Retinoschisis

Retinoschisis is a genetic eye disease that splits the retina, the light-sensitive layer of cells lining the back of the eye. It occurs in two forms, one affecting young children, the other older adults. Both forms usually affect both eyes, though one eye may be worse than the other.

Because the disease is inherited on the X chromosome, childhood retinoschisis occurs in boys more than girls. It is usually detected because of poor vision.

If the split retina involves the peripheral or side retina, peripheral vision is lost. One is also at risk for a retinal detachment. But more commonly, retinoschisis affects the macula, the area of the retina responsible for central vision. In this location, one loses central vision.

Peripheral retinoschisis, more common in adults, is usually caused by aging and does not affect vision, but it can cause a retinal detachment. If detected early, a retinal detachment can be treated with surgery or laser therapy.


Stargardt’s Disease

Stargardt’s is an inherited disease that affects the retina, the layer of light-sensitive cells lining the back of the eye. It usually becomes apparent between the ages of 8 and 14. Boys and girls are equally susceptible and more than one child in a family may have it.

Stargardt’s disease begins with slightly blurry vision that gradually gets worse. By the late 20s, vision is typically about 20/200, the level labeled legally blind. Remaining vision is good enough for most people to live fairly normal lives, though they won’t drive, or read without using magnification devices.

A build-up of lipofuscin (fatty substance) in retinal cells is thought to cause Stargardt’s disease. The buildup typically happens in the central retina, or macula, where it resembles beaten bronze. Or, it can occur in the side retina where it causes small white flecks. This form is called fundus flavimaculatus. Angiography, a special photograph of the retina, may aid in the diagnosis. Although no specific medical or surgical treatment is available, glasses and magnification help affected people adapt to the disease.

Toxoplasmosis

Toxoplasmosis is a common parasitic infection. When contracted by a pregnant woman, toxoplasmosis can pose serious risks to the unborn baby. Simple precautions can reduce the chance of infection.

Pregnant women should avoid handling litter boxes and eating raw meat because the parasite may originate in cat feces or undercooked meat. If acquired during the first trimester of pregnancy, the infection can be devastating to an infant.

Toxoplasmosis affects the retina, the light-sensitive cells lining the back of the eye. Both eyes are usually involved. If the infection settles in the macula, the area of the retina responsible for central vision, good vision is lost forever.

When toxoplasmosis heals, it leaves a scar. The infection may recur years later, sometimes near the previously infected area. Swelling that fights the infection may cause floating spots in one’s vision, red, painful eyes, and poor vision.

Treating toxoplasmosis with oral medications can be very effective. Pyrimethamine and sulfa drugs are the classic antibiotics although some doctors add or substitute clindamycin. Occasionally steroids, laser, or freezing (cryotherapy) treatments are prescribed.

Screening tests can identify women of childbearing age who are at risk of passing the infection to an unborn child.


Vitrectomy Surgery

Vitrectomy is a type of eye surgery used to treat disorders of the retina (the light-sensing cells at the back of the eye) and vitreous (the clear gel-like substance inside the eye). It may be used to treat a severe eye injury, diabetic retinopathy, retinal detachments, macular pucker (wrinkling of the retina) and macular holes.

During a vitrectomy operation, the surgeon makes tiny incisions in the sclera (the white part of the eye). Using a microscope to look inside the eye and microsurgical instruments, the surgeon removes the vitreous and repairs the retina through the tiny incisions. Repairs include removing scar tissue or a foreign object if present.

During the procedure, the retina may be treated with a laser to reduce future bleeding or to fix a tear in the retina. An air or gas bubble that slowly disappears on its own may be placed in the eye to help the retina remain in its proper position or a special fluid that is later removed may be injected into the vitreous cavity.

Recovering from vitrectomy surgery may be uncomfortable but the procedure often improves or stabilizes vision. Once the blood- or debris-clouded vitreous is removed and replaced with a clear medium (often a saltwater solution), light rays can once again focus on the retina. Vision after surgery depends on how damaged the retina was before surgery.