Our medical team includes experienced retinal specialists who treat a wide range of retina disorders and conditions, including: flashes, floaters, diabetic retinopathy, retinal detachment, vein or artery occlusion, retinopathy or age-related macular degeneration.
We treat retinal disorders through a number of procedures, including: intravitreal anti-VEGF injections, Steroid Injections, vitrectomy, epiretinal membrane peel, floaterectomy, scleral buckling surgery or pneumatic retinopexy.
Anti-VEGF treatment is a way to slow vision loss in people who have a condition called “wet” age-related macular degeneration.
Age-related macular degeneration (or AMD) is the leading cause of vision loss in people 50 years or older in the United States. It involves damage to the part of the eye called the macula. The macula is a small but extremely important area located at the center of the retina, the light-sensing tissue lining the back of the eye.
The macula is responsible for your ability to see fine details clearly. You rely on your macula whenever you read, drive, or perform any other activity that requires seeing precise details, such as threading a needle.
A person with AMD loses the ability to perceive fine details both up close and at a distance. This loss of detailed vision affects only your central vision. The side, or peripheral, vision usually remains normal. For example, when people with AMD look at a clock, they can see the clock’s outline but cannot tell what time it is.
There are two common types of AMD. Most people (about 90 percent) have a form of AMD called atrophic or dry AMD, which develops when the tissues of the macula grow thin with age. Dry AMD usually causes a slow loss of vision. A second, smaller group of people (about 10 percent) have a more serious condition called exudative or wet AMD. Wet AMD occurs when abnormal blood vessels grow underneath the retina. These unhealthy vessels leak blood and fluid, which can scar the macula. For patients with wet AMD, vision loss may be rapid and severe.
Yes, Anti-VEGF treatments are versatile and effective for managing a range of retinal conditions beyond wet AMD. These include diabetic retinopathy, retinal vein occlusions, and myopic degenerations. The frequency and duration of injections vary based on the specific condition being treated.
Researchers who study wet AMD have found that a certain chemical in your body is critical in causing abnormal blood vessels to grow under the retina. That chemical is called vascular endothelial growth factor, or VEGF. Recently, scientists have developed several new drugs (anti-VEGF) that can block the trouble-causing VEGF. Blocking VEGF reduces the growth of abnormal blood vessels, slows their leakage, and helps to slow vision loss.
The anti-VEGF drug must be injected into your eye with a very fine needle. Your ophthalmologist (Eye M.D.) will clean your eye to prevent infection and will administer an anesthetic to your eye to reduce pain. Usually, patients receive multiple anti-VEGF injections over the course of many months.
As with any medical procedure, there is a small risk of complications following anti-VEGF treatment. Any complications that might occur usually result from the injection itself, which in rare circumstances can injure the eye’s lens or retina or lead to an infection. For most people, though, the benefit of the treatment outweighs the small risk of injection injury.
Your ophthalmologist will determine if the treatment is appropriate for you. Only patients with the wet form of AMD can benefit from it. In some cases, your ophthalmologist may recommend combining anti-VEGF treatment with other therapies. The treatment that’s right for you will depend on the specific condition of your macular degeneration.
Anti-VEGF treatment is a step forward in the treatment of wet AMD because it targets the underlying cause of abnormal blood vessel growth. The treatment may offer new hope to thousands of people diagnosed with wet AMD.
Vitrectomy is a surgical procedure undertaken by a specialist where the vitreous humor gel that fills the eye cavity is removed to provide better access to the retina. This allows for a variety of repairs, including the removal of scar tissue, laser repair of retinal detachments, and treatment of macular holes. Once surgery is complete, saline, a gas bubble, or silicone oil may be injected into the vitreous gel to help hold the retina in position.
Floaters are a very common ocular complaint. They are caused by opacities in the vitreous gel, which cast shadows on the retina. These are interpreted by the brain as floaters in the vision. As the eye ages these floaters become more prevalent, particularly if the vitreous gel separates completely from the retina (a process called posterior vitreous separation).
A floaterectomy (also known as a Floaters only vitrectomy, or FOV) is a procedure in which the vitreous gel is removed from the eye and replaced with a clear saline fluid. The instruments used are extremely small and therefore the incisions rarely require sutures, resulting in minimal postoperative discomfort.
While floaters can be frustrating they do not actually cause any ongoing structural damage to the eye. The symptoms will also sometimes resolve with watchful waiting. Therefore, floaterectomy surgery, or FOV, is not considered a medically necessary procedure and is not covered by Alberta Health Care.
The surgery is performed at Southern Alberta Eye Centre, and you can go home immediately after your surgery. It is recommended that a friend or family member accompany you on the day of your procedure. You will have a patch on the operated eye and will be unable to drive afterwards. The patch will be removed on your postoperative day 1 visit with your doctor. In almost all cases the surgery is performed using local anesthesia rather than general anesthesia, although general anesthesia is available as an option.
Typically, patients are seen 1 day, 1 week, and 1 month following their surgery. During the first two weeks after surgery there are a number of activities that are not recommended. These include driving, any activities requiring lifting more than 10 lbs, or getting water in your eye (including while bathing). Avoid any activities that would require bending at the waist. You should also avoid reading, using computers or mobile devices. Watching TV is ok, provided it is from a distance of 6 feet or more. Activities performed at a distance require far less eye movement or strain compared with activities done within arm’s length. Traveling by air during the first month after surgery is strongly discouraged. In some circumstances an air bubble may be intentionally left in the eye during the surgery to facilitate healing and in these circumstances air travel is absolutely contraindicated until the air bubble has disappeared.
Scleral buckling is a surgical option for treating retinal detachment. During this procedure, a small piece of silicone band or sponge is placed on the outside of the eye and sutured in place. This pushes the outer wall (sclera) of the eye inward, closing the retinal break and allowing the retina to reattach.
One benefit of scleral buckling surgery is the lower risk of cataract development compared to vitrectomy surgery. Additionally, there is no entry of instruments into the eye, and usually, no face-down positioning is required post-surgery. However, sutures are needed to secure the conjunctiva, resulting in more postoperative discomfort compared to vitrectomy or pneumatic retinopexy. These sutures are absorbable, but some pain medication is typically required for the first week.
Both general anesthesia and local anesthesia are options for this procedure, and the choice can be discussed with the anesthetist at the time of surgery.
Scleral buckles are often used in younger patients with retinal detachments, as cataract formation has more significant consequences in this age group. The configuration and extent of the detachment are key factors in deciding whether to use a scleral buckle, vitrectomy, pneumatic retinopexy, or a combination of these techniques. Your retinal specialist will advise you on the best option for your eye.
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Pneumatic retinopexy is an option for treating retinal detachment, particularly when there is a single retinal tear in the upper half of the retina. It can also be considered if there are multiple tears close to each other and the detachment is recent. Your retinal specialist will determine if this procedure is right for you.
During the procedure, a small gas bubble is injected into the back of the eye. The bubble expands and pushes the retina back in place. Once reattached, laser retinopexy or cryotherapy is applied around the retinal tear(s) to create a scar that holds the retina permanently. This may be done on the same day or a few days later. Unlike scleral buckling or vitrectomy surgery, pneumatic retinopexy is performed in the office and does not require an operating room visit.
The gas bubble eventually absorbs into the bloodstream and is replaced by clear fluid. Until the bubble resolves, it is crucial to avoid flying or significant altitude changes, as these can cause the gas to expand and increase eye pressure, leading to irreversible damage. Inform other physicians or dentists about the gas bubble, as certain medications can also cause expansion. Your retinal specialist will let you know when it is safe to travel by air.
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