Retina Procedures

What is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes that is caused by changes in the blood vessels of the eye. The retina is a nerve layer at the back of the eye that senses light and helps to send images to your brain.

When blood vessels in the retina are damaged, they may leak fluid or blood, and grow fragile, brush-like branches and scar tissue. This can blur or distort the images that the retina sends to the brain.

Diabetic retinopathy is the leading cause of new blindness among adults in the United States. People with untreated diabetes are said to be 25 times more at risk for blindness than the general population.

The longer a person has diabetes, the more the risk of developing diabetic retinopathy increases. About 80% of the people who have had diabetes for at least 15 years have some blood vessel damage to their retina. People with Type I, or juvenile diabetes are more likely to develop diabetic retinopathy at a younger age.

If you have diabetes, it's important to know that today, with improved methods of diagnosis and treatment, only a small percentage of people who develop retinopathy have serious vision problems.

What are the symptoms of diabetic retinopathy?

There are usually no symptoms of background diabetic retinopathy, although gradual blurring of vision may occur if macular edema is present. You may never notice changes in your vision. A medical examination is the only way to find changes inside your eye.

When bleeding occurs, your sight may become hazy, spotty or even disappear altogether. While there is no pain, proliferative retinopathy is a severe form of the disease and requires immediate medical attention. Pregnancy and high blood pressure may aggravate diabetic retinopathy.

How is Diabetic Retinopathy Diagnosed?

The best protection against diabetic retinopathy is to have regular medical eye examinations by your ophthalmologist. Serious retinopathy can be present without any symptoms. The disease can improve with treatment.

To find diabetic retinopathy, the ophthalmologist looks at the inside of the eye using an instrument called an ophthalmoscope. The pupils may need to be dilated (enlarged) with eye drops.

If your ophthalmologist finds diabetic retinopathy, he or she may order color photographs of the retina or a special test called fluorescein angiography to find out if you need treatment. Fluorescein angiography is a test where dye is injected in your arm and special photos of your eye are taken.

How is Diabetic Retinopathy Treated?

We will consider:

• Your age
• Your medical history
• Your lifestyle
• How much your retina is damaged

In many cases treatment is not necessary, but you will need to continue having regular eye exams. In other cases, treatment is recommended to stop the damage of diabetic retinopathy and improve sight whenever possible.

Laser Surgery

This procedure is often helpful in treating diabetic retinopathy. A powerful beam of laser light is focused on the damaged retina. Small bursts of the laser's beam seal leaking retinal vessels to reduce macular edema. This is called photocoagulation.

For abnormal blood vessel growth (neovascularization), the laser beam bursts are scattered throughout the side areas of the retina. The small laser scars reduce the abnormal blood vessel growth and help bond the retina to the back of the eye, preventing retinal detachment.

Laser surgery may be performed in your ophthalmologist's office or an outpatient clinic. If diabetic retinopathy is detected early, laser surgery slows down vision loss. Even in the more advanced stages of the disease (proliferative retinopathy, it reduces the chance of severe visual impairment.

Cryotherapy

If the vitreous is clouded by blood, laser surgery cannot be used until the blood settles or clears. In some cases of bleeding into the vitreous, cryotherapy, or freezing, of the retina may help shrink the abnormal blood vessels.

Vitrectomy

In advanced proliferative diabetic retinopathy, the ophthalmologist may recommend a vitrectomy. This microsurgical procedure is performed in the operating room. Vitrectomy removes the blood-filled vitreous and replaces it with a clear solution.

About 70% of vitrectomy patients notice an improvement in sight after surgery. Sometimes the ophthalmologist may wait from several months up to a year to see if the blood clears on its own, before going ahead with a vitrectomy.

Retinal Repair

If scar tissue detaches the retina from the back of the eye, severe sight loss or blindness can result unless surgery is performed to reattach the retina.

If you have questions or would like further information, please contact us.