Retinal Questions

It appears that the holes in your retina have been treated very successfully. Unfortunately there is very little that one can do on a preventative basis to avoid additional holes in the retina. Regular examinations and immediate evaluation of any unusual visual symptoms occur especially floaters or flashes of light are the best method for avoiding problems from holes in the retina.

The good news is; that there is almost nothing in terms of an individual's activity that would cause a hole in the retina or predispose one to develop them. In particular, use of the eyes even in the fashion you described will not have any effect on the development of retinal holes so there should be no concern with extensive reading or computer-work, for example.

My friend's 11-year -old son has the following case of history: Five year old patient had read a book holding it on the normal distance from the eyes. He had normal focus of vision. Six and half years old (April 1994) patient has been inspected (before school) and shown 0.4 per each eye. In August of this year the results was 0.1 per each eye. Physicians had not precise diagnosis (all was under question). They found a little astigmatism. Doctors can not gave any recommendations concerning vision correction. During more detail inspection physicians concluded that diagnosis can be following: atrophic of the visual nervous. In 1996 the diagnosis "Atrophic of the visual nervous" has been deflected after examination with the help of laser. Doctors decided that nervous was discolored. The little divergent squint and loss of central fixation of vision had discovered. In 1997 patient had course of needle reflexotherapy. The vision on the left eye improved up to 0.3, on the right - up to 0.2. Half year later the results returned to the previous figures – 0.1 per each eye. During next inspection (in 1998) physicians changed diagnosis on the "Macula-dystrophy of retina". Citomegalovirus (as version) was excluded. So the questions are: 1. Does this seem to be curable at all. 2. Where in Canada/USA can it be done. 3. Approximately, how much may it cost. Thanks for your help. P.S. His another boy, 8-years old, seems to have alike problem.

The eye problem you describe has obviously been difficult to evaluate and diagnose. It appears that it may involve either the macula, the center of the retina or the optic nerve or both. While certain conditions affecting the areas of the eye do not have any treatment or cure, it would be important to determine exactly which type of problem is present before making the best determination of whether treatment is possible. A detailed examination by an ophthalmologist who is a specialist in retinal diseases and/or a neuro-ophthalmologist would be very helpful in determining whether or not treatment could be beneficial. If the child's brother has a similar problem this may be an hereditary condition and knowing the condition of both boys and having them both examined could greatly aid in the diagnosis and possible treatment. Please contact us if you have further questions.

What are "cotton wool spots" and what causes them?

Cotton wool spots are small areas of yellowish white coloration in the retina. They occur because of swelling of the surface layer of the retina, which consists of nerve fibers. This swelling almost always occurs because the blood supply to that area has been impaired and in the absence of normal blood flow through the retinal vessels the nerve fibers are injured in a particular location resulting in swelling and the appearance of a "cotton wool spot. " The most common causes of cotton wool spots are diseases, which affect the retina such as diabetes and high blood pressure. Often cotton wool spots will disappear on their own, but new ones may occur because the underlying condition may continue to cause blood flow problems. Most often the cotton wool spots themselves do not cause visual difficulties, but the condition which led to the cotton wool spots can cause retinal damage and the best treatment is to address the disease that caused the cotton wool spots initially.

Question from New York
I was diagnosed with Central Serous Retinopathy, also known as Central Serous Choroidopathy. I would like to know if there has been any information published or research done which explains the cause of this condition. I would also like to know if there is anything that can be done to eliminate the condition or prevent it from happening again. I'm 36. I was diagnosed 2 years ago. The first leakage, in my left eye, healed within 6 months but left scars, on the retina, which causes straight lines to look crooked. I just had another test done which shows leakage on the opposite side of the same eye, just left of the macula.

Central serous retinopathy is a relatively uncommon condition that generally affects young healthy people but at present has no known cause. Researchers have studied this but as yet, there is no conclusive information on why certain people develop this condition and why flare-ups occur at a particular time in one eye or the other, although there has been much theorizing in that regard. As you may have heard in certain situations, laser treatment can be beneficial when leakage occurs although it is not always advisable and in some cases it may not, eliminate visual symptoms all together or may even be unsuccessful at improving the visual distortion experienced. Active research in this area, as well as other disorders of retinal leakage is occurring and it may be that new treatments or information will be available in the future.