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Macular Mishaps

There are many conditions that can affect the central vision and cause permanent vision damage.  It’s important that if you ever have any symptoms such as sudden blurry vision, floating spots,and central visual blur, to call your eye doctor immediately.

One such condition that affects the central vision is a macular hole.  Symptoms usually include decreased vision or distortion.  It usually only affects one eye at a time.  Upon clinical exam, there is usually a red spot apparent in the macular area (fovea) of the retina that may appear cyst like.  There are 4 stages of macular holes with 4 being the worst and most vision threatening stage.  They can be caused by macular edema, trauma, or epiretinal membranes or a previous eye surgery.  The treatment depends on the stage.  Fifty percent of stage 1 holes resolve on their own.  In more advanced stages, a retinal surgery including a vitrectomy or drainage of the vitreous may be needed.

Another condition that affects the central vision is an epiretinal membrane.  Many patients with these, do not have symptoms and do not realize they are present.  They usually occur in one eye at a time.  Epiretinal membranes can be caused by a retinal break, other vascular disease, or a posterior vitreous detachment, or following a surgery.  Treatment for these is a retinal surgery which involves peeling the membrane off of the macula.

With all of the talk of the eclipse this year, another condition that can affect the central vision is solar retinopathy.  Symptoms include decreased vision or visual distortion.  Upon exam, there is usually a yellow/white spot upon initial retinopathy.  Classic late finding is a red cystic like area in the fovea.  This can occur if a person stares at the sun directly without proper eye protection.  Treatment would be to refer to a retinal specialist if severe, however, usually not much can be done once this occurs.

Bests disease is another condition that affects the fovea. Its clinical appearance consists of a yellow, round lesion that looks like an egg yolk. This condition, unlike the others, is usually bilateral. This condition is usually present at birth but may not be detected until later in life upon initial eye exam.  Unfortunately there is no treatment for this devastating disease.

Stargardts Disease causes decreased vision in childhood.  The clinical appearance may include a semi normal appearing retina except for some retinal pigment epithelial changes.  There may be yellow flecklike deposits at the level of the RPE and may have a bulls eye appearance or beaten metal apperance.  What is complicated about this disease and diagnosing it is that in early stages, the vision declines before the macular changes develop.  Some doctors may feel as if the child is making up the symptoms because there may be no clinical appearance just yet.  Treatment for this disease is lacking but UV light blocking glasses may help the patient along with low vision aids.  As of yet, there is no cure.

If you have any decrease in vision, blurry vision, or visual distortion, please contact Metrolina Eye Associates.

By Dr. Stacy Schorner

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