To prevent progression of
diabetic retinopathy, it is important to
control your levels of blood sugar,
blood pressure, and cholesterol.

Treatment of Diabetic Eye Disease

During the first three stages of diabetic retinopathy, you do not need treatment, unless you have macular edema. To prevent progression of diabetic retinopathy, it is important to control your levels of blood sugar, blood pressure, and cholesterol.

How is Macular Edema treated?

Macular edema is treated with focal laser treatment. Your retina-vitreous specialist places up to several hundred small laser burns in the areas of retinal leakage surrounding the macula. These burns slow the leakage of fluid and reduce the amount of fluid in the retina. This treatment is usually completed in one session, although you may require this laser surgery more than once to adequately control the leaking fluid. If you require focal laser treatment in both eyes, your retina specialist typically will treat one eye at a time, several weeks apart.

Focal laser treatment stabilizes vision. In fact, focal laser treatment reduces the risk of vision loss by 50 percent. In a small number of cases, if a patient has lost vision, it can be improved by this procedure.

How is Proliferative Retinopathy treated?

Scatter Laser Treatment: Scatter Laser Treatment helps to shrink the abnormal blood vessels. Your retina surgeon places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because the treatment requires a large number of laser burns, your physician will often complete your treatment in two or more sessions. Although you may notice some loss of your side (peripheral) vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may also slightly reduce your color vision and night vision. Scatter Laser Treatment works better before the fragile new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. But even if bleeding has started, this type of treatment may still be possible, depending on the amount of bleeding.

Vitrectomy: Proliferative diabetic retinopathy can cause the fragile new vessels to bleed into the vitreous—the clear, gel-like substance that fills the center of the eye. A very large bleed can block out all or most of your vision, in which case your doctor may perform a vitrectomy. During this microsurgical procedure, which is performed in the operating room, the doctor removes the blood-filled vitreous and replaces it with a clear salt solution. Because the vitreous gel is mostly water, you will notice no change between the salt solution and the original vitreous gel. If you need a vitrectomy in both eyes, your doctor will usually perform them several weeks apart.

Photo Credit: National Eye Institute, National Institutes of Health

I need laser treatment. What can I expect?

Both focal and scatter laser treatment are performed in your retina ophthalmologist's office or eye clinic. Before the surgery, your doctor will dilate your pupil and apply drops to numb the eye. The retina specialist may also numb the area behind your eye to prevent discomfort. The lights in the office will be dim. As you sit facing the laser machine, your doctor will hold a special lens to your eye. During the procedure, you may see flashes of light. These flashes eventually may create a stinging sensation that can be uncomfortable. Because your pupil will remain dilated for a few hours and your vision will probably be a bit blurry for the rest of the day, you will need someone to drive you home after surgery and you should bring a pair of sunglasses.

I need a vitrectomy. What can I expect?

Your retina surgeon will perform your vitrectomy in an operating room while you are under either local or general anesthesia. The retina surgeon makes a tiny incision in your eye and uses a small instrument to remove the vitreous gel that is clouded with blood. The doctor will then replace the vitreous gel with a salt solution. You will probably be able to return home after the vitrectomy, although some people stay in the hospital overnight. You can expect that your eye will be red and sensitive, and you will need to wear an eye patch for a few days or weeks to protect your eye. Your doctor will also give you medicated eyedrops to protect against infection.