Treatment of Diabetic Retinopathy
Specific treatment is not typically used until the more advanced stages of diabetic retinopathy and your vision is at risk. At all stages controlling your diabetes is vital and plays a large part in mitigating the condition. Managing your diabetes in the early stages can help prevent or reduce the damage to your eyesight and in the later stages can reduce the extent of vision loss.
For advanced diabetic retinopathy that is threatening the patient’s sight treatment includes:
- Laser treatment
- Eye injections
- Eye surgery
Laser treatment
Laser treatment is used to treat the growth of new blood vessels in the back of the eye as they tend to be weak and often bleed into the eye. This treatment will not usually improve the patient’s sight but it can help to stabilize the changes in the eye and stop the patient’s vision getting any worse.
Treatment is done under a local anaesthetic to numb the eyes with eye drops to dilate the pupil and special contact lenses to hold the eye open and focus the laser onto the retina. The procedure usually takes around 20-40 minutes and doesn’t usually require an overnight stay in hospital. You may need to return for subsequent treatment at a laser clinic as required.
Treatment can have some side effects for a few hours such as sensitivity to light, blurred vision and aching or discomfort. These issues should be easy to manage with some self-care at home such as painkillers, wearing sunglasses and resting until you feel better.
There are some risks associated with laser treatment such as:
- Bleeding into the eye
- Floating objects in your field of vision (floaters)
- A small permanent blind spot close to the centre of your vision
- Loss of night or peripheral (side) vision which may stop you driving
- You may be able to see the pattern left by the laser on the back of your eye for a few months.
Eye injections
In some cases eye injections of anti-VEGF directly into your eyes may be used to prevent new blood vessels from forming in the retina. The main medicines used are called ranibizumab (Lucentis) and aflibercept (Eylea) and they can help improve vision or stop the condition getting worse.
The treatment is given under local anaesthetic so the eye is numb and the injection is given through a very fine needle directly into the eye ball. They are usually given once a month to begin with but will be less frequent or stopped once the patient’s vision begins to stabilise. Alternatively if the anti-VEGF medications do not work steroid mediations may be used instead.
There are some risks associated with eye injections including:
- Watery, dry or itchy eyes
- Eye discomfort or irritation
- Bleeding inside the eye
- Floating objects in your field of vision (floaters)
There is also a small risk of the injections causing a blood clot which may lead to a stroke or heart attack. This risk is small but it is important to be aware of it before undergoing treatment.
Eye surgery
Surgery (known as vitreoretinal surgery) may be used to remove some of the transparent jelly-like substance that fills the space behind the lens of the eye (vitreous humour). This operation is known as vitreoretinal surgery and may be necessary if there is a significant amount of blood collected in your eye or if there is a lot of scar tissue which may cause or has already caused retinal detachment.
The surgery is carried out under local anaesthetic and sedation meaning the patient is unconscious during the surgery and does not experience any pain. During the procedure the surgeon makes a small incision and removes some of the vitreous humour and any scar tissue before using a laser to prevent any further loss of vision.
Potential risks of this surgery include:
- Retinal detachment
- Further bleeding in the eye
- Infection in the eye
- Fluid build-up in the cornea
- Developing a cataract
