| Treatment
of Diabetic Retinopathy
Diabetic Retinopathy is a
complication of diabetes that is caused by changes in the
blood vessels of the eye. It can cause permanent loss of
eyesight and is one of the leading causes of blindness in
the United States. But if a person with diabetes receives
proper eye care regularly, and treatment when necessary,
diabetic retinopathy will rarely cause total blindness.
Ophthalmologists at The Eye Clinic have extensive experience
in the diagnosis and treatment of diabetic retinopathy.
There are two types of
diabetic retinopathy, and the appropriate treatment depends
upon which type a person has.
Background Diabetic
Retinopathy
Background or nonproliferative retinopathy occurs when tiny
blood vessels within the retina become damaged and leak
blood or fluid. Approximately half of the people who have
diabetes for 10 years or more will develop this condition.
While this stage does not usually affect vision, it can lead
to more sight-threatening stages. There are usually no
symptoms of background retinopathy, although gradual
blurring of vision may occur if macular edema (the
accumulation of leaking fluid in the macula) is present. A
medical examination by a qualified ophthalmologist is the
only way to find changes inside your eye. In many cases of
background retinopathy, treatment is not necessary, but
continued monitoring is required through regular dilated eye
exams.
Proliferative Diabetic
Retinopathy
Proliferative retinopathy describes the changes that occur
when new, abnormal blood vessels begin growing on the
surface of the retina. This occurs in diabetic patients when
the retinal blood vessels become obstructed and new blood
vessels begin growing on the surface of the retina. These
new vessels are weak and often break and bleed, leaking
blood into the clear, jelly-like vitreous portion of the
eye. This blocks light from entering the eye, causing
blurred and distorted vision. If left untreated,
proliferative retinopathy can cause extensive scar tissue to
grow along these vessels which can distort and detach the
retina, leading to severe vision loss. While not painful,
proliferative retinopathy requires immediate medical
attention.
Ophthalmologists diagnose and
determine the required treatment for diabetic retinopathy by
looking at the inside of the dilated eye with an
ophthalmoscope. If signs of the disease are detected, a
specialized test called a Fluorescein Angiography may be
required to determine if the disease requires treatment. At
The Eye Clinic, our physicians are skilled in providing
several advanced treatment options for diabetic retinopathy:
Laser Surgery
Laser surgery is a very effective technique for treating
diabetic retinopathy. The laser used is a high energy beam
that turns to heat when it is focused on the parts of the
retina to be treated. Small bursts of the laser's beam
seal leaking retinal vessels, creating photocoagulation.
At The Eye Clinic, our physicians are specially trained to
use this laser procedure, which is performed in our office
and usually takes approximately 20 to 30 minutes. The
major purpose of laser surgery is to prevent further
visual loss. It may not be necessary in every case, and
may not be possible in others because of the degree or
severity of the disease. The decision to use laser
treatment depends on the type of diabetic retinopathy, its
severity and a qualified physician's judgment regarding
how well your case will respond to the treatment.
Cryotherapy
If the vitreous is clouded by blood, laser surgery cannot
be used until the blood settles or clears. In some cases,
cryotherapy, or freezing, of the retina may help shrink
the abnormal blood vessels. This procedure is performed in
our office.
Vitrectomy
In advanced proliferative retinopathy, when a large amount
of vitreous hemorrhage prevents laser surgery, a
vitrectomy can be performed. This microsurgical procedure
is performed in a hospital under general anesthesia. An
ophthalmic surgeon removes the blood-filled vitreous gel
and replaces it with a gas bubble or a clear fluid that is
compatible with they eye. Over time, this replacement
material is absorbed by the eye and is replaced by the
eye's own fluid.
Retinal Repair
If scar tissue detaches the retina from the back of the
eye, severe vision loss or blindness can result unless
surgery is performed to remove the scar tissue and
reattach the retina. This is also a microsurgical
procedure and is performed under general anesthesia in a
hospital by an ophthalmic
surgeon.
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