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What are retinal conditions?

The retina is composed of a light-sensitive tissue that lines the inner surface of the eye, Upon entering the eye, light passes through the cornea, the lens and the vitreous (clear gel that fills the space between the lens and the retina) before reaching the retina. The optics of the eye create an image on the retina, much like a camera film, that triggers electrical impulses that stimulate various visual centres of the brain via the optic nerve. In the centre of this nerve tissue is the macular, which provides the sharp, central vision needed for reading, driving and seeing fine detail.

Over time, the usually clear vitreous can become opaque, and will impede light from reaching the retina, resulting in visual problems such as ‘floaters’ (cobwebs or specks in your field of vision) or hazy vision.

There are a number of different disorders that may affect the retina, a few of which are detailed below:

  • Age-related Macular Degeneration (AMD) has been covered in great detail; for more information regarding this disorder please use the menu above.
  • Macular hole – this is a small hole in the macular, which is located at the centre of the retina, and is responsible for our sharp and detailed central vision.
  • Retinal detachment – the retina may peel away from its underlying support tissue and therefore become detached or torn. The reason for the detachment may be due to a shrinking vitreous, in an ageing eye. The force exerted by the vitreous as it shrinks can be enough to tear the retina.
  • Diabetic retinopathy – diabetes can affect sight by causing cataracts, glaucoma and may cause damage to blood vessels inside the eye. This latter problem may cause the retina to leak blood, grow fragile brush-like branches and scar tissue.

Who is at risk?

Retinal disorder may be caused by a number of factors, ranging from a weakness of the retina to family history. However, it is difficult to clearly stipulate the risk factors associated with these conditions, as there are individual factors for each individual condition.

  • Firstly, diabetics will be most at risk of developing diabetic retinopathy (both type I and type II), although it will affect those who have suffered from diabetes over a longer period.
  • Macular holes are most likely to arise in patients over 55 years of age, and will gradually cause degradation to eyesight.
  • Retinal detachment is relatively rare, but the risk of developing this disorder may be increased in patients who are very short-sighted (myopic), those who have recently received an injury to the eye or blow to the head, and in patients who have recently undergone cataract surgery, etc. All risks of these surgeries will, of course, be discussed and outlined by your consultant prior to the surgery itself. Also, the risk of spontaneous retinal tears or detachments will increase as we grow older.

How retinal conditions affect our vision

At its earliest stages, diabetic retinopathy may have no symptoms, which is why it is important for diabetics to have regular check-ups. The symptoms that may occur include blurred or distort vision. In addition, patients may suffer from the following:

  • Difficulty reading
  • Sudden loss of vision in one eye
  • Seeing rings around lights
  • Dark spots or flashing lights

Contrastingly, retinal detachment may give rise to the following symptoms:

  • Flashes of light in the extreme peripheral (side) vision
  • ‘Floaters’
  • Feeling of heaviness in the eye

If left untreated, retinal detachment can lead to blindness, and is considered a very serious condition.

In addition, if you have experienced retinal detachment in one eye, you are at an increased risk of developing one in your other eye (approximately 10%). However, generally speaking, this is a relatively uncommon disorder.

Macular holes usually only affect one eye, but there is also a 10% chance that your other eye will eventually be affected.

How retinal conditions are treated

In milder cases, treatment for diabetic retinopathy may not be necessary, although regular exams are critical. For more advanced cases, your consultant may recommend one of the following types of treatment to prevent vision loss:

  • Scatter laser treatment and Cryotherapy (freezing) both help to shrink the abnormal blood vessels within the eye
  • A Vitrectomy may be recommended if there is a lot of bleeding within the eye, and will look to remove any part of the vitreous containing blood

Similarly, your consultant may recommend Vitrectomy surgery for a macular hole, which can be carried out under general or, more commonly, local anaesthetic. Your consultant will remove any opaque cells contained in the vitreous, allowing the light to effectively reach the retina again.

With respect to retinal detachments, vision loss can be prevented using sclera buckling or vitrectomy surgery. Laser surgery or cryotherapy (freezing) may also be utilised to seal tears and prevent detachment.

All options available to you for treatment for any retinal disorder will be fully discussed with your consultant at your initial consultation.

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