The eye works a lot like a camera. Light enters through the cornea (the clear front window of the eye) and passes through the pupil, the opening controlled by the colored iris. The lens, located just behind the iris, focuses that light onto the back of the eye.

The retina is the thin layer of light-sensitive tissue lining the back wall of the eye. If the eye is a camera, the retina is the film. It captures the light focused by the lens, converts it into electrical signals, and sends those signals through the optic nerve to the brain, where they become the images you see.

At the very center of the retina is a small area called the macula. The macula is responsible for your sharp, detailed central vision, the vision you use to read, drive, recognize faces, and see fine detail. The rest of the retina provides your peripheral (side) vision.

Because the retina is delicate and cannot be replaced, conditions that affect it can have a serious impact on vision. The good news is that many retinal conditions can be treated effectively, especially when they are caught early.

Patient Education

Understanding your eyes and your diagnosis is an important part of your care. Below you'll find a simple overview of how the eye works and some of the most common conditions we treat.

The Eye and the Retina

Common Retinal Conditions We Treat

Age-Related Macular Degeneration (AMD)

AMD is a gradual breakdown of the macula, the part of the retina responsible for central vision, and is the leading cause of vision loss in adults over 60. It comes in two forms. Dry AMD, the more common form, progresses slowly as small deposits called drusen accumulate under the retina. Wet AMD is less common but more serious: abnormal blood vessels grow beneath the retina and leak fluid or blood, which can damage central vision quickly.

Treatment: Dry AMD is managed with monitoring, specific vitamin supplements (the AREDS2 formula), and healthy lifestyle habits. Newer injectable medications are also available for advanced dry AMD. Wet AMD is treated with injections of medication into the eye (anti-VEGF therapy) that stop the abnormal vessels from leaking. These injections sound intimidating, but they are quick, performed with numbing drops, and have preserved vision for millions of patients.

Diabetic Retinopathy

High blood sugar from diabetes can damage the small blood vessels of the retina over time, causing them to leak, close off, or grow abnormally. In its early stages, diabetic retinopathy often has no symptoms at all, which is why every person with diabetes needs regular dilated eye exams. A related complication, diabetic macular edema, occurs when fluid builds up in the macula and blurs central vision.

Treatment: The most important treatment is good control of blood sugar, blood pressure, and cholesterol. In the eye, options include anti-VEGF injections to reduce swelling and leakage, laser treatment to seal leaking vessels or slow abnormal vessel growth, and surgery (vitrectomy) for advanced cases with bleeding or scar tissue.

Retinal Tears and Retinal Detachment

The inside of the eye is filled with a gel called the vitreous. As we age, this gel shrinks and can tug on the retina, sometimes creating a tear. Fluid can then pass through the tear and lift the retina off the back wall of the eye, like wallpaper peeling off a wall. This is a retinal detachment, and it is a medical emergency. Warning signs include a sudden shower of new floaters, flashes of light, or a dark curtain or shadow moving across your vision.

Treatment: A retinal tear caught early can usually be sealed in the office with laser treatment or freezing therapy (cryopexy), preventing a detachment. A detached retina requires surgery, which may involve placing a gas bubble in the eye (pneumatic retinopexy), a flexible band around the eye (scleral buckle), or removing the vitreous gel and reattaching the retina from the inside (vitrectomy). Prompt treatment greatly improves the chances of preserving vision.

Macular Hole

A macular hole is a small gap that forms in the very center of the macula, usually as a result of the vitreous gel pulling on the retina as it separates with age. It causes blurring and distortion of central vision, and often a small blind spot in the middle of what you're looking at.

Treatment: Most macular holes are repaired with vitrectomy surgery. The vitreous gel is removed and a gas bubble is placed in the eye to gently hold the edges of the hole together while it heals. Patients may need to keep their head in a face-down position for a period of time after surgery. Success rates are high, especially when the hole is treated early.

Epiretinal Membrane (Macular Pucker)

An epiretinal membrane is a thin layer of scar tissue that grows on the surface of the macula. As it contracts, it can wrinkle the retina underneath, much like cellophane pulled tight over a surface. Many membranes are mild and cause few symptoms, but some cause noticeable blurring or make straight lines appear wavy.

Treatment: Mild membranes often need only monitoring. When vision becomes significantly blurred or distorted, the membrane can be removed with vitrectomy surgery, in which the scar tissue is gently peeled off the retinal surface. Vision typically improves gradually over the following months.

Retinal Vein Occlusion

Sometimes described as a "stroke in the eye," a retinal vein occlusion happens when one of the veins draining blood from the retina becomes blocked. Blood and fluid back up into the retina, causing swelling and sudden, painless blurring or loss of vision in one eye. High blood pressure, diabetes, and glaucoma are common risk factors.

Treatment: The swelling caused by a vein occlusion responds well to anti-VEGF injections, and steroid injections are another option. Laser treatment is sometimes used for complications. Managing underlying conditions like blood pressure is an important part of care.

Posterior Vitreous Detachment (Floaters and Flashes)

As the vitreous gel shrinks with age, it eventually separates from the retina. This is called a posterior vitreous detachment, or PVD, and it happens to most people at some point, typically after age 60. It often causes new floaters (small specks, cobwebs, or squiggly lines drifting through your vision) and sometimes brief flashes of light.

Treatment: A PVD by itself is harmless and usually needs no treatment; the floaters become less noticeable over time. However, in a small number of cases, the separating gel tears the retina. That's why any sudden onset of new floaters or flashes should be evaluated promptly with a dilated exam, so we can make sure the retina is intact.