
• Flashes
• Eye floaters
• Peripheral vision issues
• General vision quality problems

Complications of Cataract Surgery

Aging and medical conditions can make your eyes’ lenses thicker, less flexible and less transparent. As they cloud, cataracts form, blurring your vision. Cataracts usually develop slowly, in both eyes, but not always at the same rate. Over time, your eyesight is disturbed, requiring stronger lighting and eyeglasses.

If this interferes with your life, surgery may be necessary. Generally, it’s safe and effective, but like any procedure, there are complications, especially with underlying eye conditions. A simple outpatient procedure, about 90 percent of patients report improved vision. Your ophthalmologist removes your natural, clouded lens, replacing it with an artificial, or intraocular lens (IOL), which restores vision at various distances, without maintenance.

Cataract Surgery Risk Factors

While safe and effective, cataract surgery may have risk factors, although they can be treated successfully. Your risks may be greater if you have another eye disease, like glaucoma, and surgery may not always be successful.

Posterior Capsule Pacification (PCO)

You may develop a second cataract, called posterior capsule opacification (PCO). During surgery, the back of the lens capsule is not removed. This part supports the lens implant, and it can become cloudy and impair vision. PCO is treated with a painless, five-minute outpatient procedure called yttrium-aluminum-garnet (YAG) laser capsulotomy. A laser makes a small opening in the capsule for light to pass. You’ll remain for an hour to ensure eye pressure doesn't rise.

Other post-surgical complications include:

• Infection, which may include light sensitivity, pain, redness, and vision problems. Post-surgery infections, while rare, require an antibiotic injection in your eye.
• Inflammation – While some is normal, you may require eye drops or medication.
• Retinal detachment – This requires immediate ophthalmologic treatment, especially if new floaters or flashes appear, or a curtain covers part of your eye.
• Lens fragments – During surgery, lens pieces may fall into your eye. Bigger pieces may require surgery to remove the vitreous and prevent swelling.
• Fluid buildup in the retina, due to retinal blood vessels leaking during surgery. As it accumulates, your vision becomes blurry. This is treated with eye drops, with healing taking weeks or months.
• Dislocated Intraocular Lens (IOL) – Should the IOL slip out of place, you may have blurred or double vision, and possibly, bleeding and swelling. Surgery may be needed to get it back in position or to put in a new one.
• Swelling in the cornea – After surgery, the cornea, the eye’s clear, front part, can get swollen and hazy, making it harder to see. Typically a temporary issue, it’s treated with eye drops.
• Bleeding – While rare, during surgery, you may start bleeding for no reason. Heavier bleeding can lead to vision loss. Eye drops and bed rest can help, but if the blood doesn't drain or causes excess eye pressure, you may need surgery.
• Floaters and flashes – As surgery can cause the vitreous to separate from the retina, you may see squiggly lines or other shapes in your vision, along with flashes of light. They typically improve alone, but as they’re similar to retinal detachment, alert your ophthalmologist immediately.
• High eye pressure – You may experience increased eye pressure following surgery, which can damage vision. You may be prescribed eye drops, shots, or pills. Eye pressure may also increase from swelling, bleeding, or leftover lens fragments, leading to glaucoma, with treatment depending on the cause.
• Light sensitivity – You may have to temporarily wear sunglasses. But tell your doctor if it lasts more than a couple of days, as it can indicate another issue.
• Droopy eyelid – Also called ptosis, this common condition’s cause is unknown, but it typically goes away on its own. Should ptosis last more than 6 months, surgery may be necessary.
• Dysphotopsia – With this condition, there are two types: negative, in which you see a curved shadow at the edge of your vision; and positive, in which you see halos, starbursts, flashes, or light streaks. The cause is unknown, and it often goes away on its own, but if it lasts, surgery may be needed.

Retinoschisis

With the rare condition called retinoschisis, your retina splits. Your vision may be affected at the split’s location, which can be in the retina’s center, or more often, on its periphery (outer edges). There are two different causes, one due to genetics, affecting boys and young men, and the other being age-related, affecting men and women. It can lead to vision problems and retinal detachment. But as it may also be mistaken for retinal detachment, immediate surgery is needed.

Congenital X-linked Causes & Risk Factors

Congenital X-linked, or juvenile retinoschisis affects one in 5,000-25,000 individuals, almost exclusively in male infants, boys and young men. Affected women usually retain normal vision. No cause is known, and heredity is the only risk factor. Juvenile retinoschisis is a lifelong disease, and while vision may stabilize later in life, it often deteriorates in late adulthood. Affected patients require periodic eye examinations.

Degenerative Retinoschisis Causes & Risk Factors

Degenerative, or acquired retinoschisis typically occurs in men and women in their 50s, 60s and 70s, although younger patients may develop it. 1-4 percent of people over age 50 may be affected. No cause is known, although risks increase with age, especially after age 40.

Retinoschisis Signs and Symptoms

Juvenile X-linked retinoschisis may have no symptoms. But if they do occur, central or peripheral vision loss is most common. Other symptoms include:

• Cataracts
• Strabismus, or crossed eyes
• Nystagmus, or abnormal eye movements
• Amblyopia, or lazy eye
• Farsightedness (hyperopia)

Complications may include vitreous hemorrhaging (heavy bleeding), retinal detachment, and total blindness.

Acquired retinoschisis may have no symptoms. Should it worsen, or you experience retinal detachment, you may notice:

• Floaters and flashers
• Distorted images
• Central or peripheral vision loss, depending on the split’s location.

As retinoschisis patients are more susceptible to retinal detachment, regular exams are needed. Peripheral retinoschisis is often misdiagnosed as retinal detachment. Retinal specialists must carefully examine you for an accurate diagnosis. This distinction is vital, as retinal detachment requires immediate surgical intervention to prevent vision loss, while peripheral retinoschisis does not.