Diabetic Retinopathy and its Laser Treatment
What is diabetic retinopathy?
Diabetic retinopathy results FROM the effects of diabetes on blood vessels in the retina, the tissue which lines the inner eye. Diabetes causes retinal blood vessels to leak and grow abnormally.
What are the types of Diabetic Retinopathy?
There are two main stages of diabetic retinopathy:
- non-proliferative and proliferative.
- proliferative diabetic retinopathy
In non-proliferative diabetic retinopathy, patients may have normal vision. The damaged retinal vessels leak fluid. Fat and protein particles may leak FROM these vessels and become deposited in the retina in patches known as retinal exudates. The retinal blood vessels may bleed INTO the retina and result in tiny haemorrhages. If any of the leaky fluid accumulates in the central part of the retina (called the macula), the vision is affected. This condition is called macular oedema.
In proliferative diabetic retinopathy, patients grow new abnormal blood vessels which extend over the surface of the retina. These vessels occasionally invade the gelatinous contents of the eye, the vitreous. The proliferating blood vessels frequently break, causing vitreous bleeding that may significantly decrease vision. Fibrous tissue may grow over the new blood vessels and distort vision. Occasionally, the tissue may contract and pull the retina off the inner surface of the eye, causing a tractional retinal detachment.
Who gets diabetic retinopathy?
Both Types I and Type II diabetes patients develop diabetic retinopathy. Diabetic retinopathy is the leading cause of blindness in patients 20 to 74. It is more related to a duration of Diabetes Mellitus.
How do I know if I have diabetic retinopathy?
Patients may develop advanced stages of diabetic retinopathy without being aware that the disease is progressing. Type I diabetics should undergo a screening retinal examination by an ophthalmologist within the five years of the diagnosis of their diabetes. Type II diabetics should undergo this examination when their diabetes is diagnosed. Occasionally, a doctor may choose to perform an additional test called a fluorescein angiogram and OCT to view the retinal status.
Can diabetic retinopathy be treated?
The best treatment is prevention. Strict control of blood sugar levels slows the development and progression of diabetic retinopathy. Argon Green Laser and Intravitreal Injection of AntiVEGF agents are the main tools of treatment.
Who treats patients with diabetic retinopathy?
Ophthalmologists examine and treat patients with diabetic retinopathy.
How is this detected?
An eye examination yearly will detect diabetic retinopathy at an early stage. Special photographs may be necessary to help the doctor decide your plan of care.
What happens to the eye?
Blood vessels may leak in the centre of the retina; this can cause eyesight to become blurred as the retina becomes waterlogged. If blood vessels become blocked, new unhealthy ones may form and bleed into the eye cavity.
Argon Laser Treatment for Diabetic Retinopathy
What is Argon Laser Treatment?
The aim of the laser treatment is to stabilise the changes caused by your diabetes. Leakage in the central area may also be treated with intravitreal injections in some cases.
What should I bring with me?
Any eye drops as well as your glasses.
How long can I expect to stay in the centre?
We aim for your visit to be no more than 2-3 hours.
What happens before the laser treatment is done?
Nursing staff will put an eye drop into your eye to enlarge the pupil in one or both eyes. This may blur your near vision. You are advised not to drive following this treatment or go home unaccompanied. Once you have agreed on the treatment you will be asked to sign a consent form giving your permission to the laser treatment. You may be asked to attend for a laser treatment course. You may eat or drink as normal and take your insulin dose or diabetic medication.
What happens during laser treatment?
It is similar to being examined in the outpatients’ clinic. You will sit at the laser machine with your chin resting down on rest and your forehead pressed forward against a band. A numbing drop is put into your eye which may sting slightly and a special contact lens is placed onto the eye to be treated. The contact lens is used to stabilize the eye and deliver the laser beam. The laser involves focusing an intense beam onto your retina in small spots. You will hear some clicks and notice some flashing during the laser treatment.
How long does the treatment take?
The treatment usually takes 10-20 minutes depending on the type of laser treatment given.
Does this treatment hurt?
Sometimes there can be some discomfort when certain areas of the retina are treated. If you have had a lot of treatment it is possible that your eyes may ache. Please take a painkiller such as paracetamol if you experience discomfort/ache/pain.
Are there any side effects?
Depending on the type of laser treatment given, you may experience the following symptoms:
- The temporary decrease in your vision
- Tiny dark spots in your vision (laser burns)
- Constriction of peripheral vision
- Reduced night vision
- Pain during laser
- Corneal abrasion
What should I expect following laser treatment?
Your sight will normally return to its previous level over the next few hours. Rarely your sight can take longer to return to normal.
Please note: This type of treatment is done to prevent loss of vision; however, it will not improve vision. Laser treatment may permanently affect the eligibility to drive.