Vitreo Retina Management


Retinal Detachment

Diagnosis and treatment of various Vitreo-Retinal conditions.

The retina is a thin lining of nerve tissue inside the eye. It is likened to the film of a camera where the image that we see is projected into inside the eye.

The retina is important to good vision. There are numerous diseases of the retina which include age-related macular degeneration, diabetic retinopathy, retinal tears and retinal detachment.

Fortunately, most vision loss from retinal diseases is prevented by early detection and treatment of symptoms. Peregrine Eye & Laser Institute (PELI) has Vitreo-Retinal surgeons that were trained at top-notch eye centers in the US who can diagnose, provide treatment and educate patients with Vitreo-Retinal disorders.

We also offer the latest diagnostic tools, drugs, laser and surgical equipment for the diagnosis and treatment of various Vitreo-Retinal conditions.

Schedule your check up today.


What is the retina?

The retina is a thin lining of nerve tissue inside the eye. It is likened to the film of a camera where the image that we see is projected into inside the eye.

What is the macula?

The macula is the small, sensitive part of the retina that is responsible for central vision.

What is the vitreous?

The vitreous is a transparent jelly-like material that fills the space between the lens and retina of the eye.

What is posterior vitreous detachment?

The vitreous is a transparent jelly-like material that fills the space between the lens and retina of the eye.

What are the symptoms of posterior vitreous detachment?

Individuals with posterior vitreous detachment experience seeing flashing lights and floaters. Floaters are small specks or hair-like shadows that move about in your field of vision. They are usually evident or more noticeable under bright light.

What is a retinal tear?

Retinal tear is a break in the retina. It occurs when the vitreous pulls so hard on the retina. Retinal tears present with the same symptoms as posterior vitreous detachment which are flashing lights and floaters. Retinal tear may progress to retinal detachment.

What is retinal detachment?

A normal retina lies flat against the wall of the eye. Retinal detachment occurs when the retina peels away from the wall of the eye.

What are the symptoms of retinal detachment?

Patients with retinal detachment may experience seeing flashing lights, floaters and a curtain-like shadow that gradually draws over their vision. When the retinal detachment is extensive and involves the macula, it can affect central vision and the patient may complain of sudden decreased vision.

Who are at risk for developing retinal detachment?

The risks for retinal tear and retinal detachment increase as we grow older. Retinal detachment is more frequent in patients with high myopia or are very nearsighted. It is also more frequent among individuals who have relatives or family members with retinal detachment. Retinal detachment may develop as a complication of diabetes. Patients with retinal tears are also at risk to developing retinal detachment. Patients who had cataract surgery or experienced trauma to the head or eye are also at risk for retinal detachment. Patients with a retinal detachment in one eye have an increased risk of developing retinal detachment in the other eye.

How are retinal tears treated?

Retina tears are treated by applying laser around the tear. This is done to strengthen the attachment of the retina to the wall of the eye to prevent the retinal tear from progressing into a retinal detachment.

How is a retinal detachment treated?

There are several ways to treat retinal detachment depending on its extent. In mild cases, a special type of gas may be injected inside the eye to flatten the retina. This technique is called pneumatic retinopexy and requires the patient to strictly comply with head positioning. This is followed by laser application around the retinal tear. Pneumatic retinopexy has a success rate of 50-90%. It is quick and is usually done under topical anesthesia. In majority of cases, retinal detachment is treated by surgery called vitrectomy. During vitrectomy, the vitreous is removed from the eye and is replaced by gas or silicone oil at the end of the surgery. The gas or silicone oil flattens the detached retina; laser can then be applied around the retinal tears or throughout the retinal periphery to prevent it from re-detaching. In severe cases, a belt sutured around the eyeball is necessary to repair a retinal detachment. Vitrectomy usually requires general anesthesia.

What is age-related macular degeneration?

Age-related macular degeneration (AMD) is changes in the macula that is caused by aging.

What are the forms of age-related macular degeneration?

There are 2 forms of AMD: the dry type and the wet type. The dry type consists of drusen which are deposits deep in the macula and areas of thinned out retina. In the wet type of AMD, a vascular membrane forms under the macula. This membrane may bleed and may leak out protein and fluid that can cause rapid decrease in vision.

How is age-related macular degeneration detected?

AMD is diagnosed through an eye examination performed by an ophthalmologist. After measuring the level of vision, Amsler grid is performed to detect for any scotomas or distortion in vision. Pupil dilation by administration of dilating eye drops is usually required to examine the macula. The ophthalmologist uses special lenses to get a magnified view of the macula. In majority of cases, a fluorescein angiogram is requested. This test takes consecutive photos of the eye after a medical dye that is injected into the arm reaches the eye. Fluorescein angiogram helps the ophthalmologist in determining if a patient has a dry or wet form of AMD. An optical coherence tomography (OCT) of the macula is another diagnostic test that can detect the presence and amount of fluid in the macula in wet AMD.

How is age-related macular degeneration treated?

There is no cure, but age-related macular degeneration treatments may prevent severe vision loss or slow the progression of the disease considerably. Several treatment options are available, including:

Anti-angiogenic drugs. These medications — injected into the eye — block the development of new blood vessels and leakage from the abnormal vessels within the eye that cause wet macular degeneration. This treatment has been a major change in the treatment of this condition and many patients have actually regained vision that was lost. The treatment may need to be repeated on follow-up visits.

Laser therapy. High-energy laser light can sometimes be used to destroy actively growing abnormal blood vessels that occur in age-related macular degeneration.

What is age-related macular degeneration?

There is no treatment for mild forms of dry AMD except smoking cessation and increasing dietary intake of omega-3-fatty acids which is found in fish. Patients with moderate to severe forms of dry AMD are advised oral intake of antioxidants containing beta-carotene, zinc, copper and Vitamins C and E. Wet type of AMD requires more aggressive treatment including oral antioxidants, laser treatment and injection of medications into the eye.

What is diabetic retinopathy?

Diabetic retinopathy is changes in the blood vessels of the retina that is caused by prolonged periods of poorly controlled blood sugar level in a patient with diabetes. The blood vessels may become “leaky” and leak out fluid and protein to the surrounding retina resulting to macular edema. Macular edema may compromise and distort vision. The blood vessels also fail to supply the retina with adequate oxygen and nutrients resulting to retinal ischemia. Retinal ischemia, in turn, promotes growth of abnormal new blood vessels. These new abnormal blood vessels bleed easily resulting to hemorrhages that may be confined in the retina or escape to the vitreous. If there is a lot of blood in the vitreous, a patient may experience sudden loss of vision.

Who is at risk for diabetic retinopathy?

Patients who have diabetes are at risk for developing diabetic retinopathy. Patients with type 1 diabetes are advised to have their eyes examined 5 years after diagnosis.

How is diabetic retinopathy diagnosed?

Diabetic retinopathy is diagnosed thru a dilated fundus examination. The eyes are dilated by instilling 1 to 3 drops of a dilating agent. It may take 15 to 30 minutes to achieve maximal dilation. The entire retina is then examined by an ophthalmologist using special lenses and an instrument that emit bright light. Oftentimes, a fluorescein angiography is performed. This is a test that takes consecutive pictures of your retina after a medical dye that is injected to your eye reaches your retina. An optical coherence tomography (OCT) of the macula is also done to determine the degree of macular edema.

How is diabetic retinopathy treated?

Early forms of diabetic retinopathy require no treatment other than strict blood sugar and blood pressure control. Regular eye check-up is recommended to monitor progression of the disease.

Macular edema is treated with multiple injections of anti-VEGF drugs. VEGF stands for vascular endothelial growth factor. This is produced by the retina and promotes growth of abnormal blood vessels. VEGF also causes blood vessels to become leaky. Anti-VEGF drugs bind to these VEGF blocking their action. There are several anti-VEGF drugs available in the market. Two have FDA approval for intraocular use: Lucentis and Macugen. Avastin is an anti-VEGF developed for colon cancer. It is being used to treat various eye conditions for the last several years. In select cases, macular edema may also be treated by laser which targets the leaky blood vessels.

In advanced forms of diabetic retinopathy, laser is applied to the retinal periphery. Laser halts the progression of the disease. Surgery or vitrectomy is performed in severe, complicated cases, especially in eyes with vitreous hemorrhage and retinal detachment due to diabetic retinopathy.

Our Medical Services

You are assured of the best eye treatment service from Peregrine Eye and Laser Institute (PELI). From prescription glasses, treatment of eye disease symptoms to eye surgery and eye laser treatment, we offer a wide range of services and procedures that answer all your eye care needs. Schedule a check-up today!

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