Treatment of Diabetic Retinopathy


If you solely suffer from background diabetic retinopathy, then no immediate treatment is needed apart from the regular eye tests. Maculopathy too, for the most part requires no attention, but your optometrist/ophthalmologist may recommend laser eye treatment if the leakages are beginning to threaten your eyesight. This will not improve your vision, but rather deter the condition from progressing into the more serious stages.

Laser Photocoagulation

Laser treatment comes in two main forms. The type of diabetic retinopathy you have determines which laser treatment you will be prescribed. The first type is focal laser treatment, also know as laser photocoagulation. This is done by your eye doctor and can prevent the leakages in the retina. It works by your doctor administering lasers to burn and block the abnormal vessels in your eye. This procedure usually only consists of one session and will just leave your eyes blurry for a day or so afterwards. Small spots from the laser burns may become apparent in your immediate field of vision, but over time these will gradually fade. Conversely, if you suffered from swelling of the macula before treatment was given, there is a possibility that your vision will never properly recover to its previous state.

Before the procedure is carried out, your eye will be anaesthetised, but you may still find the procedure slightly uncomfortable. A small lens is placed over the eye to focus the beam into the retina. There may be bright flashes and the occasional pinching sensation, but for the most part there is usually no discomfort and most people can tolerate the treatment well. This is a one off surgery.  Over the years, laser treatment has been used to significantly reduce the chances of blindness in retinopathy sufferers.

Scatter Laser Surgery for Proliferative Retinopathy

Proliferative retinopathy requires a different form of laser surgery in order to properly treat it. When abnormal blood vessels begin to grow in this stage, lasers are administered to make them regress. The lasers are not focused on the retina directly but all over different parts of the retina. This corrects the parts of the retina that are starved of oxygen and, in turn, prevents abnormal growths from occurring.

This type of laser surgery is called scatter laser surgery. This is also professionally known as pan retinal photocoagulation. This procedure can be completed in a doctors clinic and is simply a method of shrinking any abnormal growths. The procedure will focus on the areas within the retina (but not the macula) and cure the excess growths with scattered laser burns. One to two thousand laser burns will be applied to the eyes. This is usually done over two or more sessions and you may encounter blurred vision for about a day afterwards. After you have received the treatment, you may acquire some loss of peripheral vision and find it more difficult to see at night. It could also potentially affect your colour vision, however, it is very beneficial in preventing diabetic retinopathy development and could save your eyesight. This type of laser treatment usually works better before the new blood vessels begin to leak or bleed. This emphasises the importance of a regular dilated eye exam. A scatter laser treatment may still be possible after leakages, depending on the severity.

Vitrectomy Eye Surgery

In some rare and extreme cases, eye surgery may be necessary. This will be an option if, firstly, a vitreous haemorrhage occurs. This is when the blood from the abnormal abscesses bleed into the vitreous gel in the centre of the eye. It is only diagnosed if proliferative retinopathy has been diagnosed at a later stage and if all laser treatment has been tried and proved to be ineffective.

This surgical procedure is called a vitrectomy. It removes any blood and fluids that have leaked into the vitreous and any scars pulling on the retina are removed. Unlike regular laser surgery, it is done under general local anaesthesia in a hospital or eye clinic. Doctors will mike tiny incisions into your eyes and remove any scar or blood filled tissue. They will use delicate instruments and replace anything they remove with a salt solution to help your eye maintain its structure and shape. If the retina needs to be reattached, then a gas bubble may need to be placed into the eye. If this is the case, you may need to remain face down for several days until the gas bubble disappears. It is not uncommon for the patient to spend these days in the hospital after the procedure. Furthermore, an eye patch may be needed for several weeks afterwards and you will need to apply eye drops.

Surgery only slows the progression of diabetic retinopathy and is not a complete cure. Because diabetes is a condition, which lasts a lifetime, then it is impossible to tell whether or not further losses in vision or retinal damage will occur. You must also continue with your eye examinations after you have had the treatments and further treatments may be required again where necessary. Research is currently undergoing by medical specialists into treatments for diabetic retinopathy, including a drug, which could potentially stop the growth of abnormal blood cells.

Blood leakages and abnormal growths in the eye, are by some professionals, being treated by eye injections. These include steroid injections or avastin and may be injected into the eye after proper sterilisation and anaesthetic is applied. Avastin is a specially designed substance used to shrink the abnormal blood cells. It is injected into the peripheral vein and can be used to treat other eye complications, like certain types of cancer. The avastin injections, however, have been attributed to the progression of haemorrhages and infections in the retina. Patients are given antibiotic drops with the treatment to neutralise this. Steroid injections are also known to increase the pressure within the eye, which may increase the risk of cataracts. It is important that if you should be prescribed these injections, you first discuss the risks and benefits of such treatments, to see if it is worth the risk.

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