What Is a Retina Specialist and When Do I Need One?

There are many types of medical doctors, each with their own area of expertise. Even within ophthalmology, there are several subspecialties, which can make it difficult for patients to know who does what. A common question I hear is: "How is a retina specialist different from an ophthalmologist?" Patients are surprised to learn that all retina specialists are also ophthalmologists, with the difference being additional training subspecializing in retinal disease.

Many find their way to me through a referral from their general eye doctor or through an internet search prompted by sudden visual symptoms. After I've given the diagnosis, I also sometimes hear: "Why do I need to keep seeing you? Can’t my regular eye doctor take care of this?" In many cases, the answer is no. Serious retinal conditions require ongoing monitoring using advanced imaging, and treatments that can only be provided in a retina office.

Why is that? What makes the retina so special? I'll explain briefly what the retina does and we'll see why we need to take great care of it.

The Retina Is a Direct Extension of the Brain

The retina is a thin, light-sensitive layer of tissue that lines the back of the eye and functions much like the film in a camera, capturing images and sending visual signals to the brain by way of the optic nerve. Its thickness ranges from approximately 0.1 to 0.3 mm, which is about the thickness of a sheet of standard copy paper. A layer of nerve tissue, called the nerve fiber layer, comprises the inner surface of the retina. This nerve fiber layer coalesces to become the optic nerve at the back of the eye, which is the information cable that runs a length of approximately two inches before connecting to the brain. Learning how to properly visualize, evaluate and surgically treat this microscopic and fragile tissue takes many years of training.

Cross-section of an eye model showing internal layer of retinal tissue (orange) gathering into the optic nerve on the right (yellow)

The Expertise Behind the White Coat

The path to becoming a retina specialist involves several steps. Here’s a breakdown:

1. Undergraduate Degree (4 years) The journey begins with a bachelor’s degree, usually with a strong emphasis on biology, chemistry, and other sciences.

2. Medical School (4 years) Next is four years of medical school to earn an MD (Medical Doctor) or DO (Doctor of Osteopathic Medicine) degree. This includes coursework in all areas of medicine and clinical rotations in different core specialties such as pediatrics, internal medicine, general surgery, obstetrics and gynecology, among others.

3. Internship (1 year) Graduates complete a one-year internship, which can be either in general medicine or surgery.

4. Ophthalmology Residency (3 years) Residency is where future eye doctors receive intensive training in medical and surgical eye care. They learn to treat a broad range of eye conditions, including cataracts, glaucoma, and eye trauma. Medical residents typically work 60-80 hours per week for the duration of their training.

5. Retinal Fellowship (1-2 years) After residency, those who wish to specialize in retinal diseases undergo a fellowship either in medical retina (1 year) or medical and surgical retina (2 years). This includes advanced training in diagnosing and treating complex retinal diseases, performing intricate microsurgeries, and using state-of-the-art imaging technologies.

   
   

In total, it takes at least 14 years of education and training after high school to become a retinal surgeon.

Path to becoming a medical doctor

Retina Specialist vs. Ophthalmologist vs. Optometrist

Understanding the difference between these three types of eye care providers can help patients make informed decisions:

Optometrist (OD)

• Completed 4 years of optometry school after college

• Not a medical doctor

• Provides routine eye exams, prescribes glasses and contact lenses

• Can diagnose and manage some straightforward eye conditions, not trained in surgery

General Ophthalmologist (MD or DO)

• Medical doctor with 4 years of medical school and 3 years of ophthalmology residency

• Can diagnose and treat a wide range of eye conditions, including serious blinding conditions such as glaucoma or corneal ulcers

• Performs surgeries such as cataract removal or eyelid procedures

• May refer more complex retinal issues to a specialist

  
  

Retinal Surgeon (MD or DO)

• Same knowledge and skillset as a general ophthalmologist plus 2 additional years of retina-specific fellowship training

• Specializes in medical and surgical care of retinal diseases, including its relation to systemic diseases of the body

• Performs delicate procedures like retinal detachment repair, macular surgery, and treatment for eye complications from diabetes or severe trauma

Why You Shouldn't Skip Your Retina Appointment

Retinal diseases often present with subtle symptoms but can progress quickly if not properly treated. Retina specialists have the tools, knowledge, and surgical expertise to:

• Detect retinal tears before they lead to detachment

• Offer cutting-edge treatments like retinal implants, injections, or laser surgery

• Tailor long-term care plans for chronic retinal diseases

• Diagnose systemic illnesses manifesting in the retina by drawing on their foundational knowledge as a medical doctor

  
  

Because the retina is responsible for the sharp, central vision that we rely on most, the stakes are high. There is little margin for error as there is no replacement for the retina (there is no retinal transplant yet). Seeing the right doctor at the right time can mean the difference between preserving sight and permanent loss of vision and function.

Slit lamp eye exam

Can You Get General Eye Care From a Retina Specialist?

In a traditional medical practice, retina specialists tend to deal solely with retinal diagnoses, and redirect patients back to their referring optometrist or general ophthalmologist for non-retinal care.

Beacon Retina is a concierge-style, membership-based practice that prioritizes patients' well-being first, but also considers their comfort and convenience. While I specialize in complex retinal conditions, I am also a board-certified ophthalmologist trained in comprehensive ophthalmology. At Beacon Retina, I offer my patients the convenience of a trusted single provider for specialty as well as general eye care needs if they request it. Certainly, I also respect patients' existing relationships with other eye care providers and collaborate frequently with them.

Final Thoughts

Choosing the right kind of eye doctor doesn't have to be confusing. Understanding each clinician's educational background and area of focus helps you get the most out of your visits. Whether managing a known condition or staying proactive, being informed and building a trusted relationship can make all the difference in protecting your vision long-term.

For more information, including a video with an inside look at the role that retina specialists play, visit the website of the American Society of Retina Specialists below.

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Dr. Sophia Wong is a retina specialist, surgeon and board-certified ophthalmologist. She established Beacon Retina, the first concierge ophthalmology practice in the Washington, D.C. metro region, to prioritize thoughtful, patient-centered care for preserving long-term vision.