Special Testing and Surgery
We offer complete diagnostic testing including fundus photography, fluorescein angiography, ultrasound, and visual fields. We make every effort to complete all of the special testing that might be needed on the day of your visit, depending on medical necessity and the requirements of your insurance. Our patients often require in-office procedures.
We offer state-of-the-art laser equipment and procedures including:
- Multi-wavelength thermal laser
- Ocular Photodynamic laser (Visudyne®)
- Transpupillary Thermotherapy
- Intraocular injections (Avastin, Macugen, Kenalog)
This equipment allows us to provide state-of-the-art laser surgical treatment for many retinal diseases and in particular, diabetic retinopathy and macular degeneration.
Retinal detachment and vitreous surgery is most often performed in the hospital on an outpatient basis. This surgery requires specialized equipment and specially trained nurses. We have developed a retina-vitreous surgical suite team at Sunrise Hospital, Summerlin Hospital and St. Rose Hospital Siena Campus, which meets all of our requirements for retinal and vitreous surgery.
We are fortunate to live in a time of rapidly advancing medical knowledge. We believe that ongoing research into disease states and treatments is a vital part of improving our patients' well being. Research enables new cures and better treatments.
Below are summaries of recent treatments in which the doctors in our practice are participating.
Just as in cataract surgery in which we have made many advances in making the surgery safer and less invasive with quicker healing times, we at Retina Consultants of Nevada are working on making vitrectomy less invasive. We are currently working with a system that involves few incisions, quicker healing and in many cases no stitches. This procedure does not work for all conditions requiring a vitrectomy.
Conditions our Physicians Treat
- Age-Related Macular Degeneration (AMD): Age-related macular degeneration is an ocular disease associated with degeneration and breakdown of the central retina (i.e. the macula). Macular degeneration generally does not result in total blindness. People continue to have some useful vision and are able to take care of themselves.
- Central Serous Retinopathy: This condition causes a painless loss of the central portion of the vision. There may be distortion, changes in the color vision, objects may look smaller and there is a central black or gray spot.
- Choroidal Nevus: A nevus is a benign growth on the conjunctiva (surface of the eye), the iris (the colored part of the eye) or the choroid (the back of the eye). It is similar to a freckle on the skin.
- Cystoid Macular Edema: Cystoid macular edema (CME), or swelling of the central vision (macula), typically occurs as a result of disease, injury or eye surgery. Fluid collects within the layers of the macula, causing blurred, distorted central vision.
- Diabetic Retinopathy: In diabetes mellitus, the body does not use glucose (sugar) properly. High blood glucose levels can damage blood vessels in the retina, causing diabetic retinopathy. Diabetic macular edema is a swelling, or thickening of the macula, from these damaged leaking retinal vessels. The macula is a small area in the center of the retina that is primarily responsible for our central vision. Current treatments available for these conditions involve laser treatment. These laser treatments have reduced the risk of blindness from diabetic retinopathy, but we are also evaluating some of the new medications that may help to preserve vision in this disease, such as kenalog, Avastin Lucentis and Flucinolone, either alone or in combination with laser.
- Face-Down Recovery After Retinal Surgery: The most common reasons requiring face down positioning after retina surgery is a retinal detachment or a macular hole. To repair a damaged retina or a macular hole the vitreous is removed from the eye (vitrectomy) and replaced with a gas bubble or silicone oil. This bubble helps to reattach the retina or close the macular hole. You may need to keep your head face down (parallel to the ground) for up to several weeks after surgery.
- Floaters: Floaters are little "cobwebs" or specks that float about in your field of vision. They are small, dark, shadowy shapes that can look like spots, thread-like strands, or squiggly lines. Floaters occur when the vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape, slowly shrinks. As the vitreous shrinks, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina.
- Low Vision: Low vision is a loss of eyesight that makes everyday tasks difficult. A person with low vision may find it difficult or impossible to accomplish such activities as reading, writing, shopping, watching television, driving a car, recognizing faces, and crossing the street. When vision cannot be improved with regular eyeglasses, medicine, or surgery, people with low vision need help to learn how to make the most of their remaining sight and keep their independence.
- Macular Hole: The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail. A macular hole is a small break in the macula, located in the center of the eye's light-sensitive tissue called the retina. A macular hole can cause blurred and distorted central vision. Macular holes are usually related to aging and occur in people over age 60, however they can also occur after an injury.
- Macular Pucker: A macular pucker is scar tissue that has formed on the eye's macula, located in the center of the eye's light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail. A macular pucker can cause blurred and distorted central vision.
- Photodynamic Therapy: PDT is an outpatient procedure in which a special light activated drug (Visudyne) is injected into a vein in the arm or hand. This drug accumulates in abnormal blood vessels under the macula. A non-thermal laser is then directed at the abnormal blood vessels. This causes damage to the abnormal blood vessels and spares the normal retina and normal blood vessels.
- Posterior Vitreous Detachment: Most of the eye's interior is filled with vitreous, a gel-like substance that helps the eye maintain a round shape. There are millions of fine fibers intertwined within the vitreous that are attached to the surface of the retina, the eye's light-sensitive tissue. As we age, the vitreous slowly shrinks, and these fine fibers pull on the retinal surface. Usually the fibers break, allowing the vitreous to separate and shrink from the retina. This is a vitreous detachment. In most cases, a vitreous detachment is not sight-threatening and requires no treatment.
- Retinal Artery Occlusion: A Retinal Artery Occlusion is a blockage or obstruction of the arteries in the retina. This is like a stroke in the eye. The retina is the light-sensitive layer of tissue that lines the back wall of the eye and is responsible for vision.
- Retinal Tears and Retinal Detachment: A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred, just as a photographic image would be blurry if the film were loose inside the camera. A retinal detachment is a very serious problem that almost always causes blindness unless it is treated.
- Retinal Vein Occlusion: In retinal vein occlusions one of the major blood vessels is blocked off causing swelling and bleeding in the eye. This can result in severe loss of vision. In patients with a retinal vein occlusion the vision loss may be due to the poor circulation or the leaking/edema in the eye. Some patients with leakage in the eye are treated with laser. We are evaluating the use of Avastin and Lucentis, with and without laser treatment, for the treatment of this condition.
- Retinopathy of Prematurity: Babies who are born prematurely still have a growing retina. The retina usually finishes growing a few weeks to a month after birth in full term babies, but in premature babies the retina is still growing. During the course of this growth, the blood vessels that bring blood to the retina can begin to develop abnormally. This abnormal growth is called retinopathy of prematurity.
- Tumors of the Eye: Malignant tumors can metastasize to the eye, just as they can metastasize to other parts of the body. The most common cancers that affect the internal structures of the eye originate in the breast, lung, prostate, and bone marrow (leukemia). Typically, these cancers cause tumors within the eye after the cancer has been diagnosed elsewhere.
- Vitrectomy: Vitrectomy is a microsurgical procedure in which specialized instruments and techniques are used to repair retinal disorders, many of which were previously considered inoperable.