909 East San Marnan Drive
Waterloo, Iowa 50702

Tel: 319-233-2020

Fax: 319-234-1939

Meet Dr. Girschek

Dr. Brendan Girschek is a fellowship-trained retina specialist. He is board-certified by the American Board of Ophthalmology and the Royal College of Surgeons of Canada. Dr. Girschek is a fellow of the American Society of Retina Specialists, American Academy of Ophthalmology, the Royal College of Surgeons of Canada, and the American College of Surgeons.


Retinal Vein Occlusion

Retinal Vein Occlusion (RVO) is caused by blockage of a retinal vein. RVO most commonly occur in patients with hypertension, atherosclerosis and diabetes whereby thickening of a retinal artery may pinch or squeeze a retinal vein and lead to profound congestion in the distribution of the blocked retinal vein. Patients with RVO often describe a sudden decrease or distortion of central reading vision. A few patients may remain asymptomatic or describe very mild symptoms and will be observed. Most, however, will require treatment of RVO-related macular edema, the most common cause of vision loss in RVO. The macula is the part of the retina responsible for central reading vision and swelling to the macula often leads to significant visual impairment. Treatment involves the use of anti-VEGF agents or corticosteroids injected into the eye in an attempt to resolve swelling of the macula. In some circumstances, laser surgery may be required. Your retina specialist will also carefully examine your eye for the development of abnormal blood vessels which may cause hemorrhaging, retinal detachment and elevated intraocular pressure. Some patients with RVO will return to their previous level of vision but most do not. It is critical that RVO is diagnosed and treated promptly by a retina specialist to maximize the chances of visual recovery.


Uveitis is the inflammation to one or more of the layers of the eye. Uveitis often presents with redness, light sensitivity and pain to one or both eyes. The disease may also present with a slowly-progressive decrease in vision without pain or discomfort. Most patients experience recurrent attacks of intraocular inflammation after an initial episode and close follow-up with a retina specialist is recommended in order to minimize complications such as cataract, glaucoma and macular edema. Uveitis can affect children and adults regardless of gender or ethnicity. Treatment of uveitis varies depending on the layer of the eye that is involved. Corticosteroids are the mainstay of treatment in uveitis and are commonly used in the form of drops to treat the majority of cases of uveitis. In some circumstances, corticosteroids may be injected beside or within the eye. Your retina specialist will take a detailed focused history and work closely with your primary care physician to determine a possible cause of inflammation. Common causes of uveitis include autoimmune diseases such as arthritis, vasculitis or sarcoidosis. In some instances, uveitis may be caused by an infection by bacteria, virus or parasite. Significant intraocular inflammation may be experienced post-operatively after cataract, glaucoma or retina surgery and is often due to a bacterial infection called endophthalmitis. It is crucial that any patient who recently had eye surgery or intraocular injection experiencing redness, sensitivity to light and/or pain call their eye surgeon immediately. It is likely that you will be referred to a retina specialist who will determine the best course of action. Treatment of endophthalmitis commonly requires the injection of antibiotics and corticosteroids into the eye and may require vitrectomy surgery based upon the severity of inflammation and degree of vision loss. 

Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is due to the abnormal development of retinal blood vessels in a premature infant’s eyes. These fragile blood vessels need to be carefully monitored by a retina specialist in order to determine if the infant’s retinal blood vessels are growing abnormally. Treatment may be required should an infant’s retinal blood vessels demonstrate abnormal maturation. Laser surgery and, in some circumstances, anti-VEGF medications may be required in order to prevent blindness to one or both eyes. Fortunately, the vast majority of premature infants do not require treatment. Nonetheless, frequent dilated eye examinations performed by a retina specialist are often required while the infant is in hospital and shortly after discharge. Infants born prematurely will need to be followed more closely than infants born at term as they are more likely to develop nearsightedness and strabismus (crossed eyes) during childhood.
For more information on Retina Procedures, call us at 319-233-2020.

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