Thethe retinaat the back of the eye is the tissue you rely on to see. The eyes themselves are supplied by many blood vessels and filled with fluid. However, sometimes there can be problems. Liquid may accumulate in the backthe retinadue to various conditions vizmaculaødemandcentral serous retinopathy.
Here's what you need to know to recognize what may be causing subretinal fluid and the steps to take for proper diagnosis and treatment.
Causes of fluid behind the retina
More than one thing can cause fluid to collect behind the retina. Therefore, it is important to consider the cause in your case.
For macular spots
Withmaculaødem, the fluid accumulates in an area of the retina known asblot. This is the area you rely on for sharp central vision. If fluid builds up underneath, it can become distorted as the tissue expands.
Leaking fluid can come from damaged blood vessels near the retina. This can be the result of many different conditions. Macular edema can be caused by any disease that damages the blood vessels and can even result from eye surgery.
Central serous retinopathy
Withcentral serous retinopathy, fluid can accumulate under the retina. The retinal pigment epithelium (RPE), which lies betweenchoroidand the retina, stops working as it should. Without it working properly, fluid begins to build up under the retina.
This can cause visual distortion and even a littleretinal detachmentin some cases. Those most at risk for this condition are men between the ages of 30 and 50, people with type A personalities, people taking steroids, and people with autoimmune disorders.
In case thatdiabetic retinopathyis due to the elevated blood sugar that occurs in those with diabetes. Over time, high amounts of sugar in the blood can damage the retina by affecting the blood vessels.The blood vessels swell and the tight junctions within them collapse, leading to bleeding or leakage of fluid.
Also, glycosylated red blood cells (which have sugar attached to hemoglobin) do not carry enough oxygenated blood. This triggers the formation of new blood vessels. However, these are fragile and easily leak and bleed further. This leads to more fluid behind the retina and can eventually lead to a detachment.
Thechoroidis a layer of spongy blood vessels between the retina and the white part of your eyes, known as the sclera. The role of the choroid is to provide nutrition and oxygen to the outer part of the retina.
If fluid or blood (choroid collection) gets between the choroid and the sclera, it can lead to a detachment, known as serous choroidal detachment. These are generally associated with low intraocular pressure, usually after recent glaucoma surgery.
This drop in pressure allows fluid to pool in the space around the cells, while the capillaries become more permeable due to inflammation.
Diagnosis of fluid behind the retina
To determine whether you may have fluid under the retina, your eye doctor will examine your eyes thoroughly. Some of the tests they are likely to use may include:
Amsler Grid Test
OneAmsler grid testis an easy way to determine if your all-important central view has changed. With this test, you simply look at the grid-like squares and tell the doctor if any of the lines look wavy or if areas are missing. This can help detect even small changes in vision.
Optical Coherence Tomography (OCT)
Optical coherence tomographytakes cross-sectional pictures of your retina with a special camera. It can measure the thickness of the retina and detect fluid under the retina and swelling. With this information, your doctor can determine if you need treatment for fluid trapped under the retina.
Fundus Autofluorescence (FAF)
With autofluorescence imaging, the idea is to make use of the retina's natural fluorescence. Even without dye injection, when blue light is used to illuminate the retina, some structures glow.
These glowing structures can be captured in a black and white image. Then, characteristic patterns can indicate that diseases such asage-related macular degenerationor central severe retinopathy develops and may help to indicate appropriate treatment.
Fluorescein angiographycan be used to diagnose retinal detachment. With a yellow onefluoresceindye is injected into your arm. When it reaches your eyes a few seconds later, it will make them glow brightly. A special camera can then be used to take pictures of the area. These can alert your doctor to what type of treatment is needed and where.
Indocyanine green angiography
Withindocyanine green angiography, the dye works in the same way as fluorescein, but can only be seen in infrared light. It also travels deeper into the layers of the retina, where they can be photographed with an infrared-sensitive camera. This is often used for choroidal angiography as an adjunct to retinal fluorescein angiography.
With this test, also known as a b-scan ultrasound, sound waves are used to create an image of structures in the eye. This technique can be used to detect complications such as retinal detachment, diabetic retinopathy and eye cancer.
Treatment of fluid behind the retina
Deciding on the best treatment for a particular case of fluid behind the retina will be based on the cause here. Some possible treatment methods include the following:
- Medicines such as corticosteroids or anti-inflammatory drugs aim to reduce inflammation. These may come in the form of drops, pills, or even dispersed through extended-release devices in some cases.
- Sometimes a surgical approach may need to be used such asvitrectomywhere the jelly-like substance that normally fills the eye is removed.
- In some cases, such as diabetic retinopathy, laser therapy can stop leaking blood vessels and reduce retinal swelling.
- If you have macular edema, you may be treated with the well-known anti-VEGF injections. Vascular endothelial growth factor (VEGF) is a protein that leads to the production of new blood vessels. In macular edema, these blood vessels can leak. Using anti-VEGF can slow the production of these new blood vessels.
- Making lifestyle changes, such as controlling blood sugar levels in cases of diabetic retinopathy, should also be considered when considering how to help relieve fluid behind the retina.
Fluid under the retina can occur due to inflammation or leaky blood vessels in conditions such as diabetic retinopathy, macular edema,central serous retinopathyand choroidal effusion. An eye doctor will perform an eye exam and may use different imaging methods to assess the problem.
Treatment depends on the condition causing the fluid retention. Anti-inflammatory drugs, surgery, laser therapy, anti-VEGF injections, or lifestyle changes may be used.
A word from Verywell
Fluid under the retina can come from a number of sources. The good news is that once professionals discover what may be at the root of your particular case, there are many different treatments that can correct it and help preserve your vision.
How to get rid of fluid behind the retina?
This depends on the cause. Once this is diagnosed, you may simply be given medication to reduce inflammation, or you may need to undergo laser treatment to seal the blood vessels, or you may need treatment with anti-VEGF injections, among other options.
Can fluid behind the eye cause blindness?
It's possible. Fluid behind the retina can sometimes lead to a retinal detachment, pushing the retina away as it collects. This is known as exudative retinal detachment. If the detachment is not treated early and is extensive enough, it can cause permanent vision loss.
Learn more:What is a detached retina?
Is fluid behind the eye serious?
Although it may not cause vision loss in all cases, fluid behind the eye is not normal. Therefore, it is important to see a doctor immediately and find out what is causing it so that it can be treated.
Learn more:What is excess fluid in the eyes?
Are bananas good for macular degeneration?
Yes, eating high-fiber fruits like bananas, apples, and berries, which are metabolized more slowly and lead to fewer blood sugar fluctuations, is helpful for macular degeneration. Fiber-rich vegetables such as broccoli, corn, carrots, leafy greens, legumes and beans and whole grains are also suitable.
Learn more:How to prevent macular degeneration
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts in our articles. Read ourseditorial processto learn more about how we verify and keep our content accurate, reliable and trustworthy.
American Academy of Ophthalmology.What causes macular edema?
American Academy of Ophthalmology.Central serous retinopathy.
American Diabetes Association.Eye complications.
Schrieber, C, Liu, Y.Choroidal effusions after glaucoma surgery.Curr Opin Ophthalmol.2015; 26(2):134-142. doi:10.1097/ICU.00000000000000131
American Academy of Ophthalmology.What is optical coherence tomography?.
University of British Columbia.Autofluorescence imaging.
American Academy of Ophthalmology.What is fluorescein angiography?.
University of Iowa.Indocyanine green angiography.
Retina Macula Institute.Ocular ultrasound.
National Eye Institute.For macular spots.
National Eye Institute.Diabetic retinopathy.
American Academy of Ophthalmology.Anti-VEGF therapies.
Maxine Lipner is a longtime health and medical writer with over 30 years of experience in ophthalmology, oncology, and general health and wellness.
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