Diabetic eye disease is a comprehensive term used to describe a group of eye problems that people with diabetes may face as a complication of their illness. All of these diseases have the potential to cause severe vision loss or even blindness. Therefore, diabetes eye treatment is of the utmost importance.
How is diabetes linked to eye disease?
The eye disease Diabetic Retinopathy is characterised by abnormal retinal blood vessels. Normally, the blood vessels in the retina do not leak, but with diabetes, it can develop tiny leaks, causing fluid or blood to seep into the retina. The retina then becomes wet and swollen, affecting the vision. The form of diabetic retinopathy caused by leakage of the retinal blood vessels is called Non-proliferative (or background) diabetic retinopathy, or macular swelling.
Another problem with the retinal blood vessels in the case of diabetes is that it can close. The retinal tissue, which depends on those vessels for nutrition, will no longer function properly. The areas of the retina in which the blood vessels have closed then foster the growth of abnormal new blood vessels, called Neovascularization, which can cause blindness by bleeding into the vitreous cavity. It can also cause the development of scar tissue, which can pull the retina loose (this is called a traction retinal detachment). Either of these serious problems (vitreous bleeding or traction retinal detachment) can result in severe loss of vision or even blindness. The form of diabetic retinopathy caused by closure of the blood vessels leading to the development of neovascularization (proliferates) is called Proliferative diabetic retinopathy.
Laser eye treatment
Laser eye treatment can be very helpful for the treatment of diabetic retinopathy. In Non-proliferative diabetic retinopathy, the laser heat either seals the leaking blood vessels of the macula or reduces their leakage and allows the macula to dry. In Non-proliferative diabetic retinopathy, the laser either seals the leaking blood vessels of the macula or reduces their leakage and allows the macula to dry. In Proliferative diabetic retinopathy, the laser destroys the diseased portion of the retina to stop the growth of neovascularization (abnormal new blood vessels).
Essentially, the major purpose of laser eye treatment is to prevent further visual loss. However, laser eye treatment may not always be the best option or even viable. The decision to use laser depends mostly on the type of diabetic eye disease, its severity, and a judgment regarding how well it may respond to laser eye treatment.
Because diabetes is a condition for which there is currently no cure, the disease may continue to damage the retina. Even with laser eye surgery patients may continue to lose vision. But when laser is effective, the chances are that it can prevent further visual loss.
Avastin and Lucentis injection may be beneficial to some patients suffering from macular edema related to their diabetes.
Before laser treatment can be performed a special test called Fluorescein Angiography will be done. During this investigation fluorescein dye is injected into a vein in the patient’s arm. The dye travels throughout the body, including the eyes. With a special camera and flash a series of photographs of the retina is taken as the dye passes through it. The photographs will show what types of changes have occurred in the retina. It will also provide a type of map, which Dr. Krüger will use as a guide to determine the exact location and amount of laser eye treatment necessary.
Diabetic Vitrectomy Surgery
The body will usually absorb blood from a vitreous haemorrhage, but that can take days, months or even years. If the vitreous haemorrhage does not clear within a reasonable time, or if a retinal detachment is detected, a vitrectomy procedure can be performed. During the procedure, the retina may be treated with laser to reduce future bleeding or to fix a tear in the retina. A gas bubble may be placed in the eye, to help the retina remain in its proper position. This gas bubble will eventually dissolve on its own and be replaced by the body’s own fluids.
Laser or vitrectomy can sometimes be used in conjunction with anti-vegf injections (Avastin or Lucentis). Diagnostic digital fluorescein angiography and Optical coherence tomography (OCT), performed at our clinic, assists us in the diagnosis.
It is important for all people with diabetes to have a thorough retinal examination every twelve months, even when there are no problems.
Also, be sure to talk to your own medical doctor about the importance of diet and exercise and the dangers of smoking and high blood pressure. And, most of all learn to maintain the best possible control of your blood sugar. The complications of diabetes, especially diabetic retinopathy, can be reduced by long-term, strict control of blood sugar.
Dr. Johann Krüger will always be available to answer your questions and to help in every way possible. You are encouraged to call with any unusual symptom or worry. Please do not hesitate to contact us if you have any further queries with regard to diabetic eye disease and the treatment thereof.