Retina Consultants San Diego | Diseases of the Eye and Vitreous

We Specialize In

Retinal Detachment

A torn or detached retina is a serious vision threatening problem; one that no doubt causes alarm and concern to both the patient and their family. Fortunately, with modern surgical techniques, over 90% of retinal detachments can be repaired and blindness will be prevented. Almost all of our patients return to a normal life, self-reliant, active and independent.

Macular Hole Repair

Macular hole is a relatively common disorder that can present as a spot of missing or distorted vision in the center of one eye, with a decrease in your ability to read or see clearly. Fortunately, if caught early, we have a very high success rate in repairing these holes. While most surgeons require up to 2 weeks of strict face down positioning following surgery, we require zero face down positioning and have a success rate as good or better than other surgeons. See our website at macularholesurgeons.com for a detailed explanation. Certain patients may also be a candidate for an office-based injection (ocriplasmin, Jetrea) for macular hole repair.

Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes which affects the small blood vessels in the retina. These changes can cause mild to severe loss of vision. In fact, diabetes is the leading cause of severe visual loss in Americans between the ages of 20 and 64. Nonetheless, with careful diabetic management and timely laser surgery by a retina laser specialist, good vision can usually be maintained.

Macular Degeneration

Macular degeneration (AMD) is a common eye disorder and the leading cause of loss of reading vision in the United States. It is a condition in which damage occurs to the retina, usually from an aging change. While total blindness never occurs from this condition, the ability to read and do close work can be severely affected. VEGF-inhibitor injections have revolutionized our treatment of and prognosis for AMD, and are essentially painless with our numbing techniques.

Laser Retinal Surgery

There are several types of lasers used to treat various disorders in the eye and currently lasers are being used to reduce vision loss from glaucoma, secondary cataracts, diabetes, blocked blood vessels, retinal tears, retinal detachments and macular degeneration.

Vitreous Surgery and Retinal Surgery

Vitreous surgery is a type of microsurgery which now enables eye surgeons to treat patients with diseases of the retina and vitreous who, until the advent of this type of surgery, might have been considered hopelessly blind.

Posterior Vitreous Detachment

Posterior vitreous detachment is a common disorder occurring in about 80% of people in the United States. It frequently causes the symptoms of floaters and flashing lights, but infrequently causes a loss of vision. It should not be confused with a retinal detachment. Rarely posterior vitreous detachment can cause a tear or hole to form in the retina, which may need to be treated with laser to prevent a retinal detachment.

About Us

The physicians at Retina Consultants San Diego are nationally recognized leaders in their field. They participate in most clinical trials assessing new therapies for macular degeneration, diabetic retinopathy, as well as other retinal diseases. In addition to its clinical services, Retina Consultants San Diego provides continuing education and consulting services to the local, national, and international ophthalmic communities and other healthcare industries.

Here at Retina Consultants San Diego, we use state-of-the-art diagnostic and therapeutic technology, including wide-field fluorescein photography and angiography, ICG angiography, autofluorescence, ultrasonography, and spectral-domain optical coherence tomography with enhanced depth imaging.

Each doctor in our group is board certified in ophthalmology and has completed formal subspecialty training in medical and surgical diseases of the retina, vitreous, and macula. Each member is nationally recognized for their participation in research and educational programs primarily aimed at understanding the causes of retinal diseases and developing novel treatments. For each of our esteemed doctors, a brief biographical sketch is provided.

What Makes Us Different?

Patient Education

National Meeting Notes and Summaries

American Society of Retina Specialists, 2012
Macula Society meeting, 2013

Intravitreal injections

Intravitreal drug delivery has become a popular method of treatment of many retinal diseases, commonly including AMD, Diabetic Retinopathy, and Retinal Vein Occlusions. The frequency of intravitreal injections has significantly increased since the introduction of Anti-VEGF medications. This is an important procedure that Retina Specialists use on a daily basis, and it is important to master the techniques of effective injections for patient safety and reduction of complications.

More info

Diabetic Eye Disease

Diabetic retinopathy, the most common diabetic eye disease, occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina.

Watch Dr. Tornambe's video on diabetes
Watch KUSI morning news as Dr. London discusses the health impact of diabetes
More info

Macular Degeneration

Age-related macular degeneration (AMD) is a deterioration or breakdown of the eye's macula. The macula is a small area in the retina — the light-sensitive tissue lining the back of the eye. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly.

Watch Dr. Tornambe's video on AMD

Click here to view and/or download an annotated lecture on macular degeneration by Dr. London

Retinal Vein Occlusion

Central retinal vein occlusion (CRVO) is a blockage of the main vein in the retina. (Blockage of the small veins in the retina is called branch retinal vein occlusion, or BRVO.) The blockage causes the walls of the vein to leak blood and excess fluid into the retina. When this fluid collects in the macula (the area of the retina responsible for central vision), vision becomes blurry.

More info

Central Serous Choroidopathy

In central serous retinopathy (sometimes called central serous choroidopathy), fluid builds up under the retina and distorts vision. Fluid leakage is believed to come from a tissue layer with blood vessels under the retina, called the choroid. Another layer of cells called the retinal pigment epithelium (RPE) is responsible for preventing fluid from leaking from the choroid under the retina. When, for unknown reasons, tiny areas of the RPE become defective, fluid builds up and accumulates under the RPE, much as liquid in a blister collects under the skin. As a result, a small detachment forms under the retina, causing vision to become distorted.

More info

Macular Edema

Macular edema is swelling or thickening of the eye's macula, the part of your eye responsible for detailed, central vision.

More info

Macular Hole

A macular hole is a small break in the macula, the part of your eye responsible for detailed, central vision.

More info
Macular Hole Surgeons.com
More About Macular Holes
Straight from the Cutter's Mouth - Podcast with Dr. Tornambe

Macular Pucker

A macular pucker (also called an epiretinal membrane) is a layer of scar tissue that grows on the surface of the retina, particularly the macula, which is the part of your eye responsible for detailed, central vision.

More info

Retinal Tear or Detachment

As the eye ages the vitreous gel that fills it shrinks. Usually the vitreous moves away from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through a retinal tear, lifting the retina off the back of the eye — much as wallpaper can peel off a wall. When the retina is pulled away from the back of the eye like this, it is called a retinal detachment.

More info

Vitrectomy

Vitrectomy is the surgical removal of the vitreous gel from the middle of the eye.

More info

Scleral Buckle

This treatment to repair a retinal detachment involves placing a flexible band (scleral buckle) around the eye to counteract the force pulling the retina out of place. The ophthalmologist often drains the fluid under the detached retina, allowing the retina to settle back into its normal position against the back wall of the eye. This procedure is performed in an operating room.

Watch Interview with Dr. Tornambe on Scleral Buckling
More info

Pneumatic Retinopexy

In this procedure, a gas bubble is injected into the vitreous space inside the eye in combination with laser surgery or cryotherapy. The gas bubble pushes the retinal tear into place against the back wall of the eye. Sometimes this procedure can be done in the ophthalmologist’s office. Your ophthalmologist will ask you to constantly maintain a certain head position for several days. The gas bubble will gradually disappear.

Video on Pneumatic Retinopexy by Dr. Tornambe

Optical Coherence Tomography

Optical coherence tomography (OCT) is a non-invasive imaging test that uses light waves to take cross-section pictures of your retina, the light-sensitive tissue lining the back of the eye.

Dr.Tornambe's Presentation at the imaging conference in Rome, Italy December 2017
Dr. Tornambe's Webcast on OCT Angiography (long version)
Dr. Tornambe's Webcast on OCT Angiography (short version)

More info

Fluorescein Angiography

Fluorescein angiography is an eye test that uses a special dye and camera to look at blood flow in the retina and choroid, the two layers in the back of the eye.

More info

Indocyanine Green Angiography

Indocyanine green angiography is a diagnostic test that involves taking photographs of the blood vessels in the eye with the help of a contrast dye. Indocyanine is a green dye that works with infrared light and is visualized with a special camera. The images produced by this test help doctors evaluate the retina and diagnose or monitor problems such as macular degeneration, abnormal vessel growth, macular edema, certain types of retinal detachment, and tumors.

OCT Based Non-Invasive Angiography

This exciting new technology (referred to as OCT-A) allows us to do an angiogram of the retinal circulation without an injection, and without a dye by imaging the moving cells in your blood stream. It uses light, not radiation, has no side effects, and is performed in about a minute per eye. It is particularly helpful in managing age related macular degeneration, diabetes, and vascular occlusions. In our opinion, it will help customize care for a specific patient situation, perhaps decrease the injection frequency or indicate when an injection is needed earlier than normally expected, and help us determine if the drug we are using is the most effective drug for this patient's individual problem. Although the other dye based angiograms will be needed at times, we feel OCT-A will replace a majority of dye based angiograms.

Dietary Tips for Eye Health

Dietary flavanoids that protect retinal cells from injury and death, macular degeneration

Luteolin - Spinach, wild greens, hot peppers, celery, herbs (thyme, parsley, mint)
Quercetin - Onion (esp. yellow), cranberries, cocoa, wild greens, capers, fennel, spinach, chives, celery, cherries, blueberries, apples, kale, red wine
Eriodictyol - Peppermint, citrus juices (lemon, lime, sour orange)
Fisetin - Strawberries, tomatoes, onion, oranges, apples, peaches, grapes, kili, persimmons

Our Doctors

Paul E. Tornambe, MD, FACS

Founder and President

Lon S Poliner, MD, FACS

Vice President and CFO

Nikolas JS London, MD, FACS

Director of Clinical Research

Anne Hanneken, MD

Director of Laboratory Research

Our Clinics

World-Renowned Retina Surgeons

All of our doctors were trained at outstanding institutions including Washington University in St. Louis, Wills Eye Hospital in Philadelphia, Johns Hopkins Wilmer Eye Institute and Duke University Eye Center. There is no substitute for training and experience.

Attention to Detail for Treatment & Surgery

Our physicians utilize the most advanced therapies and surgical approaches, combined with an unfailing attention to consistency and detail, to provide the best treatment available.

Cutting-edge Technology and Access to Clinical Trials

All of our offices have the latest diagnostic and therapeutic services. We keep our patients Informed - by providing information on common diseases in print and on our website. We serve as a regional leader for large-scale clinical trials, providing access to next generation therapies.

Concierge-level Care

Our doctors treat their patients like family members and take as much time as needed to explain their disease. We work hard to keep visit durations to a minimum.

Easily Accessible Offices

Our offices are easy to find, with multiple locations. We participate with most insurance plans.

Most Insurances Accepted

We participate with most insurance plans.

Patient Contact Form

Please fill out as much of this form as you can.
One of our staff or physicians will get back to you as soon as possible.
Of course, you may also call us at any time. For medical emergencies, please call 911.

* First Name

* Last Name

* Date of Birth

* Phone

* Email

Physician (if applicable)

Office (if applicable)

* Issue

Appointment question

Comment and/or suggestion

Pain

Loss of vision

Post-operative question

Other

* Question and/or Concern - please describe in as much detail as you can.