According to The National Eye Institute (NEI), part of the National Institutes of Health (NIH), age-related macular degeneration (AMD) is the most common cause of irreversible central vision loss in elderly patients.
While retinal detachment is one of the most serious eye conditions, it is surgically treatable and can result in blindness if not treated promptly.
Taking care of your precious eyes is an important part of your overall health.
In this segment, Dr. Vijay Khetpal, joins the show to discuss common retina issues including retinal detachment and macular degeneration.
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Understanding Common Retinal Disorders
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Learn more about Vijay Khetpal, MD
Vijay Khetpal, MD
Vijay Khetpal, MD is an Ophthalmologist/Retina Specialist and a member of the medical staff at Texoma Medical Center.Learn more about Vijay Khetpal, MD
Transcription:
Understanding Common Retinal Disorders
Melanie Cole (Host): According to the National Eye Institute, part of the National Institutes of Health, age-related macular degeneration is the most common cause of irreversible central vision loss in elderly patients. While retinal detachment is one of the most serious eye conditions, it is surgically treatable and can result in blindness if not treated promptly. Taking care of your precious eyes is an important part of your overall health. My guest today is Dr. Vijay Khetpal. He's an ophthalmologist retina specialist and a member of the medical staff at Texoma Medical Center. Welcome to the show, Dr. Khetpal. So, let's start with macular degeneration since this is so common. Tell us a little bit about it, and who is at risk.
Dr. Vijay Khetpal, MD (Guest): Well, thank you for inviting me. Macular degeneration is becoming a very common problem of epidemic proportion. As we get more and more baby boomers aging, it primarily affects patients over the age of 65, and it can cause central vision loss, and we see it quite commonly in our everyday practice.
Melanie: So, what are some of the symptoms that might signal to somebody, you know, get yourself to an ophthalmologist because this is something you need to have checked out right away?
Dr. Khetpal: So, it all starts off with a comprehensive eye exam after the age of 50, which I recommend every five to ten years even if you have no symptoms. The symptoms are typically very subtle in the early stages. You may have difficulty reading small print, difficulty making out the text at the bottom of the television screen or a distortion in your vision – the words seem to be blending together, and often these progress slowly, and it can progress to loss of complete central vision.
Melanie: Is there a genetic component to macular degeneration?
Dr. Khetpal: Well, that’s still under debate, and it's all being worked out. We know there is a strong tendency towards development of macular degeneration. If you have a sibling or a parent -- first-degree relative with it, certain genetic markers have been implicated in macular degeneration -- the details of which are being still worked out.
Melanie: So, then let's talk about treatments. If somebody does come to you with these symptoms, first of all, how do you diagnose it?
Dr. Khetpal: So, diagnosis of macular degeneration involves the clinical exam as well as some specialized testing, which is getting more involved at getting images of the retina, the nerve tissue inside the eye as well as some angiography testing called fluorescein angiography where we inject dye in the arms and get pictures of the eye. And that tells us the two types of macular degeneration, which is dry and wet, and the treatment is then determined based on the type of macular degeneration.
Melanie: So what does treatment look like? I mean does someone have to be scared that this is going to lead to blindness? What does treatment look like, and what is the outcome, just as a general rule and a ballpark for what you can do for somebody if they are suffering for this?
Dr. Khetpal: Sure. So we can go into the two types of macular degeneration and as the treatment protocol very slightly. The dry kind is the more common type and that tends to progress very slowly, and most people maintain good vision over decades. There is no good treatment for the dry kind at this time. Also, there are some new drugs in development. The most common treatment for moderate to advanced dry macular degeneration is eye vitamin pills which are often found on grocery store shelves. The other kind of – the more advanced kind is the wet macular degeneration. The treatment for those is injectable drugs, which if used promptly just upon the onset of the wet macular degeneration, a lot of my patients tend to maintain useful vision throughout their life.
Melanie: That’s excellent news. So now let's talk about retinal detachment because while this is a pretty serious issue, it is something that if caught early, right, can be treatable? So, first of all, how does it even happen?
Dr. Khetpal: We don’t fully understand retinal detachment. We know a lot of the risk factors. It includes history of trauma, and it can -- some cases -- be a minor trauma, and increasing incidence of nearsightedness which we see in the population, a history of retinal detachment in the family as well as a previous eye surgery. These are three or four risk factors which I see as a recurring theme.
Melanie: And so, if it's something that happens whether it's because of trauma or something else, how do you know? Would you feel it? Is this a painful condition?
Dr. Khetpal: So, the symptom of retinal detachment is no pain. The retina has no pain fibers. It’s main job is seeing and perceiving light so the symptoms are flashing lights. That’s one of the most common symptoms as well as new-onset floaters or dark spots which come in your vision. We all have some floaters; what we are looking for is new-onset floaters which are finer, and I would describe it as a dust storm in your vision, and sometimes it's followed by a curtain coming over your vision. A part of your vision seems obscured or blocked.
Melanie: So then how is it treated Dr. Khetpal?
Dr. Khetpal: Retinal detachment – it depends on how fast the patient presents. If the patient presents very early, it's treated with laser in the office and that’s all – usually the patient needs in those cases, and those patients tend to do very well. They have no down time, and they can resume all their activities within the same day. If it turns out retinal detachment has advanced, then it becomes a surgical problem, and the success rate of retinal detachment surgery is very high. It’s getting in the mid to high 90’s. It involves a trip to the operating room to get the retina back on the wall of the eye, but the newest surgical techniques – we have patients who are seeing excellent and then can maintain their vision.
Melanie: So, Dr. Khetpal, what would you like to tell listeners about these eye issues and getting those annual or as often check-ups as you think they should have? Give them your best advice for protecting their eyes, and you can even include things like sunglasses or protective eyewear. What should we be doing to take care of our eyes?
Dr. Khetpal: The most important thing is to be aware that the eye conditions can affect you and to monitor yourself – your vision and your health and could be as simple as covering one eye and then trying to read and then comparing to the other eye. The key with your eye condition is early detection and that starts off with a comprehensive eye exam. Sunglasses and other eye protections can help us from things like injuries and decrease the UV exposure. That’s very helpful as well, but a lot of conditions like macular degeneration and retinal detachment -- they would happen if somebody was to wear eye protection and eye care.
Melanie: And are there any nutrients you'd like to tell the listeners about that can help their eyes? Is it true that carrots help your eyes? Just give us a little quick overview.
Dr. Khetpal: So, carrots have beta carotene which is an important component of the pigment we see in the retina. Most of us, if we have a good diet, you get enough of these nutrients, and you don’t need to supplement additional carrots. The only supplement that’s shown to be helpful is the eye vitamin pills which are sold, and there are various brands. One of them is – they follow the AREDS 2 formula. That has been shown to be helpful in people with moderate to advanced dry macular degeneration. If you don’t have macular degeneration or got the mild kind, it seems to be not helpful in those cases.
Melanie: And why should they come to Texoma Medical Center for their care?
Dr. Khetpal: Well, we are the premiere hospital in this region. We have accumulated specialists from all areas of specialties, and TMC is undergoing rapid expansion and committed to providing high quality of care towards the entire Texoma community.
Melanie: Thank you so much, Dr. Khetpal, for being with us today. You're listening to TMC Health Talk with Texoma Medical Center. For more information, you can go to texomamedicalcenter.net. That's texomamedicalcenter.net. Physicians are independent practitioners who are not employees or agents of Texoma Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.
Understanding Common Retinal Disorders
Melanie Cole (Host): According to the National Eye Institute, part of the National Institutes of Health, age-related macular degeneration is the most common cause of irreversible central vision loss in elderly patients. While retinal detachment is one of the most serious eye conditions, it is surgically treatable and can result in blindness if not treated promptly. Taking care of your precious eyes is an important part of your overall health. My guest today is Dr. Vijay Khetpal. He's an ophthalmologist retina specialist and a member of the medical staff at Texoma Medical Center. Welcome to the show, Dr. Khetpal. So, let's start with macular degeneration since this is so common. Tell us a little bit about it, and who is at risk.
Dr. Vijay Khetpal, MD (Guest): Well, thank you for inviting me. Macular degeneration is becoming a very common problem of epidemic proportion. As we get more and more baby boomers aging, it primarily affects patients over the age of 65, and it can cause central vision loss, and we see it quite commonly in our everyday practice.
Melanie: So, what are some of the symptoms that might signal to somebody, you know, get yourself to an ophthalmologist because this is something you need to have checked out right away?
Dr. Khetpal: So, it all starts off with a comprehensive eye exam after the age of 50, which I recommend every five to ten years even if you have no symptoms. The symptoms are typically very subtle in the early stages. You may have difficulty reading small print, difficulty making out the text at the bottom of the television screen or a distortion in your vision – the words seem to be blending together, and often these progress slowly, and it can progress to loss of complete central vision.
Melanie: Is there a genetic component to macular degeneration?
Dr. Khetpal: Well, that’s still under debate, and it's all being worked out. We know there is a strong tendency towards development of macular degeneration. If you have a sibling or a parent -- first-degree relative with it, certain genetic markers have been implicated in macular degeneration -- the details of which are being still worked out.
Melanie: So, then let's talk about treatments. If somebody does come to you with these symptoms, first of all, how do you diagnose it?
Dr. Khetpal: So, diagnosis of macular degeneration involves the clinical exam as well as some specialized testing, which is getting more involved at getting images of the retina, the nerve tissue inside the eye as well as some angiography testing called fluorescein angiography where we inject dye in the arms and get pictures of the eye. And that tells us the two types of macular degeneration, which is dry and wet, and the treatment is then determined based on the type of macular degeneration.
Melanie: So what does treatment look like? I mean does someone have to be scared that this is going to lead to blindness? What does treatment look like, and what is the outcome, just as a general rule and a ballpark for what you can do for somebody if they are suffering for this?
Dr. Khetpal: Sure. So we can go into the two types of macular degeneration and as the treatment protocol very slightly. The dry kind is the more common type and that tends to progress very slowly, and most people maintain good vision over decades. There is no good treatment for the dry kind at this time. Also, there are some new drugs in development. The most common treatment for moderate to advanced dry macular degeneration is eye vitamin pills which are often found on grocery store shelves. The other kind of – the more advanced kind is the wet macular degeneration. The treatment for those is injectable drugs, which if used promptly just upon the onset of the wet macular degeneration, a lot of my patients tend to maintain useful vision throughout their life.
Melanie: That’s excellent news. So now let's talk about retinal detachment because while this is a pretty serious issue, it is something that if caught early, right, can be treatable? So, first of all, how does it even happen?
Dr. Khetpal: We don’t fully understand retinal detachment. We know a lot of the risk factors. It includes history of trauma, and it can -- some cases -- be a minor trauma, and increasing incidence of nearsightedness which we see in the population, a history of retinal detachment in the family as well as a previous eye surgery. These are three or four risk factors which I see as a recurring theme.
Melanie: And so, if it's something that happens whether it's because of trauma or something else, how do you know? Would you feel it? Is this a painful condition?
Dr. Khetpal: So, the symptom of retinal detachment is no pain. The retina has no pain fibers. It’s main job is seeing and perceiving light so the symptoms are flashing lights. That’s one of the most common symptoms as well as new-onset floaters or dark spots which come in your vision. We all have some floaters; what we are looking for is new-onset floaters which are finer, and I would describe it as a dust storm in your vision, and sometimes it's followed by a curtain coming over your vision. A part of your vision seems obscured or blocked.
Melanie: So then how is it treated Dr. Khetpal?
Dr. Khetpal: Retinal detachment – it depends on how fast the patient presents. If the patient presents very early, it's treated with laser in the office and that’s all – usually the patient needs in those cases, and those patients tend to do very well. They have no down time, and they can resume all their activities within the same day. If it turns out retinal detachment has advanced, then it becomes a surgical problem, and the success rate of retinal detachment surgery is very high. It’s getting in the mid to high 90’s. It involves a trip to the operating room to get the retina back on the wall of the eye, but the newest surgical techniques – we have patients who are seeing excellent and then can maintain their vision.
Melanie: So, Dr. Khetpal, what would you like to tell listeners about these eye issues and getting those annual or as often check-ups as you think they should have? Give them your best advice for protecting their eyes, and you can even include things like sunglasses or protective eyewear. What should we be doing to take care of our eyes?
Dr. Khetpal: The most important thing is to be aware that the eye conditions can affect you and to monitor yourself – your vision and your health and could be as simple as covering one eye and then trying to read and then comparing to the other eye. The key with your eye condition is early detection and that starts off with a comprehensive eye exam. Sunglasses and other eye protections can help us from things like injuries and decrease the UV exposure. That’s very helpful as well, but a lot of conditions like macular degeneration and retinal detachment -- they would happen if somebody was to wear eye protection and eye care.
Melanie: And are there any nutrients you'd like to tell the listeners about that can help their eyes? Is it true that carrots help your eyes? Just give us a little quick overview.
Dr. Khetpal: So, carrots have beta carotene which is an important component of the pigment we see in the retina. Most of us, if we have a good diet, you get enough of these nutrients, and you don’t need to supplement additional carrots. The only supplement that’s shown to be helpful is the eye vitamin pills which are sold, and there are various brands. One of them is – they follow the AREDS 2 formula. That has been shown to be helpful in people with moderate to advanced dry macular degeneration. If you don’t have macular degeneration or got the mild kind, it seems to be not helpful in those cases.
Melanie: And why should they come to Texoma Medical Center for their care?
Dr. Khetpal: Well, we are the premiere hospital in this region. We have accumulated specialists from all areas of specialties, and TMC is undergoing rapid expansion and committed to providing high quality of care towards the entire Texoma community.
Melanie: Thank you so much, Dr. Khetpal, for being with us today. You're listening to TMC Health Talk with Texoma Medical Center. For more information, you can go to texomamedicalcenter.net. That's texomamedicalcenter.net. Physicians are independent practitioners who are not employees or agents of Texoma Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.