Ophthalmology Manchester Ophthalmology Manchester

Diseases Treated

Dr. Gold treats all diseases of the retina and vitreous. Below are descriptions of the more common diseases he treats.

Macular Hole

The macula is a small area in the center of the retina that allows us to see objects in detail. This is the area of the retina giving us vision for reading, driving, and other everyday activities that require clear vision. A macular hole often develops as part of the natural aging process, when the vitreous gel thins and separates from the macula. This can pull on the macula and cause a hole to form.

In its early stages, a macular hole may cause a small blurry or distorted area in the center of vision. As the hole grows over time, central vision progressively worsens.

Most macular holes can be successfully treated with vitrectomy surgery with placement of a gas bubble in the eye.  This results in closure of the macular hole in the vast majority of patients and significant improvement in vision.

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Macular Pucker

An epiretinal membrane, also called a macular pucker, is a thin layer of tissue that forms over the macula, the area of the retina that gives us clear central and reading vision.

Macular puckers often develop on their own as a part of the natural aging process. Membranes may also result from eye conditions or diseases such as diabetic retinopathy, retinal detachment, inflammation, injury or vascular conditions. These are called secondary macular puckers, whereas spontaneously formed membranes are called idiopathic.

Macular pucker can be diagnosed with a careful eye examination. An OCT (optical coherence tomogram) may be recommended to study the structure of the macula. Fluorescein angiography may also be recommended to better assess the macula in patients with macular pucker.

Many macular puckers do not significantly disrupt vision. However, if there is significant visual loss, vitrectomy with membrane peeling may be recommended. Vision improves postoperatively in the majority of patients.

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Retinal Detachment and Tears

Macular Hole Treatment | Macular Pucker Treatment | Retinal Detachment and Tears Treatment | ManchesterRetinal detachment is an ophthalmologic disorder in which the retina of the eye separates from the ocular tissue to which it is anchored. This is a medical emergency and can lead to permanent blindness.

Symptoms of retinal detachment may progress slowly or rapidly, but both should be reported as soon as possible so as to minimize the risk of vision loss. A sudden decrease in visual acuity, an increase in the amount of "floaters" in vision, or the manifestation of bright flashes in the periphery are cues to see Dr. Gold as soon as possible.

The detachment may be treated in several ways. Pneumatic retinopexy involves injecting a small bubble of gas into the vitreous to close the retinal tear responsible for the detachment. Once the retinal tear is closed, the retina can reattach. 

Macular Hole Treatment | Macular Pucker Treatment | Retinal Detachment and Tears Treatment | ManchesterIn many cases, a vitrectomy will be performed to reattach the retina. This is usually followed with a gas injection that fills the entire eye. The gas bubble will reabsorb over one month. A scleral buckle procedure may be used in some cases, which consists of affixing a silicone band to the sclera (white of the eye) to reattach the retina. The success rate for surgical repair of retinal detachment is over 90 percent.

Retinal detachment is preceded by a retinal tear. A retinal tear occurs when the vitreous gel separates from the back of the eye and pulls on the retina. Symptoms of a retinal tear include flashes and floaters. These symptoms should be reported immediately to Dr. Gold. If there is a retinal tear without retinal detachment, laser surgery is generally recommended. The laser surgery seals the retina around the tear to prevent the retina from detaching. The laser surgery is an office procedure.

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