Common Eye Diseases, Conditions, and Procedures
For your convenience, we have compiled the following information and videos about common eye diseases, conditions, and procedures. Just click on the highlighted links to view the videos.
VIDEO: Glaucoma (Overview)
Glaucoma is one of the leading causes of irreversible blindness in the United States, yet most people with glaucoma have no symptoms in the early stages. This is why it is sometimes called the “silent thief of sight.” Glaucoma refers to a group of eye diseases that damage the optic nerve — the connection between the eye and the brain — typically as a result of elevated pressure inside the eye. Once optic nerve damage occurs, it cannot be reversed, making early detection critical.
The most common form, open-angle glaucoma, progresses slowly and painlessly. Many patients are unaware they have the disease until significant vision has already been lost. Less commonly, angle-closure glaucoma can present suddenly with eye pain, headache, nausea, and blurred vision — this is a medical emergency requiring immediate care.
At River City Eye Associates, glaucoma is diagnosed using a combination of eye pressure measurement, optic nerve evaluation, corneal thickness assessment, and visual field testing. Treatment options include prescription eye drops, laser therapy (SLT), and surgical procedures depending on the severity and type of glaucoma. Dr. Hager works with each patient to develop an individualized management plan aimed at preserving the vision they have.
If you have a family history of glaucoma, are over age 60, or have elevated eye pressure, regular comprehensive eye exams are especially important. Call our San Antonio office at 210-930-2015 to schedule an evaluation.
VIDEO: SLT Laser (for Glaucoma)
YAG laser capsulotomy is a quick, painless in-office procedure performed after cataract surgery to restore vision that has become cloudy or hazy due to a condition called posterior capsule opacification (PCO) — sometimes referred to as a “secondary cataract,” though it is not a true cataract.
During cataract surgery, the natural clouded lens is removed and a clear artificial lens implant (IOL) is placed inside the thin, transparent membrane called the lens capsule. Over time, in roughly 20-40% of patients, the back (posterior) portion of this capsule can become cloudy as residual lens cells migrate and proliferate across it. When this happens, patients experience symptoms that closely resemble their original cataract: blurred or hazy vision, glare, difficulty with night driving, and reduced contrast sensitivity. PCO can develop months to years after otherwise successful cataract surgery.
The YAG laser uses precisely targeted pulses of energy to create a small, clear opening in the cloudy posterior capsule, instantly restoring a clear visual axis. The procedure is performed at a slit lamp in the office, takes only a few minutes, and requires no incisions or anesthesia. Vision improvement is typically noticed within 24 hours, and there is no meaningful recovery period. Patients should plan to have someone drive them home since dilating drops are used beforehand.
YAG capsulotomy is one of the most commonly performed laser procedures in ophthalmology and has an excellent safety profile. Rare complications include a temporary spike in eye pressure immediately after the procedure and, very rarely, displacement of the lens implant — both of which are manageable when monitored appropriately.
If your vision has become cloudy or glare-affected months or years after cataract surgery, posterior capsule opacification may be the cause. At River City Eye Associates, Dr. Hager evaluates post-cataract patients experiencing these changes and performs YAG laser capsulotomy for appropriate candidates. Call our San Antonio office at 210-930-2015 to schedule an evaluation.
VIDEO: SLT Laser (for Glaucoma)
Selective Laser Trabeculoplasty, commonly known as SLT, is a safe and effective in-office laser procedure used to lower eye pressure in patients with open-angle glaucoma or ocular hypertension. It is often used as a first-line treatment — before or instead of daily eye drops — or as an adjunct when drops alone are not providing adequate pressure control.
The trabecular meshwork is the drainage system of the eye, responsible for allowing fluid (aqueous humor) to exit and maintaining a healthy internal eye pressure. In glaucoma, this drainage system becomes less efficient, causing pressure to build and damage the optic nerve over time. SLT works by applying low-energy laser pulses to targeted cells in the trabecular meshwork, stimulating the body’s natural healing response and improving fluid outflow without destroying surrounding tissue.
The procedure is performed in the office and typically takes less than five minutes per eye. A special contact lens is placed on the eye surface, and the laser is applied through a standard slit lamp. Most patients experience little to no discomfort. There is no recovery downtime, and patients can resume normal activities the same day. Eye pressure typically begins to decrease within four to six weeks, with full effect seen by three months.
One of SLT’s most significant advantages is that it can be repeated if the effect diminishes over time, which commonly occurs after five to seven years. Unlike some older glaucoma lasers, SLT does not cause scarring, preserving the option for future treatments. For patients who struggle with the cost, side effects, or daily compliance demands of glaucoma eye drops, SLT offers a compelling alternative.
At River City Eye Associates, Dr. Hager offers SLT as part of a comprehensive glaucoma management program tailored to each patient’s pressure targets, disease stage, and lifestyle. San Antonio and Karnes County patients interested in SLT can call 210-930-2015 to schedule a glaucoma evaluation.
VIDEO: Macular Degeneration (Dry)
Age-related macular degeneration (AMD) is the most common cause of central vision loss in adults over age 50 in the United States. The macula is the small central portion of the retina responsible for sharp, detailed vision — the kind needed for reading, recognizing faces, and driving. In dry AMD, the macula gradually thins and small protein deposits called drusen accumulate beneath the retina, slowly impairing central vision over time.
Dry AMD typically progresses through early, intermediate, and advanced stages. In the early stages, most patients experience no noticeable vision changes. As the disease advances, patients may notice that straight lines appear wavy or distorted, that they need more light to read, or that colors appear less vivid. In its most advanced form, dry AMD can cause a blank or dark spot in the center of vision.
While there is currently no cure for dry AMD, certain high-dose vitamin formulations (AREDS2 supplements) have been shown to slow progression in intermediate and advanced cases. Lifestyle factors such as not smoking, eating a diet rich in leafy greens, and protecting your eyes from UV light also play a meaningful role in reducing risk. Patients diagnosed with dry AMD are also instructed to monitor their central vision regularly at home using an Amsler grid — a simple checkerboard pattern that can help detect early distortion that may signal progression to wet AMD.
At River City Eye Associates, patients with dry AMD receive regular monitoring to track disease progression and are counseled on evidence-based strategies for preserving their remaining vision. If you or a family member has been diagnosed with AMD or is experiencing changes in central vision, contact our San Antonio clinic at 210-930-2015.
VIDEO: Macular Degeneration (Wet)
Age-related macular degeneration can progress from its dry form to a more advanced and aggressive form known as wet AMD. Wet AMD occurs when abnormal blood vessels grow beneath the macula and leak fluid or blood — a process called choroidal neovascularization — causing damage to the macula that can be rapid and severe. While wet AMD accounts for a minority of AMD cases, it is responsible for the majority of AMD-related serious vision loss.
Unlike dry AMD, which progresses gradually over years, wet AMD can cause significant central vision loss within weeks or months. Symptoms include a sudden worsening of central vision, distortion of straight lines such as doorframes or text appearing wavy or curved, and a dark or blurry spot in the center of the visual field. Any sudden change in central vision in a patient with a known history of AMD should be treated as a medical urgency.
The current standard of care for wet AMD is anti-VEGF injection therapy, in which medication is delivered directly into the eye to suppress abnormal vessel growth and reduce leakage. When initiated promptly and maintained consistently, anti-VEGF treatment can stabilize vision and in many cases partially restore it. Early treatment produces significantly better outcomes than delayed treatment, which is why regular monitoring — including OCT retinal imaging and daily Amsler grid checks at home — is so important for all AMD patients.
At River City Eye Associates, patients showing signs of conversion from dry to wet AMD are referred promptly to a retinal specialist for evaluation and treatment. If you experience a sudden change in your central vision, do not wait for your next scheduled appointment — call our San Antonio clinic at 210-930-2015 immediately.
A retinal tear is a break in the thin layer of tissue lining the back of the eye — the retina — which is responsible for converting light into the visual signals your brain interprets as sight. Retinal tears are a serious ophthalmologic condition that require prompt evaluation because, if left untreated, they can progress to retinal detachment, which can cause permanent and significant vision loss.
Most retinal tears are caused by posterior vitreous detachment (PVD), the age-related process in which the gel inside the eye (vitreous) shrinks and separates from the retina. In most cases this separation is uneventful, but occasionally the vitreous pulls hard enough on an area of the retina to create a tear. Less commonly, retinal tears result from trauma, extreme nearsightedness (high myopia), or a family history of retinal disease.
The hallmark symptoms of a retinal tear are a sudden onset of new floaters (especially a shower of small dots or debris), new or increased flashes of light in the peripheral vision, or a shadow or curtain appearing at the edge of your visual field. These symptoms should never be dismissed or waited out — they warrant same-day or next-day evaluation by an ophthalmologist.
When detected early, most retinal tears can be treated in the office with laser photocoagulation or cryotherapy (freezing treatment). Both techniques create a seal around the tear, essentially “spot-welding” the retina to prevent fluid from passing through the tear and lifting the retina away from the underlying tissue. The procedures are quick and, in most cases, prevent the tear from progressing to a detachment.
If you are experiencing a sudden onset of floaters, flashes, or any peripheral visual disturbance, please call River City Eye Associates promptly at 210-930-2015. Timely treatment of retinal tears is one of the most effective ways to prevent vision-threatening retinal detachment.
Retinal detachment is a sight-threatening emergency in which the retina separates from the underlying layer of supportive tissue that supplies it with oxygen and nutrients. Without prompt surgical intervention, retinal detachment can result in permanent vision loss in the affected eye. It is one of the true emergencies in ophthalmology.
The most common type, rhegmatogenous retinal detachment, begins when a retinal tear allows fluid from inside the eye to seep beneath the retina, gradually lifting it away from the back wall of the eye. Risk factors include prior retinal tears, high myopia (nearsightedness), previous eye surgery, eye trauma, and a personal or family history of retinal detachment. It can occur at any age but is more common in adults over 40.
Warning symptoms include a sudden dramatic increase in floaters, persistent flashes of light, and most distinctly, a dark curtain, shadow, or veil spreading across the peripheral or central visual field. If central vision is affected, the detachment has likely reached the macula — the central retina responsible for sharp detail — and the prognosis for full visual recovery becomes more guarded. This is why early recognition and treatment are critical.
Treatment of retinal detachment requires surgery. The most common surgical options include pneumatic retinopexy (an in-office injection of a gas bubble), scleral buckle surgery, and vitrectomy — the appropriate approach depends on the location, size, and complexity of the detachment. Visual outcomes are generally better when the macula remains attached at the time of repair.
At River City Eye Associates, patients with suspected retinal detachment are evaluated urgently and referred immediately to a retinal specialist for surgical management. If you are experiencing a sudden curtain or shadow in your vision, this is a medical emergency — call 210-930-2015 immediately or go to the nearest emergency room. Do not wait for a routine appointment.
Diabetic retinopathy is the leading cause of vision loss among working-age adults and a common complication of both Type 1 and Type 2 diabetes. When blood sugar levels remain elevated over time, the small blood vessels that supply the retina can become damaged — leaking fluid, swelling, or growing abnormally. The retina is the light-sensitive tissue lining the back of the eye, and damage to it directly affects vision.
In the early stages (non-proliferative diabetic retinopathy), weakened blood vessels may leak small amounts of fluid or blood into the retina. In more advanced stages (proliferative diabetic retinopathy), new, fragile blood vessels grow on the surface of the retina and can bleed suddenly into the eye, causing severe and rapid vision loss. Diabetic macular edema — swelling in the central retina — can occur at any stage and is a leading cause of blurred vision in diabetic patients.
Because diabetic retinopathy often has no symptoms until it is advanced, the American Academy of Ophthalmology recommends annual dilated eye exams for all diabetic patients. Tight control of blood sugar, blood pressure, and cholesterol significantly reduces the risk of developing or worsening retinopathy.
At River City Eye Associates, Dr. Hager works closely with primary care physicians and endocrinologists to coordinate diabetic eye care. Treatment options including anti-VEGF injections, laser treatment, and surgical referral are available depending on the stage of disease. Diabetic patients in San Antonio and Karnes County can schedule a comprehensive dilated exam by calling 210-930-2015.
Floaters are small shapes — dots, strands, cobwebs, or shadows — that drift across your visual field and tend to be most noticeable when looking at a bright, plain background like a clear sky or a white wall. Flashes appear as brief streaks or flickers of light, often in the peripheral vision. Both are extremely common and are usually caused by age-related changes in the vitreous, the gel-like substance that fills the inside of the eye.
As the vitreous naturally liquefies and shrinks with age, it can pull away from the retina in a process called posterior vitreous detachment (PVD). This is the most common cause of new floaters and flashes in adults over 50, and in most cases it is benign. However, when the vitreous pulls away from the retina, it can sometimes tug strongly enough to cause a retinal tear — a potentially serious condition that, if untreated, can lead to retinal detachment and permanent vision loss.
New or sudden flashes and floaters — especially a sudden shower of new floaters, a curtain or shadow in your peripheral vision, or a significant increase in flashes — should be evaluated promptly by an ophthalmologist. These symptoms can indicate a retinal tear or detachment, which are time-sensitive emergencies.
At River City Eye Associates, patients experiencing new flashes or floaters receive a thorough dilated eye exam to evaluate the retina. If a retinal tear is detected early, it can typically be treated in-office with laser therapy before it progresses to detachment. San Antonio patients with new or changing flashes and floaters should call 210-930-2015 promptly for an evaluation.