Robert Josephberg, MD

Westchester, NY Retina Specialist

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Frequently Asked Questions

Uveitis

What is the uvea?

The middle layer of the inside of the eye and it has many blood vessels.

What are the symptoms of uveitis?

Light sensitivity, blurred vision, pain, floaters, redness of the eye.

What is Uveitis?

Inflammation of the inside of the eye from the uvea.

What causes Uveitis?

Viruses, systemic inflammatory diseases such as Rheumatoid Arthritis, Sarcoidosis, Tuberculosis, shingles, injury, fungal and bacterial infections.

How is Uveitis diagnosed?

Blood tests along with signs, symptoms and clinical diagnosis on examination.

How is uveitis treated?

Many times, with anti-inflammatory drugs such as prednisone and Humira.  Both systematically and locally along with intra-ocular injections can and are given.

Are there different types of Uveitis?

Yes. Iritis, intermediate uveitis and posterior uveitis or choroiditis.

Macula Holes

What is a macula hole?

A defect in the macula.

What are the symptoms of a macula hole?

Distortion, blind spots in the central vision and loss of central vision.

Can macula holes cause total blindness?

No, only loss of central vision.

What causes the macula holes?

Most occur in the elderly and are related to posterior vitreous detachment and macular puckers.

Can nutrition, smoking or general health cause macula holes?

Generally, not.

How is a macula hole treated?

Vitrectomy surgery, gas injections and sometimes intravitreal drugs.

Can macula holes heal themselves?

In the late stages generally not. In the very early stages some can resolve by themselves.

Vitrectomy

What is a vitrectomy?

It is the type of eye surgery that treats various disorders of the retina and vitreous.

Why do you need a vitrectomy?
  • Bleeding in the eye from tears in the retina, diabetic retinopathy, vein occlusions and multiple other causes.
  • Retinal detachment repair.
  • Infections inside the eye.
  • Macula holes or macula pucker.
  • Inflammations inside the eye.
How long does a vitrectomy surgery take?

It can take from one to several hours, depending on your condition.

What does vitrectomy surgery involve?

The removal of the vitreous and scar tissue, along with laser and injection of silicone oil or gas.

What are the risks of vitrectomy surgery?

Infection, bleeding, retinal detachment and poor or loss of vision.

Floaters and Flashes

What are floaters?

Small specks moving in your field of vision. They are clumps of gel or cells inside the vitreous.

What causes floaters?

Generally aging and separation of the vitreous cause posterior vitreous detachment. Also, floaters can be caused by bleeding, retinal tears, inflammation and diabetic retinopathy.

Are floaters serious?

Yes, they can be for many people.

What can be done about floaters?

Most of the time they will not cause a problem. Sometimes, if they are very annoying, a vitrectomy or laser can be used to lessen them. While some floaters may remain in your vision, many will fade over time. If you have a sudden onset of floaters or new ones, you should see your retinal specialist.

What causes flashes of light?

When the vitreous pulls on the retina. They can appear for several weeks or months and can be like bolts of lightning.

Is there a medication for floaters?

No

Macular Degeneration

What is AMD or macular degeneration?

It is a broad term describing diseases that lead to loss of central vision. It is called aging related macular degeneration.

What are symptoms of AMD?

Loss of vision, gradually or suddenly in the central vision.

What are types of macular degeneration?

Generally, in adults, there are dry and wet types. Other types include hereditary such as Best’s Disease and cone degeneration. Toxicity from Plaquenil and pentosan can cause it also, along with other drugs.

What causes macular degeneration?

Generally, age and 35% of the cases are probably hereditary. It is more common in whites with blue eyes.

What are Drusen?

They are yellow spots in the retina associated with AMD.

Can nutrition, smoking or diet play a role in causation?

Yes, Generally, a good nutrition and a healthy diet are recommended. Please stop smoking.

AREDS2 vitamins are recommended in many types of AMD for the antioxidant properties.

What treatments are available?

Anti-VEGF treatments which involve many injections of drugs into the middle of the eye.

Do the injections hurt?

Generally, not! We treat it like cancer and in most cases this treatment works and preserves your vision.

Artery and Vein Occlusions?

What are the types? 

Branch and central artery occlusions, and branch and central artery occlusions.

What are the treatments?

Laser and injections, including anti-VEGF drugs and steroids are commonly used.

What causes the above?

Risk factors include coronary and carotid artery disease, hypertension, blood disorder, diabetes and smoking. Glaucoma can also be a risk factor along with inflammatory diseases. Artery and vein occlusions are blockages of the blood vessels in the retina.

Will vision improve?

Most times, with treatment, vision will improve and also prevent further complications and further loss of vision.

Diabetic Retinopathy

What is diabetic retinopathy?

It is damage to the retina caused by high blood sugar over many years.

What does it damage?

It damages the tiny blood vessels in the retina and can cause loss of vision with leakage of fluid or blood.

What are the two types of diabetic retinopathy?
  • Non-proliferative Diabetic Retinopathy usually causes loss of vision with leakage into the central portion of the macula called the fovea.
  • Proliferative Diabetic Retinopathy causes loss of vision from bleeding and scar tissue.

You can have both together which is common

How is diabetic retinopathy found?

Regular dilated examinations by your eye specialist, along with testing.

Are there any treatments for diabetic retinopathy?

Yes, fortunately many are available including laser, injections into the eye including steroids and anti-VEGF drugs such as Eylea, Lucentis and Avastin. Good control of your sugar also helps.

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