Seeing the details that matter most
Fellowship-trained retina specialists — from anti-VEGF injection therapy and diabetic eye care to vitrectomy and retinal detachment repair, preserving your vision for the long term.
What is the retina?
The retina is a thin layer of light-sensitive tissue lining the back of the eye. It converts light into electrical signals that travel through the optic nerve to the brain, creating the images you see. The macula — a small, specialized area at the centre of the retina — is responsible for sharp, detailed central vision used for reading, driving, and recognizing faces.
Retinal diseases can affect any part of this tissue. Some conditions develop gradually over years, while others can threaten sight within days or even hours. The common thread is that early detection and timely treatment are critical to preserving vision — and in many cases, preventing irreversible damage.
At Uptown Eye Specialists, our retina service covers two complementary areas: medical retina (conditions managed with imaging, injections, and laser) and vitreoretinal surgery (conditions requiring surgical intervention in the operating room). Together, they provide comprehensive coverage for the full spectrum of retinal disease.
Our retina team includes fellowship-trained medical retina and vitreoretinal surgery specialists affiliated with the University of Toronto, Toronto Metropolitan University, and the University Health Network — with over 250 combined peer-reviewed publications and active roles in clinical research, clinical trials, and resident training.
Conditions we treat
Retinal diseases range from slowly progressive conditions that require careful monitoring to sight-threatening emergencies demanding immediate intervention. Our retina specialists manage the full spectrum.
Age-related macular degeneration (AMD)
The leading cause of vision loss in Canadians over 50. Dry AMD progresses gradually with drusen deposits under the retina. Wet AMD involves abnormal blood vessel growth that leaks fluid, causing rapid central vision loss if untreated. Both forms require ongoing specialist monitoring.
Diabetic retinopathy
Damage to retinal blood vessels caused by diabetes — the leading cause of preventable blindness in working-age Canadians. Ranges from mild non-proliferative disease (often symptom-free) to proliferative retinopathy with abnormal vessel growth, bleeding, and risk of retinal detachment.
Retinal detachment
A medical emergency where the retina separates from the underlying tissue. Without prompt surgical repair, permanent vision loss can result. Warning signs include sudden floaters, flashes of light, or a shadow across your vision. Surgical repair is performed urgently at U Surgical Centre.
Macular edema
Fluid accumulation in the macula causing blurred or distorted central vision. Can result from diabetes (diabetic macular edema), retinal vein occlusion, or post-surgical inflammation. Treated with anti-VEGF injections and, in some cases, laser therapy. Early treatment can restore and preserve vision.
Retinal vein occlusion
A blockage in the veins that carry blood away from the retina — either a branch (BRVO) or central (CRVO) vein. Causes sudden painless vision loss, retinal haemorrhages, and often macular edema. Risk factors include hypertension, diabetes, and glaucoma. Managed with anti-VEGF injections.
Epiretinal membrane & macular hole
An epiretinal membrane (macular pucker) is a thin sheet of scar tissue on the retinal surface that can cause distortion and blurred central vision. A macular hole is a small break in the macula. Both conditions may require vitrectomy surgery when they significantly affect vision.
Retinal emergency warning signs
Seek immediate eye care if you experience any of the following:
- Sudden increase in floaters — especially many new floaters appearing at once
- Flashes of light — brief, recurring flashes in your peripheral vision
- Shadow or curtain — a dark area spreading across part of your visual field
- Sudden painless vision loss — blurring or loss of central or peripheral vision
- Distorted or wavy lines — straight lines appearing bent or crooked
If you experience these symptoms, contact your eye care provider immediately or visit your nearest emergency department. Retinal detachment and acute wet AMD require urgent treatment — early intervention significantly improves outcomes.
How we diagnose retinal conditions
Retinal diseases often develop beneath the surface — invisible to the patient until significant damage has occurred. Our retina specialists use advanced imaging technology to detect changes at the microscopic level, often years before symptoms appear.
| Test | What it measures |
|---|---|
| OCT (Optical Coherence Tomography) | Non-invasive cross-section scan of the retina — similar to an MRI for the eye. Reveals fluid, swelling, thinning, membrane formation, and structural changes invisible on standard examination. The primary tool for monitoring AMD, diabetic macular edema, and epiretinal membranes. |
| OCT angiography (OCTA) | Maps retinal blood flow without dye injection. Detects abnormal vessel growth (neovascularization) in wet AMD and diabetic retinopathy, and identifies areas of reduced blood flow in vein occlusions. |
| Dilated fundus examination | Direct examination of the retina through dilated pupils. Allows your specialist to assess the optic nerve, macula, peripheral retina, and blood vessels in real time. |
| Fundus photography | High-resolution images of the retina for baseline documentation and comparison at future visits. Essential for tracking progression of diabetic retinopathy and AMD. |
| Fundus autofluorescence (FAF) | Captures natural fluorescence of the retinal pigment epithelium. Detects metabolic changes in dry AMD and geographic atrophy that are not visible on standard imaging. |
| B-scan ultrasonography | Ultrasound imaging of the eye interior, used when the view is obstructed by dense cataract or vitreous haemorrhage. Essential for planning surgical intervention. |
Why regular imaging matters: OCT can detect macular fluid accumulation and structural changes before you notice any vision change. For conditions like wet AMD and diabetic macular edema, this early detection window is where treatment is most effective at preserving vision.
Retinal treatment options
Treatment for retinal conditions has advanced significantly in the past two decades. Many conditions that once led to inevitable vision loss can now be effectively managed — and in many cases, vision can be stabilized or improved. Your retina specialist will recommend a treatment plan based on your specific condition, severity, and individual needs.
| Treatment | How it works | Used for |
|---|---|---|
| Anti-VEGF injections | Medications injected into the eye that block abnormal blood vessel growth and reduce fluid leakage. The cornerstone of modern retinal treatment. | Wet AMD, diabetic macular edema, retinal vein occlusion, proliferative diabetic retinopathy |
| Laser photocoagulation | Precise laser treatment that seals leaking blood vessels or destroys abnormal tissue. Can be focal (targeted) or pan-retinal (widespread). | Diabetic retinopathy, retinal tears, retinal vein occlusion |
| Vitrectomy | Microsurgical removal of the vitreous gel to access and repair the retina directly. Uptown Eye’s vitreoretinal surgery program traces its roots to Dr. Mark Mandelcorn, who introduced pars plana vitrectomy to Canada in 1974. Today, vitrectomy is performed at U Surgical Centre under local or general anaesthesia by fellowship-trained vitreoretinal surgeons. | Retinal detachment, vitreous haemorrhage, epiretinal membrane, macular hole |
| Pneumatic retinopexy | In-office procedure using a gas bubble to push the detached retina back into place, combined with laser or cryotherapy to seal the tear. | Selected retinal detachments (specific tear location and characteristics) |
| Scleral buckle | Surgical placement of a silicone band around the eye to support the retina and close retinal breaks. | Retinal detachment, especially in younger patients |
| Cryotherapy | Controlled freezing applied to the outer eye wall to create a scar that seals retinal tears and prevents detachment progression. | Retinal tears, adjunct to pneumatic retinopexy or scleral buckle |
| Nutritional supplementation | AREDS2 formula vitamins (specific combination of antioxidants and minerals) shown to slow progression in intermediate and advanced dry AMD. | Intermediate to advanced dry AMD |
About intravitreal anti-VEGF injection therapy
Intravitreal anti-VEGF injections are the most significant advance in retinal treatment in a generation. These eye injections have transformed conditions like wet age-related macular degeneration, diabetic macular edema (DME), and retinal vein occlusion (CRVO and BRVO) from inevitable causes of blindness into manageable, treatable diseases. Our retina specialists collectively bring decades of injection treatment experience and active involvement in clinical research — including the PRECISE Study, a multi-centre Canadian investigation of treatment-switching strategies in diabetic macular edema presented at over 10 international conferences including AAO, EURETINA, and ASRS. Our team has also participated in multiple industry-sponsored clinical trials for anti-VEGF therapies, contributing to the evidence base that guides treatment decisions today.
Medications used for eye injections
Several anti-VEGF medications are used to treat retinal conditions. Your retina specialist will recommend the medication best suited to your diagnosis, treatment history, and individual response.
| Medication | Used for | Ontario Drug Benefit coverage |
|---|---|---|
| Aflibercept (Eylea®, biosimilars Aflivu™ and Yesafili™) | Wet AMD, diabetic macular edema, CRVO, BRVO | Biosimilars Aflivu and Yesafili are ODB-funded. Ontario’s biosimilar transition for aflibercept is in effect — patients on ODB coverage are transitioning to the biosimilar versions by May 28, 2026. |
| Ranibizumab (Lucentis®, biosimilar Byooviz®) | Wet AMD, diabetic macular edema, CRVO, BRVO | Biosimilar Byooviz is ODB-funded. Ontario’s biosimilar transition for ranibizumab completed January 31, 2025. The biosimilar is clinically equivalent to the original. |
| Bevacizumab (Avastin®) | Wet AMD, diabetic macular edema, retinal vein occlusion | Used off-label for retinal conditions. Typically lower cost than other anti-VEGF medications. May be covered by private insurance. |
| Faricimab (Vabysmo®) | Wet AMD, diabetic macular edema | A newer dual-action medication. May allow longer intervals between injections for some patients. Coverage varies by plan. |
About the biosimilar transition: Ontario’s biosimilar policy means patients covered by the Ontario Drug Benefit (ODB) program are being transitioned from original brand-name medications to biosimilar versions. Biosimilars are rigorously tested by Health Canada and are clinically equivalent in safety and effectiveness. If you have questions about your medication or the transition, your retina specialist will explain your options and guide the process.
What to expect during an eye injection
The intravitreal injection is performed in the clinic — no hospital visit or operating room is needed. Anaesthetic drops numb the eye surface completely, and the injection itself takes only a few seconds. Most patients describe mild pressure but no significant pain. You may experience mild irritation or a gritty sensation for a few hours afterward, which resolves on its own. Treatment frequency varies — typically monthly at first (the loading phase), then extended to longer intervals using a treat-and-extend protocol once your condition stabilizes. Your specialist will tailor the schedule to your individual response.
OHIP and ODB coverage: The intravitreal injection procedure itself is fully covered by OHIP. Anti-VEGF medication costs depend on the specific drug and your coverage: biosimilar aflibercept (Aflivu, Yesafili) and biosimilar ranibizumab (Byooviz) are funded through the Ontario Drug Benefit program for eligible patients. Bevacizumab and faricimab may be covered through private drug insurance plans. Your specialist will discuss medication options and any potential costs before beginning treatment.
Protecting your vision with diabetes
Diabetes affects the small, delicate blood vessels throughout the body — and the retina is particularly vulnerable. Diabetic eye disease (diabetic retinopathy and diabetic macular edema) is the leading cause of preventable blindness in working-age Canadians. But with regular monitoring and timely treatment, over 90% of severe vision loss from diabetes can be prevented. Our team is also involved in research to improve patient follow-up — including a feasibility study published in BMJ Open Ophthalmology evaluating AI-assisted post-treatment monitoring in diverse patient populations.
Stages of diabetic retinopathy
| Stage | What happens | Symptoms |
|---|---|---|
| Mild NPDR | Small areas of swelling (microaneurysms) in retinal blood vessels. No treatment needed — monitoring only. | Usually none |
| Moderate NPDR | Blood vessels begin to leak fluid and blood. Some vessels may close off entirely. | Usually none |
| Severe NPDR | Significant vessel closure reduces blood supply to the retina. The retina signals for new blood vessel growth. | May begin to notice vision changes |
| Proliferative DR (PDR) | New abnormal blood vessels grow on the retina surface. These are fragile and prone to bleeding (vitreous haemorrhage) and can cause tractional retinal detachment. | Floaters, vision loss, sudden darkening |
| Diabetic macular edema | Fluid accumulates in the macula at any stage of diabetic retinopathy. Treated with anti-VEGF injections. | Blurred central vision, difficulty reading |
Annual diabetic eye examination
Every person with diabetes (Type 1 or Type 2) should have a dilated eye examination at least once a year — even if your vision seems perfectly fine. Diabetic retinopathy often has no symptoms in its early stages, and by the time you notice vision changes, significant damage may have already occurred.
- Dilated eye examination — drops widen the pupils so the retina can be examined thoroughly
- OCT imaging — non-invasive scan to detect macular swelling or structural changes
- Retinal photography — high-resolution images for comparison at future visits
- Visual acuity assessment — checking your current level of vision
- Coordinated care — findings shared with your GP or endocrinologist
OHIP coverage: Annual diabetic eye examinations are fully covered by OHIP for patients with diabetes. Treatment for diabetic retinopathy (laser, injections) is also covered. Allow 2–3 hours for your appointment, as dilation takes 20–30 minutes to take effect.
What to expect at your appointment
| 1 | Getting referredMost patients are referred by their optometrist or family doctor. Ask for a referral to Uptown Eye Specialists specifying a retina consultation. We also accept referrals from other ophthalmologists for surgical retinal cases. |
| 2 | Your first appointmentIncludes a dilated eye examination, OCT imaging, fundus photography, visual acuity testing, and a detailed discussion of your diagnosis, treatment options, and next steps. Plan for 2–3 hours, as pupil dilation takes time to take effect. Bring sunglasses and arrange transportation — your vision will be blurry for several hours afterward. |
| 3 | Treatment & follow-upIf treatment is needed (injections, laser, or surgery), your specialist will explain the procedure, expected outcomes, and follow-up schedule. Anti-VEGF injections are performed in the clinic. Surgical procedures are performed at U Surgical Centre. |
| 4 | Ongoing monitoringRetinal conditions require regular follow-up — often for life. Your specialist will establish a monitoring schedule with OCT imaging and clinical examinations, adjusting treatment as needed. We coordinate care with your referring optometrist throughout. |
OHIP coverage: Your specialist consultation, dilated eye examination, OCT imaging, anti-VEGF injection procedures, laser photocoagulation, and medically necessary retinal surgery are all covered by OHIP. Some anti-VEGF medications and advanced imaging tests may have associated costs — your specialist will explain before ordering.
Common questions about retinal care
Our retina specialists
Dr. Hannah Chiu
MD, FRCSC
Brampton · Vaughan
Dr. Efrem Mandelcorn
MD, FRCSC
Vaughan
Dr. Mark Mandelcorn
MD, FRCSC
Brampton
Dr. Harrish Nithianandan
MD, FRCSC
Brampton · Etobicoke · Vaughan · Scarborough
Dr. Sohel Somani
MD, FRCSC, DABO
Brampton · Vaughan
Dr. Daniel Weisbrod
MD, FRCSC
Vaughan · Scarborough
Dr. Peng Yan
MD, PhD, FRCSC
Scarborough
Concerned about your retina?
Whether you’ve been diagnosed with a retinal condition, need ongoing injection therapy, or have been told you need retinal surgery, our retina specialists are here to help. Most patients are referred by their optometrist or family doctor — ask for a referral to Uptown Eye Specialists.
We see patients across multiple Ontario locations for your convenience.