Diabetes and Retina Surgery
DIABETES AND RETINAL SURGERY
Diabetic retinopathy is the damage caused by diabetes which affects the light-sensitive retina located at the back of the eye. As diabetes continues, severe high level of blood sugar results in changes which caused damage to the tiny blood vessels in the retina, this result in leakage of fluid or hemorrhage (bleed). This ultimately leads to visual problems that cannot be corrected by making use of eyeglasses or contact lenses.
The occurrence of diabetic retinopathy is linked with the proliferation of a protein known as a vascular endothelial growth factor (VEGF) in the retina. VEGF is responsible for the production of new blood vessels in the retina to bring more oxygen to the tissues, as the retinal blood circulation is insufficient because of diabetes.
Unfortunately, these tiny blood vessels that form in the retina in response to VEGF are fragile and increase the number, resulting in additional leakage of the fluid, bleeding and scarring in the retina, and progressive loss of vision.
Leakage of blood vessels due to diabetic retinopathy can cause the buildup of fluid in the macula, the most sensitive part of the retina responsible for the central vision and color vision.
This disease known as diabetic macular edema (DME) is the leading cause of loss of vision associated with diabetic retinopathy and it is the leading cause of new blindness in adults in the United States at the age of 20 to 74 years, according to CDC.
Treatment of diabetic retinopathy
Treatment, which greatly depends on the type of diabetic retinopathy you have and its seriousness, is designed to slow down or stop the progression of the disease.
Early diabetic retinopathy
If you have mild or moderate non-proliferative diabetic retinopathy, treatment may not be necessary immediately. However, your ophthalmologist will closely monitor your eyes to determine when you need treatment.
Work together with your diabetes specialist (endocrinologist), in order to determine if there are ways to improve your diabetes management. When diabetic retinopathy is mild or moderate, good glycemic control can usually slow down the progression.
Advanced Diabetic Retinopathy
In the event that you have proliferative diabetic retinopathy or macular edema, you will need swift surgical treatment. Depending on the specific problems of your retina, below are some available options:
It is a laser treatment which can also be referred to as focal laser treatment; it can stop or slow down the leakage of blood and fluid in the eyes. During the procedure, leaks from abnormal blood vessels are treated with laser burns.
Focused laser treatment is usually performed in one session in your doctor’s office or in an ophthalmic clinic. In the event that you are suffering from a blurred vision which occurs from macular edema prior to your surgery, it might be difficult for the treatment to restore your vision back to normalcy; however, the treatment can reduce the chance of your macular edema getting worse.
- Panretinal photocoagulation
This is a laser treatment which can also be referred to as scatter laser treatment; it can shrink the abnormal blood vessels. During the process, part of the retina that is distant from the macula is treated with scattered laser burns. The burns make the abnormal new blood vessels to shrink and scar.
This process is usually carried out in a doctor’s office or in the ophthalmic clinic and it involves two or more sessions. Following the procedure, you can experience blurred vision. In addition, there is a higher chance of some loss of peripheral vision or night vision after the procedure.
During a vitrectomy, a tiny incision is made in your eye; this is done to remove blood from the middle of the eye (vitreous) as well as scar tissue that is tugging on the retina. Vitrectomy can be carried out in a surgical center or in a hospital and it is done under local or general anesthesia.
4. Inject the medicine into the eye
Sometimes, your doctor may suggest that you inject the medicine into the vitreous in the eye. These drugs, referred to as vascular endothelial growth factor (VEGF) inhibitors, have been found to be helpful in putting an end to the growth of new blood vessels this is done by blocking the effects of growth signals sent by the body to generate new blood vessels.
Your doctor may recommend these medicines, also known as anti-VEGF therapy, either alone or in combination with panretinal photocoagulation. Although studies on anti-VEGF therapy in the treatment of diabetic retinopathy are promising, however, there is no evidence to standardize this approach.
The development of diabetic retinopathy is often delayed by surgery; however, it is important to note that surgery is not a cure. Due to the fact that diabetes is a chronic illness, damages to the retinal and loss of vision in the future are still possible.
Recovery from diabetic retinopathy treatment
The treatment of diabetic retinopathy is always an outpatient procedure and it usually takes only a few minutes, after which you can go home. There is a need to make arrangement for someone either a friend or close relative to drive you home this is because your vision will be blurred after the procedure. In addition to this, you will need to put on sunglasses for a certain amount of time after your appointment because your eyes will be dilated and sensitive to light.
Diabetic retinopathy costs and medical tourism
Going overseas for the treatment of diabetic retinopathy is becoming one of the most popular ophthalmic surgeries for international medical tourists. In the event that you have decided to treat your diabetic retinopathy abroad, it is important to make detailed inquiries about the cost of the treatment. This is due to the fact that the cost varies depending on your preferred destination and the approach that will be used. The prices of diabetic retinopathy can be between $ 1,000 and $ 3,000 per eye. Treatments are somewhat more expensive than some other eye defects such as short-sightedness or farsightedness. Although insurance may not cover diabetic retinopathy but there are a number of funding options that make long-term treatment of diabetic retinopathy affordable.