The retinal is the thin inner layer lining the back of the eye. The retina comprises of light-sensitive cells, also known as rods and cones, as well as nerve cells that organise visual data. The retina delivers this data to the brain by means of the optic nerve. To put it simply, the retina receives images from the world around you and deliver these to your brain where they are processed .

Most surgical retinal conditions are treated using this technique. It includes conditions such as retinal detachments, epiretinal membranes, floaterectomies and macular holes.

The procedure is performed through 3 tiny holes in the eye that usually seals by themselves after surgery. It is very similar to a laparoscopic procedure that’s used in general surgery and gynaecology, just much smaller. The 1st step in this procedure is to remove the vitreous gel which is replaced by a balanced salt solution(BSS). Shortly after the procedure, the BSS is replaced by the natural aqueous humour that the body produces.

A retinal detachment is one of the most serious eye conditions and delayed or inadequate treatment can lead to severe vision loss. Our vitreous gel, the clear substance that fills most of eye, becomes less firm with age and becomes loose from the retina. This is called a vitreous detachment. Sometimes, during this normal age appropriate process, tears/holes can form in the retina. If the vitreous gel syphers through these holes, the retina becomes detached from its base. This inevitably leads to a decrease in sight.

Light flashes (especially in the dark), new onset floaters or a curtain or shadow gradually progressing over your vision are potential symptoms of an threatening or established retinal detachment. Anyone with these symptoms should be seen by an ophthalmologist on an urgent basis. Our reception will immediately recognise these symptoms when you call and schedule an urgent appointment with one of our doctors.

If a retinal tear is diagnosed before it progresses to a retinal detachment, it can be lasered in our clinic. This will greatly reduce the chances of developing a subsequent detachment.

In general, most retinal detachments needs surgical repair in theatre. The management is complex and needs to be individualised for each client. Dr Nieder-Heitmann spends sufficient time explaining the condition, treatment and expected outcomes with all his patients. After surgery he will personally do all the follow-up consultations and ensure that there’s clear communication every step of the way.

Eye floaters are a common complaint that varies from a single floater, numerous smaller ones or even a veil that moves across your vision when looking from one direction to another. Most floaters are due to condensed areas (proteins) in the vitreous gel. The vitreous gel is the clear substance that fills most of our eye. As we get older the vitreous gel detaches from the retina and floaters often becomes more prominent during this process.

Floaters are harmless in most people and simply an annoyance. They often becomes less observable over time due to the brain adapting to them.

There are however a few circumstances where floaters can be a sign of serious eye conditions. A sudden onset new floaters with associated light flashes can be a sign of a retinal tear or detachment. People with diabetic eye disease can bleed into their vitreous gel and symptoms can range from multiple floaters to complete vision loss. Uveitis is another important cause of floaters.

If you are concerned about your floaters, it is advisible that you visit an ophthalmologist to exclude any sinister causes and to get the necessary assurance.

There are a small number of people who finds their floaters visually debilitating and intervering with their daily activities such as driving or reading. In these selected cases, a pars plana vitrectomy can be performed to succesfully remove these floaters.

The macula is the central part of our retina that gives us our focused, central vision. When a cellophane-like film, consisting of “scar tissue”, forms over this area, we refer to it as an epiretinal membrane. Epiretinal membranes can lead distorted images and decreased vision in the affected eye when they contract and changes the surface of the macula.

All epiretinal membranes does not need treatment and can often be observed over time. If it does however cause visual disturbances or continues to progress in severity over time, it needs surgical removal via a pars plana vitrectomy and peeling the membrane off the macula. The aim of surgery is to prevent ongoing damage to the macula. With time, most people will experienced improvement in their sight and less distortion of objects they are looking at.

The centre of the macula, the part of the retina giving us crispy central vision, is called the fovea. A macular hole forms when the vitreous gel detaches but is abnormally adherent to the fovea. In this case a small part of the retina detaches with the vitreous gel leaving a small round hole in the centre of the macula. Macular holes causes a blind spot in the centre of your focus area.

Macular holes are treated with a pars plana vitrectomy. A special gas is inserted into the eye after the procedure and the patient needs to position head down for a few days. The operation can have excellent results if diagnosed early and treated appropriately.