Are you looking for a retinal vein occlusion (RVO) and macular edema specialist in Laguna Hills, CA?
At Retina Associates of Orange County, we have a retinal vein occlusion and macular edema practice grounded in 23 years of clinical experience and training from Oxford University and Bascom Palmer Eye Institute.
If a blocked retinal vein has caused vision and health concerns, a retina specialist can treat the fluid and help preserve central vision. Care from a Laguna Hills, CA retinal vein occlusion (RVO) and macular edema specialist at Retina Associates of Orange County begins with imaging that measures the swelling and shows which vein is affected. All five of our physicians completed retina fellowships, and four hold certification from the American Board of Ophthalmology. Request an appointment today and set up a time to have your retina evaluated and your treatment options explained.
Retinal Vein Occlusion (RVO) and Macular Edema Specialist Laguna Hills, CA
Retinal veins carry blood out of the retina. When one becomes blocked, usually by a clot where a hardened artery presses against it, blood and fluid back up and leak into the surrounding tissue. If that fluid reaches the macula, central vision blurs. This is macular edema. Most vein occlusions involve only one eye, yet losing clear sight on one side still affects depth perception and can make falls more likely for older adults. A specialist in these conditions treats the swelling, watches for abnormal new vessels, and works to limit lasting damage.
High blood pressure is one of the main risk factors, according to MedlinePlus. In Laguna Hills, CDC PLACES data estimate that 29.6 percent of adults had high blood pressure in 2023. Diabetes, high cholesterol, glaucoma, and advancing age add to the risk.
Retinal Vein Occlusion and Macular Edema Services We Offer in Laguna Hills
A blocked retinal vein can’t be reopened. Treatment focuses instead on what the blockage leaves behind, chiefly swelling in the macula and the growth of fragile new vessels. Many people regain some vision without treatment, but fully normal vision is uncommon, so most patients benefit from active care.
- Branch retinal vein occlusion. A smaller vein closes, often where an artery crosses over it, and only part of the visual field is affected. Swelling near the center of vision is the most common reason for treatment.
- Central retinal vein occlusion. The main vein draining the retina is blocked, so vision in the entire eye can blur. Close monitoring in the first months matters, because some milder cases progress to a more severe, ischemic form.
- Anti-VEGF injections. Eylea, Vabysmo, and Lucentis reduce swelling and slow abnormal vessel growth. They don’t cure the occlusion, and most patients need a series of injections.
- Steroid implants. A long-acting steroid placed inside the eye can control swelling for several months at a time. Eye pressure and cataract development are monitored while it’s in use. For some patients, it reduces the number of office visits needed for injections.
- Laser treatment. Focal laser can help with persistent swelling from a branch occlusion. Scatter laser applied to the outer retina causes abnormal new vessels to regress. Neither form restores vision already lost.
- Diabetic retinopathy. Diabetes raises the risk of vein occlusion and produces macular edema of its own. When both are present, we treat them together.
- Cystoid macular edema after surgery. Swelling sometimes develops after cataract surgery. Anti-inflammatory eye drops are usually the first step.
- Neovascular glaucoma monitoring. New vessels can block the eye’s drainage channels and raise eye pressure, sometimes months after the occlusion. Regular pressure checks catch this early.
Why Choose Retina Associates of Orange County for RVO and Macular Edema Care in Laguna Hills, CA?
Research and International Teaching in Retinal Disease
Dr. Charles W.G. Eifrig has participated in a variety of clinical trials, the studies through which retinal treatments such as today’s injection therapies are evaluated. His research earned him an academic merit award for scholastic achievement and excellence in ophthalmic research, and he reviews submissions for two ophthalmology journals. He earned his medical degree in Chapel Hill from the University of North Carolina, then trained through residency and fellowship at Miami’s Bascom Palmer Eye Institute.
Dr. John S. Lean has lectured worldwide as a visiting professor on retinal conditions such as diabetic retinopathy. A medical graduate of Oxford University, he received all of his ophthalmology training, from residency through fellowship, at Moorfields. Among his professional memberships is the Macula Society, an organization focused on diseases of the central retina.
Finding the Cause of Macular Swelling
Macular edema has several possible causes, and a retina specialist in Laguna Hills, CA can determine which one is responsible. RVO and diabetic eye disease share risk factors. We often check for both at the same visit. Our Laguna Hills office is open Monday through Saturday and also treats complications such as retinal detachment.
Understanding Retinal Vein Occlusion and Macular Edema Care
Conditions We Treat and Treatment Options
Swelling in the macula isn’t a disease on its own. It results from another condition, and the National Eye Institute lists several possible sources. Identifying the source shapes every treatment decision that follows. Imaging and a review of your medical history usually make the cause clear.
- Retinal vein occlusion. Blood can’t drain normally from the retina, so it leaks into the macula. Treatment usually starts with injections.
- Diabetic macular edema. This is the most common cause of macular swelling. Blood sugar control works alongside injections or laser.
- Wet macular degeneration. Abnormal vessels from wet age-related macular degeneration leak fluid into or beneath the retina. Patients with this cause are treated by an AMD specialist in our practice, usually with injections.
- Swelling after eye surgery. Cataract surgery can trigger mild swelling that usually responds to drops.
- Uveitis. Inflammation inside the eye causes fluid to collect in the macula, and controlling the inflammation reduces it.
- Ischemic complications of RVO. When the occlusion cuts off blood flow to much of the retina, new vessels may grow and bleed. Laser and injections are used to prevent this.
What Should You Expect from an Intravitreal Injection?
- Numbing drops are applied first, followed by an antiseptic solution to clean the surface of the eye.
- A small instrument keeps the eyelids open. The injection itself takes only seconds, and most patients feel pressure rather than pain.
- Afterward, the eye may feel scratchy for the rest of the day, and a small red spot on the white of the eye is common.
- A few floaters from the medication can appear briefly, and they typically fade within a day or two.
- Increasing pain, worsening vision, or growing redness in the days after an injection warrants a prompt call to our office.
What Is the Typical Treatment Timeline?
- At the first visit, a dilated exam, OCT, and often fluorescein angiography measure the swelling and show how much of the retina has lost blood flow.
- Injections are commonly given about once a month at the start.
- As the swelling resolves, the time between injections is gradually extended.
- Checks for new vessels and rising eye pressure continue for several months after the occlusion.
- Some patients are eventually able to stop injections. Others need them on a longer-term basis.
Your schedule will depend on which vein is blocked, how severe the swelling is, and how your eye responds. Patients with central occlusions often need closer follow-up early on.
What Should You Bring to Your First Visit?
- Insurance information and a government-issued ID will be requested when you arrive.
- Your medication list should include any blood pressure, cholesterol, and diabetes prescriptions.
- If your primary care physician has taken recent blood pressure readings or run lab work, bring the results.
- We’ll also ask for that physician’s contact information so we can share findings about cardiovascular risk factors.
Because the eye will be dilated, arrange for a ride home. The visit concludes with a review of your scans and a plan for the weeks ahead.
What Are Some Important California Retinal Vein Occlusion and Macular Edema Resources?
Credential checks and information on controlling risk factors are both available from public and professional organizations.
- Physician license lookup. The Medical Board of California provides an online search for confirming a physician’s license and any public actions.
- Blood pressure control. The CDC explains how high blood pressure is measured and managed. Managing it is one of the main ways to reduce the risk of another occlusion.
- Patient fact sheets. The American Society of Retina Specialists offers a central vein occlusion guide covering symptoms, injections, and laser treatment.
Diagnosis and treatment decisions still require an in-person retinal examination.
Contact Retina Associates of Orange County
Contact us to request an appointment with a retinal vein occlusion and macular edema specialist in Laguna Hills. Our Laguna Hills office sees patients six days a week. At your first visit, the physician will measure the swelling, determine whether the occlusion has affected blood flow to the retina, and explain how injections, laser, or a steroid implant might help. We’ll also outline the follow-up schedule, since most patients with RVO need ongoing visits. Because the condition is linked to blood pressure and other cardiovascular factors, we may recommend a visit with your primary care physician as well.
Retinal Vein Occlusion (RVO) And Macular Edema Treatment
The Retina
The retina is the light-sensing layer of cells that lines the inner wall of the back of the eye. The retina converts light into signals that are sent to the brain where they are recognized as images.
Retinal Vein Occlusions
Your retinas require a rich supply of oxygenated blood. This blood is carried to the retina from the heart through arteries, while veins carry deoxygenated blood from the retina back to the heart via the optic nerves. The arteries that transport oxygen to your retina may stiffen and thicken over the years, especially in people with diabetes, cardiovascular disease, high blood pressure and high cholesterol.
The retinal arteries and veins are close to the optic nerve and cross various locations on the retina’s surface. As arteries thicken, they can compress the retinal vein at artery-vein crossing points or in the optic nerve. This compression can be so severe that the veins become constricted and thus blood flow to the heart is reduced. The blood then backs up into the retina not unlike the water in a clogged bathtub. The pressure of blood in the veins causes swelling (called macular edema) and bleeding in the retina. There are three kinds of retinal vein occlusions:
- The most commonly seen cases are branch retinal vein occlusions, in which the blockage occurs in a smaller vein on the retina’s surface. The consequent hemorrhaging and swelling may result in diminished vision if the macula, the retina’s center, is involved.
- The second most common form of retinal vein occlusion is a central retinal vein occlusion in which the main retinal vein is blocked within the optic nerve. This is usually a more severe kind of occlusion that causes hemorrhages and swelling throughout the retina. This often leads to a more serious decrease in sight.
- Less common is hemi-retinal vein occlusion, in which the vein draining one-half of the venous circulation is occluded. Generally, this is more severe than the branch retinal vein occlusion but less so than central retinal vein occlusion.
Eyes with retinal venous occlusive disease may develop macular edema (retinal swelling), or growths of fragile, abnormal blood vessels on the retina’s surface. These growths can cause bleeding into the vitreous gel. This bleeding is typically associated with the sudden appearance of floaters or severe loss of vision. Patients with central retinal vein occlusions may also develop abnormal blood vessels on the iris. These blood vessels can cause a severe form of glaucoma known as neovascular glaucoma.
Fortunately, retinal vein occlusion is usually only present in one eye so the other eye remains unaffected.
Risk Factors For Retinal Vein Occlusions
The main risk factors include: advanced age, high blood pressure, diabetes, high cholesterol, cardiovascular disease, glaucoma, and other blood disorders. Some patients have no risk factors and a more extensive work-up to determine underlying cause may be warranted.
Reducing Your Risk
There are some effective things that a patient who is at high risk of developing retinal vein occlusion can do to avoid developing the condition. Doing frequent exercise several times a week and eating a balanced and nutritious diet can greatly reduce the chances of getting the disease. If you have a family history of high blood pressure, blood disorders, cardiovascular issues, or other health issues, taking active steps to improve your health can make a huge difference. For more information about preventative measures you can implement in your life, you can turn to an eye doctor for guidance.
Symptoms Of Retinal Vein Occlusion
People with a retinal vein occlusion may not exhibit symptoms but those who do may have a sudden onset of blurred vision in one eye. However, blurred vision is a symptom of many ocular conditions. Therefore, one will have to undergo testing to confirm that one has retinal vein occlusion.
How A Retinal Vein Occlusion Impairs Vision
Retinal vein occlusion and related diseases can result in serious long-term damage not just to your retina, but the rest of your eyes. Because the retina is affected by blood clots, you may have difficulty processing light or adjusting your eyes to light. Loss of vision can occur gradually or quickly depending on the severity of the condition. When the retina has this kind of damage, signals to the brain are not able to be processed correctly, leading to trouble identifying images since they cannot be focused properly.
- Disruption Or Loss Of Blood Flow To The Retina
There is no treatment for this aspect of retinal vein occlusion.
- Cystoid Macular Edema (CME)
Edema means “swelling,” and this occurs when blood vessels damaged from the vein occlusion are leaky, and the fluid that leaks from these vessels accumulates in the retina. The macula is the centermost part of the retina, which is responsible for much of high quality vision. Swelling in the retina results in vision loss. There are very effective treatments for macular edema caused by a retinal vein occlusion.
- Neovascularization
When the eye loses blood flow, it may respond by creating abnormal “new blood vessels” (neovascularization). Neovascular blood vessels can impact the vision by:
Vitreous Hemorrhage: A vitreous hemorrhage is bleeding into the eye. Instead of being filled with clear fluid through which one can see, the back of the eye is filled with blood, causing vision loss.
Tractional Retinal Detachment: The new blood vessels pull on the retina (create “traction”) and pull the retina off the eye wall (“retinal detachment”). The photoreceptors in detached retina cannot see and undergo damage, resulting in severe vision loss, sometimes irreversible vision loss.
Glaucoma: If the abnormal blood vessels form in in the front of the eye, they can result in glaucoma, which involves elevated eye pressure and if untreated, vision loss.
Evaluating A Retinal Vein Occlusion
There are multiple ways to evaluate a retinal vein occlusion:
- Dilated Retinal Examination
- Optical Coherence Tomography (OCT): A scan to look for swelling in the retina.
- Fluorescein Angiography: In this procedure, a dye is injected into the arm and travels through the blood to the eye. Photographs are taken of the eye which map out all the blood vessels and blood flow in the retina. This test identifies areas of blood flow loss as well as areas of new blood vessel growth (neovascularization).
- B-Scan Ultrasound: This is a painless procedure whereby an ultrasound is performed over the closed eyelid to evaluate the retinal anatomy in eyes where hemorrhage prevents visualization of retinal details through the eye exam alone.
Treatment for Retinal Vein Occlusion
There are also numerous treatment options to reduce the risk of vision loss in cases of retinal vein occlusion. For those with macular edema resulting from this condition, laser photocoagulation may help. Anti-vascular endothelial growth factors (anti-VEGF) drugs such as Lucentis, Avastin, Eylea, Eylea HD, Pavblu, Vabysmo, or Ozurdex may be injected into the vitreous gel to treat the swelling associated with this condition. These medications are injected into the eye after drops are given over 5-10 minutes to clean and numb the eye. The injection itself takes only seconds.
Steroids such as triamcinolone (Triessence) and dexamethasone (Ozurdex) may be used to reduce inflammation that contributes to leaky blood vessels causing an edema. Like many medical conditions, the treatment is done to manage the disease and reduce the risk of worsening. Thus, with intravitreal injections, patients may require life-long treatment.
Retina specialists can treat patients with the more severe kind of venous occlusive disease (neovascular glaucoma) with scatter laser to the retina and/or continued injections in hopes of stabilizing the disease process and preventing severe vision loss or blindness.
Neovascularization from a retinal vein occlusion can be treated with laser treatments, injections if there is an edema present, or surgery.
A vitreous hemorrhage from a retinal vein occlusion can be treated with observation and medical management or surgery. A vitreous hemorrhage may resolve on its own, and thus it may be monitored. After the hemorrhage resolved, laser treatment may be performed. If the hemorrhage fails to clear or other complications are noted, surgery may be necessary.
In a pars plana vitrectomy surgery, the hemorrhage is removed, the traction from the new blood vessel (neovascularization) membranes is relieved, and laser treatment is applied to allow the neovascularization to regress. An injection of anti-VEGF medication may be given prior to surgery to reduce intraoperative and postoperative complications risk.
As retinal vein occlusions are typically associated with high cholesterol, diabetes and high blood pressure, monitoring and treating these medical conditions are important in those patients with venous occlusive disease. Thus, following up with your primary care doctor is imperative.
Epiretinal Membranes Or Macular Puckers
An epiretinal membrane, also known as a macular pucker is a scar tissue that grow on top of the macula of the retina. This can significantly reduce vision and is treated through a surgical procedure.
The epiretinal membrane pulls on and wrinkles the macula, distorting the orderly arrangement of photoreceptors and other cells required for high quality, crisp vision. Vision symptoms include blur, decreased vision, and distortion (straight lines appearing bent or distorted).
Why Epiretinal Membranes Form
In most cases, epiretinal membranes form as part of the natural aging process of the eye. Epiretinal membranes may also form in eyes with a history of retinal tear, retinal detachment, inflammation (uveitis), hemorrhage, or prior surgery.
Treating Epiretinal Membranes
An epiretinal membrane can be treated through observation and surgery. Observation may be appropriate for eyes with mild epiretinal membranes with minimal impact on vision and minimal impact on retinal anatomy. Surgery may be appropriate for visually significant epiretinal membranes. A pars plana vitrectomy is an outpatient, micro-incisional surgery whereby the delicate epiretinal membrane is gently peeled off the retinal surface, allowing the retina to assume a more healthy contour (and in turn, achieve an improvement in vision) over time.
Meet With an Eye Doctor
Any kind of eye complications can be hard to live with, but if you have a serious condition like retinal vein occlusion, it is possible to mitigate the effects and consequences if you seek treatment right away. You should take this condition seriously and talk to an experienced doctor so you can begin exploring your options. Your condition may be in the early stage, so there could be multiple ways that your symptoms can be alleviated. Do not think that it is too late to save your vision if you think that you have a retinal vein occlusion and other retinal issues.
When you go to an experienced eye doctor who can help you discover suitable treatments, you can preserve the health of your eyes and reduce vision loss. Find out more about Laguna Hills retinal vein occlusion RVO and macular edema services in your area now so you can schedule a consultation.
To learn more about venous occlusive disease and how our retina specialists can help, contact our Laguna Hills Retinal Vein Occlusion (RVO) and Macular Edema Specialist.
Key Risk Factors For Blocked Retinal Veins
Vision health is paramount, and understanding the factors behind retinal vein occlusion is an important step towards maintaining good eye health. With a history of award-winning patient care (and extensive experience in clinical research), the team at Retina Associates of Orange County is ready to help you next. Take a look at some of these key risk factors, and contact us today to get started wit your treatment.
1. High Blood Pressure
High blood pressure can cause damage to the blood vessels in the retina, the layer of tissue at the back of your inner eye that processes light. Managing blood pressure is not only crucial for your overall health but also for maintaining healthy retinal veins.
2. Diabetes
Diabetes increases the risk of various eye conditions, including problems with the retinal veins. High blood sugar levels can damage the delicate vessels in the eye, leading to swelling and impaired function. Controlling your blood sugar levels through diet, exercise, and medication can help reduce this risk.
3. Smoking
Smoking is harmful to almost every organ in the body, including the eyes. The harmful substances in tobacco can constrict blood vessels, worsen blood flow, and increase the risk of damage to the retinal veins. Quitting smoking is one of the best decisions you can make for your eye health and overall well-being.
4. High Cholesterol
High levels of cholesterol can lead to the buildup of plaque in the blood vessels, including those in the eyes. This buildup can narrow the vessels and restrict blood flow, potentially leading to retinal vein occlusion and macular edema. A healthy diet and regular physical activity are effective ways to control cholesterol levels.
5. Obesity
Carrying excess weight can increase the risk of diabetes and high blood pressure, which in turn can impact the health of your retinal veins. Maintaining a healthy weight through a balanced diet and regular exercise can significantly lower the risk of eye issues.
6. Sedentary Lifestyle
A lack of physical activity can contribute to several health issues, including obesity, high blood pressure, and high cholesterol. Regular exercise helps improve blood circulation, which is beneficial for the health of the blood vessels in your eyes.
7. Use Of Certain Medications
Some types of medications, such as those that increase the risk of blood clots or affect the blood’s viscosity, can affect the health of your retinal veins. It’s important to discuss all medications you are taking with your healthcare provider to understand their impact on your eye health.
By understanding these risk factors, you can take proactive steps to protect your eye health. Regular eye examinations are important, as they allow for the early detection and treatment of problems before they progress. At Retina Associates of Orange County, we are dedicated to providing comprehensive eye care and helping you maintain your vision.
Let’s Get In Touch
If you have concerns about your eye health or any of the risk factors mentioned, please don’t hesitate to contact us. Schedule an appointment today to ensure that your eyes are as healthy as they can be. Let us help you keep a clear view of the world around you. Get in touch with our Laguna Hills Retinal Vein Occlusion (RVO) and Macular Edema Specialist today, and see how we can assist with your retinal vein occlusion and macular edema.
