Diabetic Retinopathy: Treatment
How is diabetic retinopathy treated?
Recently, scientists have found that laser treatment can prevent visual loss in many people with diabetic macular edema. In this treatment, called photocoagulation, powerful beams of light from a laser are aimed at leaking retinal blood vessels in the macula. The goal of treatment is to seal the vessels and prevent further leakage. In many patients, this treatment halts the decline in vision or even reverses it.
Research also has shown that laser photocoagulation can dramatically reduce the risk of blindness in people who have proliferative retinopathy. For these patients, the laser is used in a different way: It is not directed at the macula but is aimed at hundreds of spots in other parts of the retina. The purpose of the treatment is to destroy diseased tissue and stop the retinopathy from getting worse. In fact, the treatment can reduce the risk of severe visual loss by 60 percent.
The studies which proved the value of laser treatment for people with diabetic retinopathy were supported by the National Eye Institute. It is part of the National Institutes of Health, a component of the U.S. Department of Health and Human Services.
These studies also have helped ophthalmologists determine which diabetic patients need laser treatment and when to begin it.
Who should have laser treatment?
An ophthalmologist (a medical doctor who specializes in the care of eye conditions) usually will consider laser treatment when a person with diabetes has proliferative retinopathy or retinal signs that suggest this condition may soon develop. Also, people with a significant degree of macular edema would now be considered for laser treatment.
When deciding whether to recommend laser treatment to a particular patient, the ophthalmologist weighs the potential benefits - preventing or delaying severe visual loss - against the risk of unwanted side effects. These may include some loss of central or side vision.
Unfortunately, laser treatment cannot restore sight to the person who has already suffered severe retinal damage from diabetic retinopathy. Also, the laser generally is not used when bleeding inside the eye has made it difficult or impossible for the ophthalmologist to see the areas that need treatment.
What is vitrectomy?
A few diabetic retinopathy patients - including some who have had photocoagulation - go blind from massive bleeding inside the eye. Now, ophthalmologists can remove the blood and scar tissue from the center of the eye. This procedure is known as vitrectomy. Following vitrectomy, patients can often see well enough to move around on their own. Occasionally, vision in the operated eye recovers enough for the patient to resume reading or driving.
What help is available to the person who has 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, your eye care specialist can generally prescribe them. Often, he or she will be able to suggest further sources you might contact to get information about counseling, training, and other special services for people with low vision. These may include a nearby school of medicine or optometry.
This information was prepared by the National Eye Institute, NIH, Building 31, Room 6A32, Bethesda, MD 20892. The telephone number is: (301) 496-5248.
NIH Publication No. 89-2171
More Information about Diabetic Retinopathy