Diabetes is a malady involving metabolism, which is way more menacing than one may estimate. It, thus, would not be wrong to state that diabetes does belong to the category of destructive diseases. This silent killer not only targets the heart, kidneys, legs and skin, but also the eyes.
In fact, diabetes happens to be the leading cause that results in progressive loss of vision and complete blindness in both, young and old people. The inner most layer of the eye, known as retina is impacted by inadequate control over blood glucose level. Diabetes can thus damage the tiny blood channels in the eye resulting in its weakening and complete destruction.
Diabetic retinopathy has four distinct stages, beginning with mild non proliferative retinopathy, moderate non proliferative retinopathy, which advances to severe and finally, reaches the advanced stage of prolifertaive retinopathy. Although there does not exist any absolute cure for diabetes blindness, there are a few treatment options to avail.
4 Treatment Options for Diabetic Blindness
The type of treatment suggested depends mainly on the type of diabteic retinopathy the patient has.
Scatter Laser Treatment
Proliferative retinopathy can be treated using a surgical approach that makes use of laser. Such a procedure is known as Scatter laser treatment or Pan retinal photocoagulation. The aim of this retinal laser eye surgery is to shrivel up the abnormal blood carrying vessels. To treat diabetic blindness, approximately 1000-2000 laser burns are precisely and carefully targeted in retinal areas away from the macula. This laser application results in shrinkage of the blood vessels. As more number of laser spots is needed, two to four sessions are usually required so as to successfully wrap up the eye treatment.
What must be noted is that pan-retinal photocoagulation does not typically restore the vision already lost, but aids in halting further worsening of vision, even blindness. This particular surgical treatment renders better results before the delicate blood vessels begin to bleed. If in case the amount of bleeding is not alarming, Scatter laser treatment can still be performed. However, in cases where the bleeding is severe, the patient may require another type of surgical intervention, called a Vitrectomy.
Some of the undesirable changes patients report, post the procedure include loss of peripheral vision, diminution of night vision as well as an imperfect colour perception.
If the diabetic patient has a lot of blood accumulated in the central area of the eye (Vitreous gel), he or she may need to undergo a procedure called Vitrectomy for restoration of eyesight. The purpose is to clear the blood as well as pull out the scar tissue to prevent progressive blindness. As a result of this, the chances of further hemorrhage caused by abnormal blood vessel are nullified. If both the eyes need the procedure, Vitrectomy is performed in the other eye after an interval of several weeks.
This eye procedure is carried out under local or general anesthesia, due to involvement of a tiny incision that needs to be made in the eye. Using a small, sterile instrument, the blood stained vitreous gel is extirpated. To maintain the normal shape of the eye, the gel removed is immediately substituted with an infusion of saline.
As the surgery reaches completion, a temporary protective patch is placed over the eye. Some of the uncommon risks involved in Vitrectomy are as follows- Retinal detachment, profuse bleeding in the eye being operated on, cataract or an abnormally high intraocular pressure. Once the eye heals thoroughly, around 80% of all patients begin to see more clearly as the removal of blood plus scar tissue re enables the retina to collect and transfer light to areas of the brain.
In the few unfortunate or severe cases wherein retinal laser treatment does not bring about much improvement or fails completely, steroid therapy can be tried. In this therapy, cortisone is injected into the affected eye or eyes, under the effect of local anesthesia. However, this mode of treatment comes with a lot of potential side effects which are serious in nature. One such side effect of steroid administration is an increased pressure buildup in the eye, which can eventually lead to Glaucoma, if left untreated.
Focal Laser Treatment
If in diabetics, fluid leaks into the central portion of the macula (which happens to be the center where sharp image formation occurs), it can lead to the following changes. The fluid accumulation leads to swelling of macula and consequent blurring of vision. This condition of macular edema can be treated using the procedure called Focal laser treatment, also called photocoagulation.
This laser treatment is administered in the eye clinic using topical anesthesia. A special type of contact lens is placed atop the patient’s eye and hundreds of small laser beams are directed in the region surrounding the macula. This is a short, single sitting process in which the patient only sees flashes of light, but no pain.