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The retina is the innermost nerve layer that lines the back of the eye.
Many ophthalmologists compare this to the film of a camera. The retina
is responsible for processing the images projected onto it and then the
optic nerve transmits this to the brain. The retina is susceptible to many
types of diseases.
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| What are the common problems associated with the retina? |
1. Retinal detachment
A retinal detachment is a very serious problem that almost always causes
blindness unless it is treated.
As a person’s normal eye ages the vitreous gel contracts and then becomes
more liquid.
As the vitreous gel becomes more liquid it may pull on the retina and create
a retinal tear (and then tear.)
When fluid passes through a tear, it will lift the retina from the back
of the eye creating (making) a retinal detachment.
2. Macular Degeneration
Macular Degeneration, also called age related macular degeneration (ARMD),
affects primarily the aging population and gradually destroys central vision.
As noted above the central vision is critical for seeing fine details and
necessary for performing daily tasks such as reading and driving.
This degenerative eye disease causes no pain and typically develops over
a long period of time.
Patients may notice a blurring or distortion in their central vision.
In other words, lines that should be straight may appear to have a bend
in them.
3. Diabetic Retinopathy
Diabetic retinopathy is a leading cause of blindness.
In the majority of diabetic retinopathy cases, blindness is completely
preventable.
The use of medications and daily blood sugar monitoring can make a major
impact on preventing or containing any worsening of diabetic retinopathy.
4. Flashes/Floaters
Floaters may appear as small specks or dark shadows.
These specks can actually move or float around in the visual field.
Most people have some level of floaters and normally do not notice them
until they become very obvious.
Sometimes floaters can be seen when you stare up at the sky and they may
appear as curvy lines or small specks.
This condition actually develops from changes in the back of the eye also
known as the vitreous cavity.
In typical cases floaters are part of the aging process.
5. Macular Edema
Macular Edema is also called Cystoid Macular Edema or (CME). Macular Edema
sets in when blood vessels leak into the eye and form cysts and swelling
that obstruct central vision. CME can best be seen from a diagnostic vision
test called fluorecein angiography or optical coherence tomography.
6. Retinitis Pigmentosa
Retinitis Pigmentosa refers to a group of inherited eye diseases causing
the degradation of the retina.
As we have discussed throughout the retina section of this website, the
retina is a critical component of the eye responsible for interpreting
images and transmitting them onto the brain.
When retinitis pigmentosa develops, the cells, which are called rods and
cones, die.
The loss of visual fields is the indicator for retina pigmentosa and begins
as a ring like distortion in the mid-periphery.
Throughout the course of this degenerative eye disease the central vision
is also lost and the result is tunnel vision.
As a result of this progression patients are told not to drive automobiles
even in the early stages.
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| Perimetry |
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Perimetry is the systematic measurement of visual field function.
The two most commonly used types of perimetry are Goldmann kinetic perimetry
and threshold static automated perimetry.
With Goldmann or "kinetic" perimetry, a trained perimetrist moves
the stimulus; stimulus brightness is held constant.
The limits of the visual field are mapped to lights of different sizes
and brightness.
With threshold static automated perimetry, a computer program is selected.
The most commonly used one tests the central 30° of the visual field using
a six degree spaced grid.
This is accomplished by keeping the size and location of a target constant
and varying the brightness until the dimmest target the patient can see
at each of the test locations is found.
These maps of visual sensitivity, made by either of these methods, are
very important in diagnosing diseases of the visual system.
 
Normal vision Defect appeared in vision
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| Funduscopy |
 
Also termed ophthalmoscopy. The examination of the back of the eye
known as the fundus.
The examination is carried out to check eye health and to ensure that there
are no signs of retinal detachment,
retinal holes or other eye problems such as diabetic retinopathy and glaucoma.
The examination may begin with dilating the pupil so that examination is
easier.
The back of the eye is illuminated using a beam of light through a funduscope.
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| Fluorescein fundus photography |
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This is a technique for examining the circulation of the retina using the
dye tracing method.
It involves injection of sodium fluorescein into the systemic circulation,
and then an angiogram is obtained by photographing the fluorescence emitted
after illumination of the retina with blue light at a wavelength of 490
nanometers.
The fluorescein dye also reappears 12-24 hours in the patient urine, causing
a yellow-green appearance.
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| OCT (Optical Coherence Tomography) |
OCT (Optical Coherence Tomography) is a test to shoot a fault screen of
the retina.
This test clarifies the condition of the retina, which is difficult to
diagnosis,
and helps to decide treatment plans for retina disease.
OCT is necessary for diseases such as macular hole, diabetic maculopathy,
macular edema, age-related macular degeneration, detachment of the retina,
and glaucoma.
Cases of test results
Normal section of the retina 
Section of macular edema. 
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| Amsler Grid |
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The Amsler grid is a tool that eye doctors use to detect vision problems
resulting from damage to the macula (the central part of the retina) or
the optic nerve.
The damage may be caused by macular degeneration, glaucoma or other eye
diseases, so the Amsler grid is useful in detecting these problems.
An early diagnosis means early treatment, so it may help to limit or at
least slow the vision loss you experience.
If you are at risk for macular degeneration or other eye diseases, you
can use this chart at home to monitor your vision.
But using the chart doesn't mean you should skip regular visits to your
eye doctor, because you can easily miss signs that only a trained eye care
practitioner will find.
The chart below is an approximation of the printed chart used by eye doctors.
For more accurate detection of macular damage, you will need a complete
eye exam.
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| Treatment of Retina |
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| If you have retina detachment or retinal break, you need to operate your
eye. |
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| State of the retina detachment |
type of operation |
contents of operation |
| become split your retina |
Photocoagulation |
close up the surrounding your eye crack
with the laser light |
enter into liquefied vitreous body
and peel off your retina |
Retinopexy |
put your peeled retina back in its place |
bleed to vitreous body from blood vessel
when your retina will split |
Vitreous surgery |
remove your impure vitreous body by bleeding |
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Director:Tomoko Nishioka
(A board-certified ophthalmologist Ph.D)
Memberships
Japan Ophthalmological Society
Japan ophthalmlogists Association
Career
1998 Graduate-Medical Department of Mie University
2003 Doctorate-Tokyo Medical and Dental University
2003 Department of Ophthalmology of Nagareyama
General Hospital
2005 Shinjuku-Higashiguchi Eye Clinic
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Yasuharu Noma
(A board-certified ophthalmologist)
Memberships
Japan Opthalmological Society
Japan Opthalmologists Association
Japan Glaucoma Society
The Japanese Neuro-Opthalmology Society
Career
1998 Graduate- Okayama University Faculty of Medicine
1999 Miyoshi Central Hospital
2001 Hiroshima Railway Hospital
2002 Chugoku Rosai Hospital
2003 Hiroshima University Hospital
2004 Miyoshi Central Hospital
2008 Shinjuku-Higashiguchi Eye Clinic
Main Research Presentations
“The effect of Betaxolol towards the progression of visual field defect
in Glaucoma”
“The retinal nerve fiber layer thickness in glaucoma cases examined by
2 types of Optical Coherence Tomographys”
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We have 2 full-time service orthoptists, 1 part-time orthoptist, and 2
part-time nurses in our clinic.
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Another several ophthalmologists are working here.
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