Dr Zack Oakey, MD

Dr Zack Oakey, MD Dedicated to advanced surgical and medical treatments and public education.

Board-certified retina specialist and ocular oncologist specializing in retinal diseases, macular degeneration, diabetic retinopathy, retinal detachments, and ocular tumors.

A macular hole is a small break or opening in the macula, which is the central part of the retina responsible for sharp,...
04/24/2026

A macular hole is a small break or opening in the macula, which is the central part of the retina responsible for sharp, detailed vision. These holes typically form due to age-related changes in the vitreous, the gel-like substance that fills the eye. As we age, the vitreous shrinks and pulls away from the retinal surface. If the vitreous is firmly attached to the macula, this pulling (traction) can cause a physical tear or hole to develop, leading to blurred or distorted central vision.

Treatment for a macular hole usually involves a surgical procedure called a vitrectomy. During this surgery, the ophthalmologist removes the vitreous gel to relieve the traction on the retina and may peel back the innermost layer of the retinal tissue to help the hole close. A gas bubble is then injected into the eye to act as an internal bandage, pressing the edges of the macular hole together to facilitate healing. Following surgery, patients often must maintain a face-down position for several days to ensure the bubble remains in the correct position against the macula.

04/23/2026

Can we prevent retinal detachment?

04/22/2026

How much myopia is really important for the risk of retinal detachment?

04/21/2026

Can we cure diabetic retinopathy?

Proliferative diabetic retinopathy (PDR) is the advanced stage of diabetic eye disease, primarily driven by a state of c...
04/20/2026

Proliferative diabetic retinopathy (PDR) is the advanced stage of diabetic eye disease, primarily driven by a state of chronic retinal ischemia. When high blood sugar levels persist over time, they damage the delicate endothelial cells lining the retinal capillaries, leading to microaneurysms and eventual vessel occlusion. As these tiny blood vessels become blocked or “wither away,” large areas of the retina are deprived of essential oxygen and nutrients. This lack of perfusion creates a hypoxic environment, signaling to the eye that it is essentially starving for blood flow.

In a desperate attempt to restore oxygenation, the hypoxic retinal tissue triggers the overproduction of **Vascular Endothelial Growth Factor (VEGF)**. This protein stimulates **neovascularization**, the hallmark of the proliferative stage, where new blood vessels sprout across the surface of the retina and into the vitreous humor. Unlike healthy vessels, these new sprouts are structurally fragile and prone to leakage. Because they grow haphazardly along the scaffold of the vitreous, they often cause vitreous hemorrhages or create fibrous tension that can pull the retina away from the back of the eye, leading to tractional retinal detachment and severe vision loss.

04/20/2026

Some people say retinal detachments happen out of the blue with no explanation. Let cover this.

Watch a retinal detachment resolve!
04/19/2026

Watch a retinal detachment resolve!

04/19/2026

What causes subretinal bleeding? How do we fix it??

04/18/2026

Usher syndrome is a rare genetic disorder primarily characterized by the combined loss of both hearing and vision. It is the leading cause of **deaf-blindness** and is typically categorized into three main types based on the severity and onset of symptoms. Most individuals are born with sensorineural hearing loss, ranging from moderate to profound, and eventually develop **Retinitis Pigmentosa (RP)**. RP causes the layer of light-sensitive tissue in the eyes to deteriorate over time, leading to night blindness and a progressive loss of peripheral vision, often referred to as “tunnel vision.”

Beyond sensory challenges, Usher syndrome can also significantly impact an individual’s sense of **balance**. This occurs because the genetic mutations affecting the hair cells in the inner ear (the cochlea) often simultaneously affect the vestibular system, which regulates equilibrium. As a result, children with Type 1 Usher syndrome often experience significant delays in sitting up or walking. While there is currently no cure, early intervention through cochlear implants, hearing aids, and low-vision rehabilitative services can help individuals manage the condition and maintain a high quality of life.

04/17/2026

Floaters are normal right?

Retinal detachment in the context of diabetic retinopathy is primarily a **tractional retinal detachment (TRD)**, occurr...
04/16/2026

Retinal detachment in the context of diabetic retinopathy is primarily a **tractional retinal detachment (TRD)**, occurring during the advanced stage known as proliferative diabetic retinopathy. As high blood sugar causes chronic oxygen deprivation (ischemia) in the retina, the eye releases growth factors that trigger the formation of fragile, abnormal new blood vessels. These vessels often grow along with fibrous scar tissue into the vitreous gel. Over time, this scar tissue contracts and acts like a tightening “plastic wrap,” physically pulling the sensory retina away from the underlying retinal pigment epithelium. Unlike common rhegmatogenous detachments caused by sudden tears, TRDs often develop slowly and can be asymptomatic until the pulling affects the macula—the center of the vision—leading to severe blurring or a “curtain-like” shadow in the visual field.

Treatment strategies are focused on relieving this physical tension and managing the underlying vascular disease. The gold standard for surgical repair is a **pars plana vitrectomy**, where the surgeon removes the vitreous gel and uses micro-instruments to meticulously peel or “delaminate” the tractional scar tissue from the retinal surface. To prevent future vessel growth, **panretinal photocoagulation (PRP)** laser therapy is often applied to the peripheral retina. In some cases, the eye is filled with a gas bubble or silicone oil to hold the retina in place during healing. To make surgery safer and reduce bleeding, doctors may also use **anti-VEGF injections** (like aflibercept or bevacizumab) a few days before the procedure to shrink the active abnormal blood vessels. While these interventions can successfully reattach the retina, the final visual outcome depends heavily on how long the macula was detached and the overall health of the retinal nerves.

04/16/2026

Let’s talk about complications of eye injections.

Address

114 Pacifica Suite 390
Irvine, CA
92618

Opening Hours

Monday 8am - 5:30pm
Tuesday 8am - 5:30pm
Wednesday 8am - 5:30pm
Thursday 8am - 5:30pm
Friday 8am - 5:30pm

Telephone

+19498680144

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