These are the diseases and conditions that Dr. Radtke and his staff specialize in treating. Descriptions, photographs, and treatments are provided to help you understand them better. The most frequent diseases that are treated by our center are: diabetic retinopathy, age-related macular degeneration, retinal detachment surgery, vitreous surgery for floaters, macular hole, and macular pucker.
Acute Multifocal Placoid Pigment Epitheliopathy
Acute Multifocal Placoid Pigment Epitheliopathy (AMPPE) is a condition of rapid loss of central vision, which usually resolves in 2 to 3 weeks without treatment. The disease is a multifocal inflammatory disorder that generally appears as irregular creamy yellow-white or gray shaped opacities, located around flat lesions in the choroid and retinal pigment epithelium. Symptoms appear as painless vision loss over several days often preceding a viral illness. The patients will often complain of headaches, photophobia, pain, and red eyes, stiff neck, vomiting, fever, and malaise. Of note is that occasionally hearing loss occurs. Vision loss recovers in 80% of patients leaving discrete pigment epithelial scars…
Acute Zonal Occult Outer Retinopathy
Acute zonal occult retinopathy is a rare disorder known as AZOOR that is characterized by…
Angioid Streaks
Angioid streaks are found in the Bruch’s membrane (the layer separating the choriocapillaris from the retinal pigment epithelium) and radiate outward from the optic disc in the shape of irregular linear crack or splits that look like a partially broken window pane. The cracks and splits may lead to a disciform type of macular degeneration. Decreased vision may result from choroidal and subretinal neovascularization. If the patient is highly myopic, the streaks may appear with a tilted disc and peripallary atrophy, as well as macular degeneration may be present in their history. Of note, angioid streaks are associated with increased risk of GI bleeds and cardiovascular complications…
Age Related Macular Degeneration (Wet and Dry)
The wet form of age-related macular degeneration occurs in approximately 15% of patients who have age-related macular degeneration…
Behcet’s Disease
Behcet’s disease was initially described by Behcet in 1937 as a triad of oral ulcers, genital ulcers, and hypopyon uveitis. The most common ocular manifestations are ididocyclitis with or without a hypopyon and retinal vasculitis. Ocular inflammations have occurred in countries along the Mediterranean Sea to Japan and are of unknown etiology. Conjunctivitis, keratitis, and scleritis occasionally have been described, but are far less common. In addition, neuro-ophthalmic lesions due to the vascular involvement include cranial nerve palsies, papilledema, and ischemic optic neuropathy, the characteristic posterior segment lesion is retinal vasculitis, which may include both veins and arteries…
Benign-Appearing Choroidal Nevus
Like a raised freckle on the skin, nevi can also occur inside your eye. The most common choroidal nevus are unusual and can only be seen by a dilated eye examination. Like a nevus on the skin, a choroidal nevus can grow into a malignant melanoma. This is why it is important to be followed on an annual basis as these can lay dormant for 10 years and suddenly develop into a malignant melanoma…
Best’s Disease
Best Disease is also known as vitelliform macular dystrophy. This disease primarily affects the macular area and is degenerative in nature and generally begins at birth. The detection of symptoms does not readily appear and may take years, but the early lesions resembles the appearance of an egg yolk (round/oval shaped lesions and yellow in color), and the later stages resemble a scrambled egg appearance in the foveal area. With the degeneration, the patient will develop hemorrhage, abnormal blood vessel formation in the choroid, and scarring of the disc. This disease, in the late stages, is very difficult to distinguish from age related macular degeneration. Acute and permanent loss of central vision may occur in association with bleeding from new vessels. A macular hole may occasionally occur in some instances…
Birdshot Retinochoroidopathy
Birdshot Retinochoroidopathy (BSRC) is a rare ocular disorder that is characterized by bilateral chronic intraocular inflammation and multiple, discrete, cream-colored foci of depigmentation scattered diffusely throughout the fundus. These hypopigmented lesions often have a vascular orientation. The disease has exacerbations and remissions and can lead to markedly reduced visual acuity…
Branch Retinal Vein Occlusion
The retina is very dependent upon a rich supply of nutrient to meet its high rate of metabolism and receives these nutrients by removing them from the blood by way of a system of fine blood vessels. One of the most common diseases to affect these fine retinal vessels is an obstruction of a small branch retina vein. The arteries and the veins run together and sometimes cross over each other. At these crossing points the two vessels share a common wall and these intersections are frequent trouble spots…
Cavernous Hemangioma
A cavernous hemangioma of the retina is a rare vascular tumor composed of clumps of dark intraretinal aneurysms that demonstrate a characteristic “cluster of grapes” appearance. The retinal cavernous hemangiomas are composed of clusters of saccular aneurysms filled with clotted blood…
Central Retinal Artery Occlusion
A retinal artery occlusion occurs when the central retinal artery, or one of the branch retinal arteries, becomes blocked or closed. This condition usually results in a sudden, painless, severe loss of vision in the affected eye. If the central retinal artery is blocked, vision loss is usually complete. If one of the branch arteries is affected, vision loss is typically partial…
Central Serous Chorioretinopathy
Central serous chorioretinopathy (CSCR) is blister-like elevated areas in the macular area. It is characterized by an accumulation of transparent fluid at the posterior pole of the fundus, causing a circumscribed area of retinal detachment at the posterior pole. This elevation results is reduction and/or distortion of vision that usually recovers in a few months, but can reoccur. CSCR usually affects more men between the ages of 25 and 50 than women. Patients generally present with blurred central vision, wavy or distorted vision, or a central blind spot. Occasionally, the patient’s central vision loss is permanent, but it usually clears spontaneously in 3 months. Amsler grid assessment should be performed daily by the patient with reporting of any changes in vision immediately…
Central Retinal Vein Occlusion
A central retinal vein occlusion is an unfortunate condition affecting the main vessels in the retina. Only one central vein drains all the blood from the retina. At the point where this vein leaves the eye, it shares a common wall with the central retinal artery. The vein may become blocked in a number of ways. Because of its close adoration with the artery, the vein may become occluded as a result of any disease affecting the arterial wall…
Choroidal Hemangioma
Choroidal hemangioma is a benign and relatively rare hamartomous tumor. There are two forms: a discret form and a diffuse form. The diffuse form is generally associated with the Sturge-Weber-Syndrome…
CMV Retinitis
When the retina becomes infected it is called retinitis. There are many organisms that may cause retinitis, but the most common is a virus called cytomegalovirus or CMV. CMV Retinitis is most commonly seen in patients with acquired immunodeficiency syndrome (AIDS) or other causes of immunosuppression. In many cases, CMV retinitis can be treated with intravenous medication intravitreal antibiotic injection, or the placement of a sustained-release Ganciclovir pellet into the vitreous…
Coats Disease
Coats disease is an idiopathic condition characterized by dilated and stretched vessels with intraretinal and subretinal exudates that generally occurs in both children and adults, predominantly males…
Cone-rod Dystrophy
Cone-rod dystrophy is characterized by early loss of visual acuity and color vision, with subsequent progressive peripheral loss of visual field. In the early stage of the disease, before peripheral field defects or peripheral abnormalities are apparent, a diagnosis of macular or cone dystrophy may be made. Peripheral retinal bone pigmentation in later disease may resemble that seen in classical retinitis pigmentosa…
Cystoid Macular Edema
Cystoid Macular Edema is a condition in which clear fluid fills many cyst-like formations in the segment of the retina that is responsible for central vision, called the macula. these cystoid formations create macular edema, or swelling of the macula…
Diabetic Retinopathy (Background, Proliferative)
Diabetic retinopathy is a complication of diabetes caused by changes in the retina (see diabetes education and resources). It is one of the leading causes of blindness among adults. There are two types of diabetic retinopathy — background diabetic retinopathy, or nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy…
Eales Disease
Eales Disease is an idiopathic obliterative vasculopathy that primarily affects the peripheral retina of adults. Retinal changes include extensive peripheral non-perfusion, perivascular sheathing, and neovascularization. Visual loss is usually caused by bilateral recurrent vitreous hemorrhage. It is prevalent in India and parts of the Middle East…
Epiretinal Membrane
Epiretinal membrane is also known as a macular pucker, epimacular proliferation, and cellophane maculopathy. This entity causes wrinkling in the macular area, which is when the clear membrane that lies on the retinal surface contracts. The patient will generally present with blurred vision, double vision (noticeable even with one eye covered), vision where straight lines appear bent or wavy. The early stage of epiretinal membrane does not affect the vision with the exception of glittery light reflex in the macular area. The later stage of the disease shows significant wrinkling and distortion of the retina, special photography may show swelling, bleeding and cotton-wool spots with significant vision loss…
Floaters and Flashes
Vitreous Floaters are small particles of gel or cells inside the clear gel-like fluid that fills the eye called the vitreous. The shadows from these particles are seen by the patient and may look like dots, circles, lines, clouds or cobwebs that float in and out of vision throughout the day…
Hypertensive Retinopathy
Hypertension has been ranked as the fourth largest mortality risk factor in the world, accounting for 6% of all deaths. Mild hypertension accounts for the largest proportion of cardiovascular deaths in the United States because of its high prevalence. It is estimated that as many as 58 million adults in the United States have elevated blood pressure (systolic blood pressure greater than or equal to 140 mmHg or diastolic blood pressure greater than or equal to 90 mmHg) or are taking antihypertensive medication. Although improvement in the diagnosis and treatment of systemic hypertension in the past several decades has reduced the morbidity and mortality rates due to this disease, the management of hypertension and its complications challenges all physicians…
Lattice Degeneration
Lattice degeneration of the retina is the most common of all hereditary vitreo-retinal degenerations in about 6 - 8% of the general population, equal in males and females, with no racial preference and found more commonly in myopic eyes. Symptoms include flashing lights, floating spots in front of your vision, or a veil coming down over your vision…
Leber’s Congenital Amaurosis
Leber’s congenital amaurosis is an inherited condition that causes poor vision. Findings commonly first appear after 2-3 months of age. It affects the rods and cones (cells which detect light) of the retina…
Macular Hole
Most macular holes occur as an age related primary idiopathic condition unrelated to other ocular problems or antecedent events such as trauma, laser treatment, retinal vascular disease, macular pucker, or retinal detachment…
Macular Pucker
A macular pucker, sometimes called an epiretinal membrane, is a condition in which scar tissue grows on the surface of the retina directly over the macula. The macula is the part of the retina responsible for central and detailed vision. This scar tissue can contract, causing the retina to wrinkle. Vision loss, blurred vision, double vision, and distorted vision are all symptoms of a macular pucker…
Malignant Melanoma of the Eye
A melanoma is a malignant tumor that most often arises in the skin. Less commonly, it is found in the eye and other sites of the body. In the eye, melanoma arises from the pigmented cells (melanocytes) of the uvea (iris, ciliary body, or choroid). Melanoma carries the potential to spread from the eye to other parts of the body. Larger melanomas carry greater potential to spread than smaller tumors…
Multiple Evanescent White-dot Syndrome
Multiple Evanescent White-dot Syndrome (MEWDS) is an acute multifocal, usually unilateral, retinopathy affecting young adults…
Norrie Disease
Norrie disease is an inherited eye disorder that leads to blindness in male infants at birth or soon thereafter. It causes abnormal development of retina, the layer of sensory cells that detect light and color, with masses of immature retinal cells accumulating at the back of the eye. As a result, the pupils appear white when light is shone on them, a sign called leukocoria. The irises (colored portions of the eyes) or the entire eyeballs may shrink and deteriorate during the first months of life, and cataracts (cloudiness in the lens of the eye) may eventually develop…
Ocular Toxoplasmosis
Ocular toxoplasmosis is a potentially blinding necrotizing retinitis that may have a prolonged and relapsing course. Human toxoplasmosis may occur as either a congenital or an acquainted form. It can be acquainted in humans by…
Pars Planitis
Pars planitis is a true posterior/intermediate uveitis that chronically affects younger, healthy patients with no significant medical history. It is idiopathic and unassociated with systemic disease. Patients are frequently asymptomatic, but may present with moderately diminished vision that is slowly progressive, as well as complaints of floaters. There have been some implications of an associate of autoimmune disease (juvenile rheumatoid arthritis) and demyelinating disease. Inflammatory mediators will increase vasopermeability of retinal capillaries resulting in posterior segment inflammatory cells as well as cystoid macular edema…
Presumed Ocular Histoplasmosis Syndrome
Presumed Ocular Histoplasmosis Syndrome in the eye causes loss of central vision. The Presumed Ocular Histoplasmosis Syndrome is a major cause of visual impairment in the central and eastern United States, especially in the Ohio and Mississippi River valleys. Histoplasma Capsulatum is a soil fungus that is acquired through the respiratory tract. This syndrome can result in abnormal blood vessels that can bleed and lift the retina, causing a decrease in vision. However, there are several treatment options available today that were not available five years ago. These include traditional laser treatment, photodynamic therapy (also see below), and submacular surgery. Treatment options vary according to the severity, size, and location of abnormal blood vessels…
Proliferative Vitreo-Retinopathy
Proliferative vitreo-retinopathy (PVR) is the most common cause of failed repair of a retinal detachment and occurs when scar tissue creates traction on the retina…
Retinal Detachment
A Retinal Detachment is a serious condition that must be treated promptly by a retinal specialist. A retinal detachment occurs when the retina becomes separated from the inside wall of the eye. There are many different causes of retinal detachments…
Retinal Tears and Holes
The retina is the delicate inner lining of the eye that reacts to light through a chemical process that sends nerve impulses directly to the brain. It is only about 1mm thick and has the consistency of wet tissue paper. Because of its delicate structure, it is vulnerable to breaks that can cause the retinal layers to become detached from each other. Some people are predisposed, by heredity, to have retinal tears and holes. Early detection and treatment of tears or holes can help prevent blindness or severe damage to vision…
Retinitis Pigmentosa
Retinitis pigmentosa (RP) is a term used for a group of disorders that are characterized by inherited, progressive dysfunction, cell loss, and eventual atrophy of retinal tissue. Initial involvement of photoreceptor leads to subsequent damage to inner retinal cells. Eventually, there is widespread atrophy of several, if not most, layers of the retina…
Sarcoidosis
Sarcoidosis is a multisystem granulomatous disorder of unknown etiology, characterized by intrathoratic involvement. Ocular involvement is common and occurs in approximately 15 to 25% of patients with sarcoidosis…
Sickle Cell Disease
Ocular symptoms are uncommon in the early stages of the disease. Systemically, symptoms include painful crises of abdominal and musculoskeletal discomfort. Sickle cell vaso-occlusive events can affect every vascular bed in the eye, often with visually devastating consequences in advanced stages of the disease. Since early stages of sickle cell eye disease do not usually result in visual symptoms, the disease can go undetected unless a formal eye examination is performed by an ophthalmologist. The examination should include an accurate measurement of visual acuity, assessment of pupillary reactivity, careful evaluation of the anterior structures of the eye using a slit-lamp biomicroscope, and a thorough examination of the posterior and peripheral retina through a dilated pupil. Diagnostic tests, such as a fluorescein angiogram, will aid in findings early ocular manifestation of sickle cell disease. People with sickle cell disease should have annual dilated eye examinations beginning at childhood…
Sjogren’s Syndrome
Sjogren’s syndrome, also known as “Sicca syndrome,” is a systemic autoimmune disease in which immune cells attack and destroy the exocrine glands that produce tears and saliva. Nine out of ten Sjogren’s patients are women and the average age of onset is after menopause in women, although Sjogren’s occurs in all age groups in both women and men. It is estimated to affect as many as 4 million people in the United States along, making it the second most common rheumatic disease…
Stargardt’s Disease
Stargardt’s disease manifests itself in patients who show an atrophic macular area surrounded by some or many yellowish, ill defined flecks. Stargardt’s disease seems to be caused by the ADCR gene on the short arm of chromosome 1…
Telangiectasis
Retinal telangiectasis refers to a developmental retinal vascular disorder characterized by ectasias of capillaries of the retina, in which irregular capillary dilation and incompetence occur in the retinal periphery or at the macula. If only the capillaries of the foveal…
Usher Syndrome
Usher syndrome is the most common condition that affects both hearing and vision. The major symptoms of Usher syndrome are hearing loss and an eye disorder called retinitis pigmentosa. Retinitis pigmentosa causes night-blindness and a loss of peripheral vision (side vision) through the progressive degeneration of the retina. As retinitis pigmentosa progresses, the field of vision narrows — a condition known as “tunnel vision” — until only central vision remains. Many people with Usher syndrome also have severe balance problems…
Vitreomacular Traction Syndrome
As the eye ages, the vitreous cortex can pull away from the retina, leading to a condition known as a posterior vitreous detachment (PVD). This detachment usually occurs as part of the normal aging process.
There are instances where a PVD is incomplete, leaving the vitreous partially attached to the retina, and causing traction (pulling) that can cause anatomic damage. This is called vitreomacular traction syndrome (VMT)…