Comprehensive management and regular monitoring of your diabetes is the first, and perhaps the most important, step in the treatment process. That includes getting your hemoglobin A1c level, blood pressure and lipid levels under the best possible control. Multiple studies have demonstrated that when these indicators are as close to normal as possible, you are less likely to develop diabetic retinopathy—and more likely to slow its progress if it does occur. Diabetes management should include:
- maintaining a healthy diet and exercise regularly
- taking prescribed medication
- controlling high blood pressure
- limiting alcohol intake and avoid smoking
- attending regular diabetes check-ups
- having a comprehensive dilated eye exam every 4 to 6 months
In addition, with early detection of the disease, you can reduce the risk of blindness by 95 percent. For that reason, people with diabetes should have a thorough, dilated eye exam once a year, and even more frequently if diabetic retinopathy has already been diagnosed. Regular eye examinations are especially important for:
- people who have had diabetes 5 years or longer
- people who have difficulty controlling the level of sugar in their blood
- diabetic women who are pregnant
All of these people are at increased risk for diabetes-associated eye problems.
Diabetic Retinopathy Treatment Options
Depending on the stage of the diabetic retinopathy, your ophthalmologist has several treatment options:
- Eye Injections - Anti-VEGF (vascular endothelial growth factor), a first-line treatment in which medicine is injected directly into the eye. The purpose of anti-VEGF agents is to block abnormal blood vessel growth and, in the case of macula edema, reduce swelling. Commonly used anti-VEGF agents by ophthalmologists are ranibizumab (Lucentis®), bevacizumab (Avastin®) and afibercept (Eylea®). The treatment is performed in a doctor’s office is made painless for the patient, by administration of local anesthesia. The process requires repeated injections at intervals determined by your physician depending on the severity of your condition and your response to the medication.
- Laser Surgery- Retinal laser photocoagulation, which uses laser applications to the retina to treat damaged tissue, causes regression of leaking blood vessels that lead to diabetic macula edema and proliferative retinopathy. New York Eye and Ear Infirmary is the only ophthalmic center in the area that offers Computer-Navigated Laser Treatment, providing its surgeons with pinpoint accuracy for targeting areas of the retina that need treatment. This state of the art approach is also faster and more comfortable for patients than standard laser treatment.
- Surgery - Vitrectomy, is a surgical procedure where the surgeon removes the vitreous (the clear, gel-like substance) that fills the central chamber of the eye with the help of tiny instruments that are inserted into the eye. This enables removal of blood that has leaked into the vitreous and clouded vision, or of scar tissue that is pulling on the retina, producing a detachment. Laser treatment is often performed as part of the procedure and the cloudy vitreous is replaced with clear saline fluid. As the eye heals, it produces its own replacement fluid to take the place of the excised vitreous. NYEE’s surgeons have extensive experience performing minimally invasive, small gauge vitrectomies which minimize complications and promote quicker recovery.
What can I do if I already lost vision from diabetic retinopathy?
There are many useful devices that can help a partially sighted person to make the most of his or her remaining vision. Called low vision aids, these devices have special lenses or electronic systems that produce enlarged images of nearby objects. If you need low vision aids, NYEE’s eye care specialists can help you identify the proper device.