A quick look at some of the most common eye diseases diagnosed and often treated at Bogey Hills Vision Center.
Diabetic Eye Disease
Diabetes can cause damage in multiple organ systems of the body, which includes the eyes. It causes the small blood vessels in the delicate inner lining of the eye (retina) to leak fluid, blood, and proteins which can damage the retina. This is called background diabetic retinopathy. Early diabetic retinopathy may not require any treatment itself, but it is important to monitor closely and take necessary steps to better control blood sugar. If retinal swelling extends to the central, most sensitive part of the retina, visual acuity may be compromised. This is called diabetic macular edema and usually requires treatment. As diabetic retinopathy progresses, the damaged, oxygen-starved retina sends out signals that cause new blood vessels to form. This is called proliferative diabetic retinopathy and is almost always visually devastating due to damage to the retina and end-stage retinal detachment.
Diabetes is the leading cause of new vision loss in adults in the United States, so it is crucially important for those with diabetes to have regular, comprehensive eye examination and early interevention if there are any ocular findings. Diabetics also have a higher rate of dry eyes, cataracts, and poor healing of the front of the eye in case of an injury, etc. The doctors at Bogey Hills routinely evaluate those with diabetes for any signs of retinopathy. We have retinal cameras to photo-document any findings and an instrument called an OCT that images the microscopic, individual layers of the retina and measures any retinal swelling. Our doctors will always send communication or a report to your primary care doctor or endocrinologist.
Glaucoma is a disease of the optic nerve in the eye. Glaucoma is actually a general term that includes more than one disease process of the eye. There is a congenital type that is caused by genetic malformation of the front of the eye, presenting in infancy or early childhood. Glaucoma can be ‘secondary’ to something like a major injury to the eye. There are less common subtypes called ‘pigmentary glaucoma’, ‘psuedo-exfoliative glaucoma’, and ‘neovascular glaucoma’. Also, there is a type called narrow-angle glaucoma which is caused by a rise of fluid pressure in the eye due to an anatomically small fluid drainage area. Narrow-angles may sometimes lead to something called an ‘angle closure’. This involves a sudden significant increase of fluid pressure in the eye that causes symptoms of pain, nausea, and blurred vision and potentially irreversible damage to the optic nerve. This is an ocular emergency and needs to be treated right away.
More often than not, though, the term ‘glaucoma’ is commonly used for a condition called ‘primary open angle glaucoma’, a slow but progressive degeneration of the optic nerve of the eye that may result in visual field loss and potentially blindness. It is called ‘the silent thief of sight’, because there generally are not any symptoms. Having high fluid pressure in the eye is a risk factor, but some individuals may develop glaucoma when their eye pressures are in the range considered ‘normal’. While there is no cure for glaucoma, there are medications and surgery available that can help halt further vision loss. Early detection and regular eye exams are vital to slowing the progress of the disease.
Macular degeneration is a chronic, progressive disease that gradually destroys sharp central vision due to a deterioration of the macula, a tiny spot in the central portion of your retina comprised of millions of light-sensing cells. Because it is so commonly associated with aging, it is also known as age-related macular degeneration (AMD or ARMD). Risk factors include family history, smoking, race, sun exposure, and possibly improper diet. Chemical reactions occur in the retina when visible light is converted to impulses in the cells of the retina. The job of the pigmented tissue layer underneath the retina is remove the waste products that are the result of this process. It seems that in ARMD, waste products are not removed properly and yellowish spots called ‘drusen’ appear. This is a sign of ‘Dry’ ARMD. Dry ARMD may range from a person being asymptomatic to significant vision loss. There is no cure for Dry ARMD, though the use of antioxidant dietary supplements do seem to slow the progression in a portion of those affected. In a percentage of those with ARMD, ‘Wet’ ARMD will occur. This is where new blood vessels grow under the macula. Unfortuntely, this blood vessels are poorly contructed, and leak, causing more damage. There are newer medications available now that are quite effective in treating Wet ARMD if administered in a timely manner.