When your sight clouds over, it matters who examines it.

Retinal detachment

This is an eye emergency. It happens when the retina separates from the inner wall of the eye and loses its blood supply. Typical symptoms are a sudden shower of floaters, flashes of light and a shadow or curtain spreading across your field of vision. Surgery should be done as soon as possible to preserve sight.

There are two main approaches: pars plana vitrectomy (the most widely used technique today) and scleral buckling in selected cases. The choice depends on the type of detachment, your age and the state of your lens.

Age-related macular degeneration (AMD)

AMD is the leading cause of central vision loss in people over 60. There is a dry form, which progresses slowly, and a wet or neovascular form, which is more aggressive but treatable with anti-VEGF intravitreal injections (aflibercept, ranibizumab, faricimab, etc.). Close monitoring with OCT is essential.

Macular hole and epiretinal membrane

These conditions of the vitreoretinal interface distort central vision (metamorphopsia) and reduce visual acuity. When treatment is indicated, it is vitrectomy with internal limiting membrane peeling, sometimes with a gas bubble and positioning after surgery.

Diabetic retinopathy

Diabetes is one of the main causes of sight loss in adults, and retinal damage can go unnoticed for years. Regular check-ups — at least yearly, or as your stage requires — make it possible to treat in time with laser, intravitreal injections or vitrectomy. Diabetic macular oedema is particularly important; in fact, it was the subject of my research project awarded at the American Society of Retina Specialists (ASRS) meeting.

Retinal vein and artery occlusion

When a retinal vein or artery becomes blocked, sudden vision loss with macular oedema can occur. Treatment includes controlling cardiovascular risk factors, intravitreal injections and, in some cases, laser. I have published directly on this topic as lead author of the corresponding chapter in the Manual de estudios diagnósticos en Oftalmología (Mexico, 2019).

Intravitreal injections

Intravitreal injections are now among the most common medical treatments in ophthalmology. They are given in a sterile setting, under topical anaesthesia, and take only a few minutes. They control many retinal diseases that used to lead to blindness: wet AMD, diabetic macular oedema, vein occlusions and more.

High myopia and peripheral degeneration

High myopia (more than −6 dioptres) carries a higher risk of retinal disease: peripheral degeneration, retinal holes and myopic maculopathy. Monitoring with a dilated fundus examination and specific tests allows treatable lesions to be detected before they become a problem.

Second opinion from abroad

If you have been diagnosed with a retinal condition and would like an expert second opinion, you can send me your OCT scans, retinal photographs and reports through an online consultation. I will review them before the video call and give you a clear explanation of the options, whether treatment is with your own doctor or here in Santander.

When is it an emergency?