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Retinovitreous Services

Retinovitreous Services at the Eye Institute are provided by outstanding specialists at two Ottawa Hospital locations:

The retina, a light sensing membrane lining the back of the eye, and the vitreous gel, which lies immediately in front of it, are two of the most important and delicate structures inside the eye.

Subsequent to degenerative and inflammatory diseases, the retina may detach (retinal detachment) from the underlying tissue. If not repaired by laser therapy or surgery, this condition can result in blindness.

Macular degeneration, an aging process that diminishes normal function of the retina's central point of vision, affects thousands of otherwise healthy, aging Canadians. It is currently the leading cause of permanent loss of reading vision. The diagnosis and management of these disorders make up 80 per cent of the clinical activity of the Eye Institute's retinal surgeons.

The retinovitreous service provides a broad range of diagnostic services, including digitized fluorescein and indocyanine green angiography, ultrasonography, and electrophysiologic testing. The Eye Institute also has stationary and portable multiple wavelength lasers, which can be used in both outpatient and operating room settings.

The service has pioneered new vitreous surgical techniques such as the use of silicone oils, perfluorocarbon liquids and gases, intraocular biologic mediators, and subretinal and submacular dissecting instrumentation. More than 700 vitreo-retinal operations and 2,000 laser treatments are performed annually.

Ophthalmologists at The Ottawa Hospital, General Campus, performed the first vitrectomy in Canada, and for two decades have been the regional referral centre for Eastern Ontario and Western Quebec. Today, 40% of all patients are referred from outside the Ottawa/Gatineau area.

Clinical and basic science research activity in retinovitreous includes:

• pharmacological and surgical therapy of choroidal vascular membranes;
• use of silicone oil in complex retinal detachments;
• evaluation of intraocular perfluorocarbon gas toxicity;
• Erbium Yag intraocular membrane dissection;
• development of a surgical teaching program using a virtual reality surgical simulator.

In addition to training Residents and Fellows, the retinal surgeons have been instrumental in training foreign ophthalmologists who then return to their home countries, proficient in the latest surgical techniques. These surgeons have actively participated in the development of retinovitreous services in more than 30 countries worldwide.

Dr. Brian Leonard of the University of Ottawa Eye Institute is a member of Orbis, an international network which develops eye surgical centres in Third World countries. The programme brings together volunteer surgeons, nurses, technicians, pilots and sponsors to carry equipment and skills to these countries aboard a refurbished DC-10, outfitted as an ophthalmological flying operating room.