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the eye institute of west florida

Retina

Retinal Diseases Largo, Clearwater, St. Petersburg, and Tampa

At the Eye Institute of West Florida, we treat the most complex retina-vitreous disorders in a safe and caring environment. Our Tampa Bay retina specialists are world-renowned experts at diagnosing eye diseases and offering the latest treatment options.

There are a number of disorders that can affect the retina and vitreous. Some conditions commonly treated by our retina specialists include age-related macular degeneration, cystoid macular edema, flashes and floaters, diabetic retinopathy, macular holes, retinal tears, retinal detachment, retinitis pigmentosa or other inherited retinal diseases, strokes of the retinal vein, wrinkled retina, and cancers of the eye.

Our retina specialists may also treat a patient who has experienced severe eye trauma, severe inflammation of the eye, or complications from other eye surgery.

About The Retina

Retina Diagram

The retina is a very thin tissue lining the back wall of the eye that is connected to the brain. The outer part of the retina is nourished by a single special layer of cells called the retinal pigment epithelium that lies underneath the retina like a pad under a carpet on the floor.

The transparent cornea and lens in the front of the eye focus incoming images onto a central area of the retina called the macula. The retina converts these images into a chemical message that is sent to the brain. The macula is where incoming light is focused. The macula is the only part of the retina which allows you to read the small print and perform visual tasks that require fine or “central” vision. The retina outside of the macula is responsible for the “side” or peripheral vision.

The clear jelly-like substance that fills the eye is called vitreous. The vitreous is attached to the retina. Conditions that affect this area are also treated by a retina specialist.


Common Symptoms of Retinal Diseases

Blurred vision with Retinal DiseasesIf you experience any changes in your vision, it is important to seek care from an ophthalmologist. Some common signs and symptoms that indicate problems with the retina include:

  • Suddenly seeing floating specks, cobwebs, or flashing lights
  • Blurred or distorted vision
  • A curtain or veil obscuring your vision
  • Lost vision

Dr. Leonard Kirsch, Dr. Richard Hairston, and Dr. Janie Ho are our board-certified, fellowship-trained ophthalmologists with advanced medical training in the subspecialty of the retina and vitreous care. At The Eye Institute of West Florida, you will always receive the personal attention of an expert to help diagnose and treat your condition.

 

“Overall my experience at the Eye Institute has been excellent! All staff have been most courteous, professional, knowledgeable, friendly and efficient. In particular, Lauren did an excellent job of setting up and coordinating everything for my eye surgery. Also, the technician who took pictures of my eye and assisted with post-op was terrific! “

Teri – patient of Dr. Richard Hairston


What Are Floaters?

Floaters look like tiny specks floating around on the surface of your eye. However, no matter how much you rub your eyes or use eye drops, these specks are still there. That’s because these specks are actually on the inside of your eye.

Floaters come in all shapes and sizes. They can appear as cobwebs, spots, thread-like strands, or squiggly lines.

Causes of Floaters

The middle of your eye is filled with a clear substance called vitreous gel. Light passes through the vitreous gel and onto the retina. As you age, pieces of the vitreous gel begin to clump together. These little clumps cast a shadow on your retina, resulting in the appearance of specks floating in your vision. The vitreous gel can also start to shrink and pull away from the eyewall. This is common with age and is referred to as posterior vitreous detachment.

Floaters are also quite common after cataract surgery or if you have had an inflammation of the eye.

Treatment for Floaters

Although floaters themselves are harmless, there are instances where you should seek treatment.

Floaters can affect your field of vision over time, making it more difficult to go about your everyday life. In other cases, a sudden increase in floaters can be a sign of retinal detachment. Contact us immediately to be evaluated by one of our Retina-Vitreous Specialists if you experience this issue.

At The Eye Institute of West Florida, floaters can be treated by a simple outpatient laser procedure called YAG Laser Vitreolysis.

This highly effective, painless procedure involves the use of a nano-pulsed YAG laser to vaporize protein strands in the vitreous part of the eye. This procedure is commonly used after cataract surgery by our team to ensure the best vision possible for our patients.


What Are Flashes?

Flashes appear in the peripheral vision as “flashes” of bright light, similar to lightning. Some patients compare them to “seeing stars” after being hit on the head. Flashes are common in older people and can appear in one or both eyes and may last up to 20 minutes. They can occur for weeks at a time, or even months.

Causes of Flashes

It is common for older people to experience flashes occasionally. Flashers can be a symptom of posterior vitreous detachment, usually occurring as the vitreous pulls or rubs on the retina.

If you experience flashing lights for the first time or a sudden increase in the frequency of flashes, coupled with one or more of the following, you may be experiencing retinal detachment:

  • New floaters
  • A shadow in your peripheral vision
  • A gray curtain that covers part of your vision

If you experience any of these symptoms, contact us immediately to be evaluated by one of our specialists.

Treatments for Floaters and Cobwebs

Most floaters are not a problem but when they are very dense they can become a nuisance for many people. Now with advances in technology, The Eye Institute of West Florida is one of the few practices able to eliminate your annoying floaters with a simple laser procedure called a YAG Laser Vitreolysis.

Benefits of Vitreolysis:

  • Highly effective in providing functional improvement
  • Low complication rate
  • The simple, pain-free out-patient procedure
  • Immediate results
  • A high degree of patient satisfaction
  • Avoids needing a vitrectomy when successful

Vision is restored immediately and the patient is able to return to daily activities right away.

If you have questions or concerns regarding flashes or floaters, contact us to schedule an appointment.


Diabetic Retinopathy

If it weren’t for the Eye Institute I would be blind today. I am grateful for Dr. Kirsch’s care and follow-up care.”
Wayne – Patient of Dr. Leonard Kirsch

Diabetes mellitus affects approximately 16 million Americans. Although diabetes is a disorder of glucose metabolism, the disease affects many different parts of the body including the eyes.

When diabetes affects the eyes, the most serious problems are found in the retina.

The retina is nourished by many small blood vessels that are damaged after a person has diabetes for several years, especially if the blood glucose is poorly controlled. This complication of diabetes, called diabetic retinopathy (link to Diabetic retinopathy page in Learning Center), is the leading cause of new blindness in the United States among people aged 25 to 64 years.

Macular edema and proliferative retinopathy are the two main forms of diabetic retinopathy that can potentially cause loss of vision.

Macular edema occurs when the damaged small blood vessels in the macula begin to leak protein-filled fluid into the retinal tissue. A patient may not notice any change in vision; however, the eyesight will gradually diminish if the fluid remains in the macula.

Proliferative diabetic retinopathy occurs when the blood vessels supplying the retinal tissue become so damaged they lose the ability to adequately nourish the retina. The eye responds to this situation by increasing the production of vascular endothelial growth factor (VEGF) which starts the process of growing new blood vessels. The abnormal new blood vessels can cause major problems leading to loss of vision.

The most common treatment for both is laser surgery. Different types of advanced microsurgery are performed by our specialists in our Largo Ambulatory Surgical Center.

Most of the retinal problems caused by diabetes can be detected in the early stages and are successfully treated. Working together with your primary doctor, our team can help to preserve the precious gift of sight for a lifetime.

Learn more about Diabetic Retinopathy


Age-Related Macular Degeneration


Age-Related Macular Degeneration (ARMD) occurs in two main forms: a “dry” or atrophic type and a “wet” or exudative type. Everyone with macular degeneration initially has the dry form and develops the disease in both eyes, however, one eye can worsen more quickly than the other. There are four major forms of ARMD. In about 10% of cases, the type will change to wet macular degeneration.

Treatment for Macular Degeneration

All patients with dry macular degeneration should have a coating on the lenses of their eyeglasses to block the ultraviolet rays from the sun. A daily multivitamin with antioxidants, lutein, zeaxanthin, and zinc may slow the progression of high-risk dry ARMD and wet ARMD.

There are a variety of medications available for the treatment of wet ARMD. Because our physicians are directly involved in many clinical studies sanctioned by the FDA, our patients receive the latest medications and newer technologies before they are made available to the general public.

Learn more about Treatment Options.

Dr. Leonard Kirsch, Dr. Richard Hairston, and Dr. Janie Ho are available for the diagnosis, treatment, and management of any disease affecting the retina.


Cystoid Macular Edema

In what situations does cystoid macular edema occur?

The most common time for cystoid macular edema to occur is about one to two months after cataract surgery. Other causes of cystoid macular edema include diabetes affecting the retina, retinitis pigmentosa, age-related macular degeneration, strokes of the retina, or a variety of conditions causing chronic inflammation inside the eye.

Treatment

Treatment for cystoid macular edema is custom-designed for your individual situation. The treatment depends especially on the underlying cause of the cystoid macular edema.

If you have cystoid macular edema following cataract surgery, the initial treatment (often started already by the cataract surgeon) is eye drops and perhaps an oral medication. For cystoid macular edema due to diabetes or a stroke in the retina, laser treatment is usually recommended as the first choice.

Read more about Treatment Options for Macular Edema


Retinal Tears and Detachments

By age 60, 90% of all people will have a vitreous detachment in at least one eye.

Woman receiving an Eye Exam

A vitreous detachment occurs suddenly without any warning. It is more common as people get older. It is so common we consider it to be a normal part of aging. Patients that are very nearsighted have a higher chance of a vitreous detachment at a younger age, as do people who are hit in the eye or in the head.

A patient who experiences flashes and floaters should have a detailed examination by a retina specialist.
Visual: Use photo labeled “Patient Testing Doc Mom v2”

Symptoms
The main symptom of a retinal detachment is the sensation of a “curtain” coming across the field of vision from the side toward the center. The “curtain” gets progressively larger over several hours or days.

As the detachment reaches the center of the retina (the macula), the vision becomes very blurry, often preventing the patient from seeing anything other than fingers in front of their faces. Flashing lights and floaters will persist during this time.

Treatment
A retinal detachment is a true emergency and needs to be treated as soon as possible. If a hole or tear is found in the retina, it can be easily treated using a laser.

There are three main procedures used to treat retinal detachments:

  • Pneumatic Retinopexy
  • Vitrectomy
  • Scleral Buckling

Although a vitreous detachment is usually not dangerous by itself, it can have serious consequences.

Call us if you experience these symptoms. Your eyesight may depend on it.

Our retina specialists at The Eye Institute of West Florida are world-renowned experts at diagnosing eye diseases and offering the latest treatment options.

Learn more about these physicians available to care for you.
Dr. Leonard Kirsch
Dr. Richard Hairston
Dr. Janie Ho

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