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Anatomy of the Retina

The retina is the light-sensitive tissue lining the back of our eye. Light rays are focused onto the retina through our cornea, pupil and lens. The retina then converts the light rays into impulses that travel through the optic nerve to our brain, where they are interpreted as the images we see. A healthy retina is key to clear vision.

Distortions of vision, such as blurred words on a page, a dark spot that appears in the center of vision, or straight lines that appear wavy, can all be signs of retinal condition.

Diagnostic Testing

Fluorescein and Indocyanine Green (ICG) Angiographies are very useful for finding leakage or damage to the blood vessels which nourish the retina. In both tests, a colored dye is injected into your arm. The dye travels through the veins and into the arteries that circulate throughout the body. As the dye passes through the blood vessels of the retina, a technician uses a special camera to take a series of photographs. These photographs will reveal the condition of the blood vessels within the retina. This information is used to determine whether additional monitoring, laser procedures or injections are warranted.

Optical Coherence Tomography (OCT) allows for the imaging and measurement of retinal thickness. OCT is very useful in detecting retinal swelling or fluid accumulation due to a variety of retinal conditions. It is also useful for following the response of a retinal treatment.

Fundus Autofluorescence (FAF) is an imaging technique which assesses the retina at a metabolic level, and can be used to detect certain eye diseases which may not yet be visible when viewing the retina with more traditional methods. It works by detecting chemical structures called fluorophores. When exposed to a particular wavelength of light, fluorophores become illuminated. Fundus Autofluorescence is an effective method of detecting early signs of retinal disease and can be used as a diagnostic or monitoring tool for  hereditary conditions such as Best’s and Stardgardt’s disease. It has also been shown to detect early stages of Macular Degeneration, and is a vital technique when imaging intraocular lesions, such as a Choroidal Nevus.

Ultrasonography (B-Scan)  uses sound waves to view the internal structures of the eye. It is used when the physician cannot obtain a clear view of your retina or other internal structures due to bleeding, a dense cataract, corneal cloudiness or lesions. It can also be used to locate and follow cancerous tumors and other abnormalities.

Sushma K. Vance, M.D.

Dr. Vance is a board certified, fellowship trained retina specialist. She graduated with distinction from the University of Michigan in biology and anthropology and received her medical degree and ophthalmology residency training at Northeast Ohio Medical University. While in residency, Dr. Vance authored and secured several research and community service grants and was also awarded the William H. Falor award for best resident research. After completing her ophthalmology residency, Dr. Vance completed a medical retina fellowship at the Vitreous Retina Macula Consultants of New York and the Manhattan Eye, Ear, and Throat Hospital followed by a surgical retina fellowship with Texas Retina Associates in Dallas.  After fellowship, Dr. Vance was in private practice for six years before joining the Atlantic Eye Institute in January 2017. Dr. Vance specializes in the treatment of age-related macular degeneration, diabetic retinopathy, retinal vascular disease, uveitis, and retinal tears and detachments.

She has published numerous scientific papers focused primarily on retinal imaging and complex retinal disorders and serves as a Clinical Assistant Professor of Ophthalmology at the University of Central Florida College of Medicine.

Dr. Vance has been involved with several volunteer organizations including Surgical Eye Expeditions (SEE) International, the Student Sight Savers Program, and Prevent Blindness America.  She is a member of the American Academy of Ophthalmology and the American Society of Retina Specialists.

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