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Dealing with Diabetic Retinopathy

Early stage diabetic retinopathy does not require treatment. However, patients should schedule regular checkups with their optometrist to check if the disease is progressing. While stage 2 of diabetic retinopathy may still not require treatment, a comprehensive evaluation must be done.  Dilating the pupils and careful 3D observation, using an instrument called a slit lamp biomicroscope, best performs this.  Advanced Optometrical practices now also have an instrument called an Optical Coherence Tomographer.  It is by far the most sensitive way of dignosing diabetic macula oedema.

If the patient’s diabetic retinopathy has reached an advanced stage, there are a couple of intervention options available for those with copious amount of bleeding from the blood vessels in the eyes.

Photocoagulation

Here are some things to remember regarding this type of laser treatment for diabetic retinopathy:

•    Treatment is on an outpatient basis, though it may require more than one visit to the doctor.
•    Topical anesthesia and eye drops are placed to numb the eye surface and to widen the eye’s pupils, respectively.
•    A clamp, or a special contact lens, will be placed to keep the lids open.
•    Small beams will target the affected portion of the retina. Leaking blood vessels will be sealed during this stage. Abnormalities in the blood vessels located in the retina will also be eliminated.
•    Painkillers or sedatives may be required, especially for those who have had laser treatments before.

Afterwards, the patient would do well to keep the following in mind:

•    Vision may be blurred initially, though it should go back to normal after several hours.
•    A pair of sunglasses must be worn, as the eyes are still adjusting and still sensitive to light.  Related to this, make sure you have someone with you who can drive you from the hospital.
•    The outer part of the retina would be at risk during the procedure, so there is an even chance that you will encounter night vision problems, and a smaller chance of losing a bit of your peripheral vision.

Intravitreal Anti VEGF Injections

Originally designed to treat macular degeneration for those advancing in age, this intervention has also been believed to be effective in helping those suffering from diabetic retinopathy.   Keep in mind though that this intervention is relatively new when it comes to this disease, so its long-term effectiveness has yet to be proven.

Some things to remember for those using this treatment for their diabetic retinopathy are:

•    Eye drops will be given days before the procedure to prevent possible infections.
•    Treatment is on an outpatient basis.
•    Before the actual injection, your eyes and the area surrounding it will be cleaned and sterilized.
•    A clamp will be used to keep the eye open.
•    Anesthesia in the form of eye drops will be placed to numb the eye.
•    The medication will be injected directly into the eye to stop the leakage of affected blood vessels.

It does not end, however, after this procedure. Things to keep in mind include:

•    Eye pressure will be measured, as more treatment may be needed if it remains high.
•    There will be discomfort for a few weeks as the medication moves around the eye.  Improvement will be noticeable after one month.
•    More injections should be done on monthly intervals, until such time that there is no more vision improvement for 3 consecutive months. This means that the diabetic retinopathy has been contained.

At The Eye Practice we regularly perform diabetic evaluations and are able to refer to the best qualified eye surgeons for treatment if required.  Make an appointment by either calling (02) 9290 1899 or CLICK HERE to organise it online. (http://www NULL.theeyepractice NULL.com NULL.au/bookeyeexam)

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

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