Anatomy of the retina and vitreous:
The retina is the neurosensory tissue lining the inner eye that receives light from perceived images and relays this information to the brain through the optic nerve. The macula is the central portion of the retina and is primarily responsible for color perception and our sharpest central vision. The vitreous gel in the central portion of the eye has a vital role in development of the eye. The vitreous is composed of a matrix of solid collagen fibers and fluid called the vitreous humor. After birth, the vitreous functions to maintain a normal oxygen and nutrient balance in the eye.
Diseases of the retina and vitreous:
Diabetic retinopathy: Chronically elevated blood sugars from uncontrolled diabetic disease can cause abnormal changes to the retina and retinal blood vessels, called diabetic retinopathy. Diabetic retinopathy is classified into nonproliferative and more advanced proliferative disease. With either forms of retinopathy, microaneurysms can form and leak into the macula, causing swelling known as macular edema. Proliferative diabetic retinopathy results in the growth of abnormal vessels that may further progress to bleeding in the eye (vitreous hemorrhage) or detachment of the retina from the growth and contraction of blood vessels and scar tissue. Diabetic diseases of the eye can be treated with injections of medications into the eye, laser treatment, or vitrectomy surgery.
Floaters: The vitreous gel liquefies as we age, and the solid component becomes more visually pronounced. A sudden worsening of floaters (tiny dots, strands, or haziness) can be a sign of posterior vitreous detachment, a process most common in the elderly where the vitreous separates from the retina. Floaters may also be a symptom of a new retinal tear or detachment.
Macular degeneration: Degeneration of the macula can cause distortion and loss of central vision. There are dry and wet forms of macular degeneration. Dry age related macular degeneration (ARMD) typically occurs more slowly as we age, with atrophy or thinning of the central macula, resulting in central distortion and loss of vision. Vitamin and anti-oxidant nutritional supplementation is important in slowing down this process. Wet age related macular degeneration occurs from the growth of abnormal blood vessels that leak or bleed into or under the retina, causing more rapid loss of central vision. Wet ARMD can be treated with injections of medication into the eye to slow or sometimes reverse vision loss
Dr. Erica Uman is a residency-trained optometrist with expertise in Primary Care Optometry and Ocular Disease, and is available to address retinal concerns from flashes and floaters to age-related macular degeneration. She is passionate about managing ocular manifestations of systemic diseases such as diabetes and sickle cell anemia, and is able to address any questions or concerns you may have in both English and Spanish. She always takes the time to explain the disease processes and treatment options moving forward, and is happy to communicate with other providers in your health care team to ensure best quality of care.
In advanced cases where surgery is needed, she will be able to connect you with one of our excellent referring surgeons and can monitor for progression or complications between treatments.
Dr. Andrew Sumnicht will be available to see new patients at the Edmonds and Northgate clinics starting in August, 2022. He is a comprehensive ophthalmologist who trained at a high volume residency program in Southern California. He is passionate about diagnosing, monitoring, and treating a wide variety of ocular conditions. Some of his particular interests include glaucoma, cataract, diabetic retinopathy, and age-related macular degeneration. He will be happy to accept new patients and continue managing care for your eye disease including injections and laser treatments. He has language proficiency in Spanish and enjoys explaining the disease process and how it can be treated in English or Spanish. He will be working in close conjunction with our optometrists and subspecialists when needed to provide excellent comprehensive care to optimize your ocular health and vision