Retina

Common conditions of the retina and vitreous that can be improved with surgery include retinal detachment, macular hole, epiretinal membrane or macular pucker, diabetic retinopathy, vitreous hemorrhage, floaters, hemorrhage from macular degeneration, and complications from cataract surgery.

If you or someone in your family suffers from vitreo-retinal diseases of the eye, the doctors at North Suburban Eye Specialists can provide the care needed to appropriately treat this condition.

Diabetic retinopathy

Diabetes can affect the eye in many ways, including causing cataracts, glaucoma, retinopathy, and edema (swelling). Patients with either type I or type II diabetes should have an eye exam at least once a year or as recommended by their doctor who helps treat their diabetes. Patients with diabetes who are pregnant should have an eye exam once a trimester or as directed by their OB/GYN doctor.

Diabetes that has been present for 15 years and patients with poorly controlled diabetes are at highest risk for vision loss due to diabetes. Ask your doctor about your hemoglobin A1c (Hgb A1c). Retinal specialists recommend an Hgb A1c less than 7.0 to help prevent vision loss. Blood pressure and blood cholesterol control are also important in preventing vision loss from diabetes.

Types of diabetic retinopathy

Diabetic retinopathy is classified by either non-proliferative background diabetic retinopathy or proliferative retinopathy. Both types of retinopathy can have diabetic macular edema, which affects the central vision. Without macular edema, a patient may not notice their retinopathy. However, retinopathy is serious and can lead to vision loss and blindness.

Non-proliferative background retinopathy

Non-proliferative background retinopathy is classified into mild, moderate and severe. As background retinopathy gets worse, your ophthalmologist will stress the importance of good blood sugar, blood pressure and cholesterol control. Improving your Hgb A1c, blood pressure and cholesterol can reverse the changes from non-proliferative diabetic retinopathy, thus, diet, exercise and taking the medications recommended by your doctor can prevent worsening of your diabetes as is relates to your eye.

Proliferative retinopathy

In proliferative retinopathy, new, abnormal blood vessels grow. The abnormal blood vessel growth is referred to as neovascularization. These new blood vessels can leak and cause swelling or edema, or they can break and bleed inside the eye. When bleeding occurs, it causes blurred vision or blindness. Patients may notice bleeding as a shower of new floaters. If this occurs, contact your eye doctor to seek advice. The new, abnormal blood vessels may cause scar tissue, which can lead to retinal detachment. A retinal detachment is a serious condition that often leads to permanent, vision loss or blindness.

Symptoms of diabetic retinopathy

The symptoms of background diabetic retinopathy usually go unnoticed. This is why it is so important to have an eye exam at least once a year or as directed by your doctor. Often, when there are symptoms related to diabetic retinopathy, there is significant damage that may lead to permanent vision loss.

How diabetic retinopathy is diagnosed

Diabetic retinopathy can only be diagnosed by a skilled eye doctor. Frequent eye exams are extremely important in monitoring any diabetic changes in the eyes. If diabetic retinopathy is found on an eye exam, your doctor may order further testing to assist with determining if treatment is needed. These tests can be performed in the office the same day as your visit.

Treatment of diabetic retinopathy

Diabetic macular edema is currently treated with a combination of laser surgery and injections of medications into the eye. Injections in the eye often help in the short term and laser often helps in the long term. Thus, your doctor may recommend one or both treatments for your macular edema.

Proliferative diabetic retinopathy is often treated with laser surgery. The laser surgery takes 15-20 minutes and is done in the office. The eye is numbed prior to starting the laser and you may go home with a patch over the eye that is removed in the evening. Laser surgery helps to reverse the changes, but this takes months. Laser surgery will not immediately restore vision that is lost and it will not remove the blood that is in the eye from the abnormal blood vessels. Often laser surgery can cause the abnormal blood vessels to shrink, which prevents the need for surgery. Your doctor may recommend laser surgery without you having symptoms. This is to prevent vision loss and the need for future surgeries.

When diabetes continues to get worse in the face of laser and injections, vitrectomy surgery is often performed. This procedure involves removing the vitreous, and often blood, thereby removing visual obstructions within the eye.

Responsibility of diabetes patients

Patients should have regular medical and eye exams. It is important to work with your doctor to maintain good blood sugar, blood pressure, and cholesterol.