Conditions affecting the retina and vitreous humour

Our retina ophthalmologist specialises in treating diseases of the retina.

Common retinal diseases or diseases of the vitreous are:

Floaters

What are floaters?

If you see black, floating spots, dots or lines in your field of vision, especially against a light background like a computer screen or bright light, that may mean you have ‘floaters’.
These spots move slowly with the movement of your eyes and always look like they are returning to their starting position. They can occur in one eye or both eyes. Floaters are structures that move around in the vitreous, the gel that fills your eyes. Although these are mostly harmless and just a bit annoying, floaters are sometimes a symptom of another condition. Follow-up by your eye doctor is therefore required.

Symptoms of floaters

Treating floaters

Black, floating spots, dots or lines in the field of vision.
Noticeable against light backgrounds, such as a computer screen, white surface or clear sky.
Spots that move with your eyeball in the direction you are looking.
In one eye or both eyes.

During a preliminary examination, your eye doctor will look into your eye to assess the retina and the vitreous. To do so, the pupil is dilated as far as possible with drops. Driving afterwards is not possible for at least three hours. Sometimes the retina cannot be assessed properly. In that case, we will use an ultrasound device to see whether your retina has become detached. This examination is painless and safe.

If the cause of the floaters is a posterior vitreous detachment, then no treatment is needed or possible. The floating spots will become less annoying over time, but they usually do not disappear completely. Flashes of light generally stop on their own or if the vitreous no longer pulls away from the retina. Sometimes, floaters are an indication of an underlying eye condition that requires further treatment.

Age-related macular degeneration (AMD)

What is age-related macular degeneration?

Age-related macular degeneration (AMD) is a condition of the central part of the retina. This part of the retina, the macula, is responsible for seeing small details. Age-related macular degeneration is often referred to as the ‘wearing’ of the retina or ageing of the retina. AMD affects visual acuity. This can be due to such factors as an hereditary condition, age or environmental factors.

Symptoms of AMD

Treatment of AMD

How much does treatment of macular degeneration cost?

Less clear or blurred near vision
Dark spots or dots at the centre of the image
Distortion of the image, especially of straight lines
Fading of colours
Reduced night vision

We start with a detailed examination to determine what form of macular generation you have. This can be either dry or wet age-related macular degeneration. Each form requires a different approach, and so a correct diagnosis is crucial.

What treatments do we offer?

Injections

The principal treatment for wet AMD is anti-VEGF injections, such as ranibizumab, bevacizumab and aflibercept. These stop abnormal blood vessel growth and reduce eye leakage. After a monthly initial injection, the frequency of the follow-up injections will be determined depending on the check-up results – often four to six times a year. Although the injections are effective, they don’t guarantee complete restoration of vision; they mainly stabilise the condition. Regular check-ups by the eye doctor are essential for optimal treatment.

Photodynamic therapy (PDT)

Photodynamic therapy can be used in certain cases of wet AMD. In this process, a light-sensitive medicine known as verteporfin is injected into the bloodstream. The medicine is then activated by laser light and will attack and destroy selective abnormal blood vessels in the macula. PDT is used less often nowadays, because anti-VEGF injections have proven more effective.

Combination therapy

In some cases, a combination of treatments may be recommended. This can involve the simultaneous use of anti-VEGF injections and photodynamic therapy, in order to address and maximise the treatment outcomes of various aspects of the condition. Combination therapy is only applied in exceptional cases.

Laser photocoagulation

Although this is performed less often, laser photocoagulation can be considered in certain cases of wet AMD. In the past, a laser was used to close off or destroy abnormal blood vessels in the macula. Laser photocoagulation is used mostly for smaller, well-defined areas of abnormal blood vessels that are not in the central field of vision.

Sometimes a laser is used to reduce the drusen and thereby prevent further progress of wet AMD. This treatment is still a subject of discussion, however.

Diabetic retinopathy

What is retinopathy?

If you have diabetes, the blood vessels in the retina may be affected. This is known as diabetic retinopathy. This form of damage to the retina due to leaking or abnormal blood vessels can lead to a deterioration of vision or even blindness. Regular check-ups by your eye doctor are therefore very important.

Symptoms of retinopathy

Treatment of retinopathy

How much does the treatment of retinopathy cost?

Sometimes there are no symptoms
Less sharp vision
Blurred vision
Spots or floating spots in the field of vision
Distortion of the image, especially of straight lines

Leaky blood vessels are treated with intravitreal injections with anti-VEGF medication or with cortisone injections. This treatment needs to be repeated a few times, depending on the reaction to the injections.

In the event of oxygen deficiency, known as ischemia, sometimes a laser treatment can be used. Several sessions may be necessary in this case as well. For this treatment, the pupil is dilated, meaning that you can’t drive a car in the first few hours after the treatment. So please have someone accompany you to our eye centre.

The cost of retinopathy treatment depends on your specific situation and the type of treatment chosen and will be discussed during the consultation. These treatments are covered by medical insurance.

Frequently Asked Questions

What are floaters in the eyes and what causes vitreous opacities?

Floaters are drifting spots, dots or strands that you see floating through your field of vision. They are especially noticeable against a plain, light background, such as a white sheet of paper or a computer screen. Floaters are caused by ageing of the vitreous humour. From the age of 50 to 60, the composition of this gel-like fluid changes, making opacities and protein residues visible. This occurs more frequently in strongly nearsighted people.

Do floaters ever go away and what can you do about them?

Floaters usually become somewhat less bothersome over time, but they generally do not disappear completely on their own. At Oogcentrum Brugge, floaters can be treated with vitreolysis: a completely painless laser treatment that converts the floaters into tiny gas bubbles. One session takes 20 to 40 minutes and two to three sessions are usually needed.

What is macular degeneration and what is the difference between dry and wet macular degeneration?

Age-related macular degeneration is wear and tear of the macula, the central part of the retina responsible for sharp vision. Complaints include blurred vision, a spot in the centre of the image and distortion. In dry macular degeneration, deposits (drusen) accumulate slowly. In wet macular degeneration, blood vessels beneath the macula begin to leak, causing vision to deteriorate more quickly.

What is diabetic retinopathy and how is it treated?

Diabetic retinopathy is damage to the retina caused by leaking blood vessels, a consequence of diabetes. Patients notice reduced or blurred vision, spots in their field of vision and image distortion. At Oogcentrum Brugge, the leaking blood vessels can be sealed with a laser treatment. The treatment slows down the deterioration, but does not completely cure the retinopathy.