Diabetic Retinopathy Surgery

Diabetic Retinopathy is a serious eye condition that affects individuals with diabetes, caused by damage to the blood vessels in the retina due to high blood sugar levels.These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal new blood vessels grow on the retina. It is one of the leading causes of vision loss, especially if left untreated.

Diabetic retinopathy progresses through several stages, and understanding these can help patients stay vigilant about their eye health. There are two main stages of diabetic eye disease.

  • NPDR (non-proliferative diabetic retinopathy): This is the early stage of diabetic eye disease. Many people with diabetes have it. With NPDR, tiny blood vessels leak, making the retina swell. When the macula swells, it is called macular edema. This is the most common reason why people with diabetes lose their vision. Also with NPDR, blood vessels in the retina can close off. This is called macular ischemia. When that happens, blood cannot reach the macula. Sometimes tiny particles called exudates can form in the retina. These can affect your vision too.
  • PDR (proliferative diabetic retinopathy): PDR is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels. This is called neovascularization. These fragile new vessels often bleed into the vitreous. If they only bleed a little, you might see a few dark floaters. If they bleed a lot, it might block all vision. These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or lead to a detached retina. PDR is very serious, and can steal both your central and peripheral (side) vision and result in sever vision loss.
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What are Systemic Complications of Diabetes?

In addition to diabetic retinopathy, diabetes can affect many other organs in the body, which is why it’s important to undergo regular systemic checkups to monitor for complications such as:

  • Kidney Disease (Diabetic Nephropathy): Diabetes can lead to kidney damage, which can worsen retinopathy.
  • Heart Disease: Cardiovascular issues often accompany diabetic retinopathy, necessitating heart health monitoring.
  • Neuropathy: Nerve damage from diabetes can affect vision as well as overall health.

Maintaining good blood sugar control, alongside routine checkups for other complications, helps manage diabetes effectively and reduces the impact on your eyes.

You can have diabetic retinopathy and not know it. This is because it often has no symptoms in its early stages. As diabetic retinopathy gets worse, you will notice symptoms such as

The symptoms of diabetic retinopathy vary depending on the stage of the disease. Some patients may experience:

  • Blurry vision
  • Floaters
  • Dark spots or areas of vision loss
  • Difficulty seeing at night

If left untreated, diabetic retinopathy can lead to blindness.

Diabetic retinopathy symptoms usually affect both eyes.

Do you have diabetes and need an exam for eyeglasses?

Changes in blood sugar levels can affect your vision. Make sure your blood sugar is under control for at least a week before an eye exam. Eyeglasses prescribed when your blood sugar levels are stable work best!

Drops will be put in your eye to dilate (widen) your pupil. This allows your ophthalmologist to look through a special lens at the inside of your eye.

Your doctor may do fluorescein angiography to see what is happening with your retina. Yellow dye (called fluorescein) is injected into a vein, usually in your arm. The dye travels through your blood vessels. A special camera takes photos of the retina as the dye travels throughout its blood vessels. This shows if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing.

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Optical coherence tomography (OCT) is another way to look closely at the retina. A machine scans the retina and provides detailed images of its thickness. This helps your doctor find and measure swelling of your macula.

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The Importance of Routine Eye Checkups for Diabetics

Even if you do not have symptoms, regular eye checkups are crucial for anyone with diabetes. Diabetic retinopathy can progress silently, meaning damage can occur to your retina without noticeable vision changes. By the time symptoms appear, significant damage may have already occurred.

Key reasons for regular checkups
  • Early Detection: Regular screenings can help detect diabetic retinopathy in its early stages, allowing for timely intervention and treatment to prevent further damage.
  • Preventing Vision Loss: Early treatment can help stop the progression of retinopathy and reduce the risk of vision loss.
  • Monitoring Disease Progression: For patients already diagnosed with retinopathy, periodic checkups are essential to monitor the disease and adjust treatment as necessary.

“ We recommend an annual dilated eye exam for anyone with diabetes, and more frequent checkups for those with existing eye conditions. “

Your treatment is based on what your ophthalmologist sees in your eyes. Treatment options may include:

Medical Control

Controlling your blood sugar and blood pressure can stop vision loss. Carefully follow the diet your nutritionist has recommended. Take the medicine your diabetes doctor prescribed for you. Sometimes, good sugar control can even bring some of your vision back. Controlling your blood pressure keeps your eye’s blood vessels healthy.

Medicine

Controlling your blood sugar and blood pressure can stop vision loss. Carefully follow the diet your nutritionist has recommended. Take the medicine your diabetes doctor prescribed for you. Sometimes, good sugar control can even bring some of your vision back. Controlling your blood pressure keeps your eye’s blood vessels healthy.

Intravitreal Injections

One type of medication is called “anti-VEGF” medication. This helps to reduce swelling of the macula, slowing vision loss and perhaps improving vision. This drug is given by injections (shots) in the eye. Steroid medicine is another option to reduce macular swelling. This is also given as injections in the eye. Your doctor will recommend how many medication injections you will need over time.

Lasers

Lasers might be used to help seal off leaking blood vessels. This can reduce swelling of the retina. Laser surgery can also help shrink blood vessels and prevent them from growing again. Sometimes more than one treatment is needed.

Vitrectomy

If you have advanced PDR, your ophthalmologist may recommend surgery called vitrectomy. Your ophthalmologist removes vitreous gel and blood from leaking vessels in the back of your eye. This allows light rays to focus properly on the retina again. Scar tissue also might be removed from the retina.

Preventing vision loss from diabetic retinopathy: Key factors influencing prognosis:

  • Blood Sugar Control: Keeping your blood sugar levels within a healthy range can greatly slow the progression of diabetic retinopathy.
  • Blood Pressure and Cholesterol: Maintaining optimal levels of blood pressure and cholesterol is also critical for preventing further damage to the retina.
  • Regular Eye Exams: Early detection through routine eye exams can significantly improve the pronosis
  • Get treatment for diabetic retinopathy as soon as possible. This is the best way to prevent vision loss.

Our centre is equipped with the latest diagnostic and treatment technology to provide superior care for diabetic retinopathy patients:

  • Zeiss Cirrus OCT: This advanced imaging device provides detailed cross-sectional images of the retina, helping us detect even the slightest changes in retinal structure.
  • Kowa Angiography: Captures detailed images of the retinal blood vessels, essential for diagnosing vascular conditions related to diabetic retinopathy.
  • Zeiss Humphrey Visual Fields: This machine allows us to assess the visual field for any damage, which is important in advanced diabetic retinopathy cases.
  • Appasawmy Marvel Ultrasound B-Scan: Used for detecting retinal detachments or vitreous hemorrhages when the view of the retina is obscured.
  • Zeiss Visulas 532 Green Laser: This laser is used for precise retinal treatments, including panretinal photocoagulation for proliferative diabetic retinopathy.
  • Anti-VEGF Injections: Medications like Avastin, Lucentis, or Eylea are injected into the eye to reduce the growth of abnormal blood vessels and decrease swelling in the retina.
  • Vitrectomy Surgery: In cases of vitreous hemorrhage or retinal detachment, a vitrectomy may be necessary to remove the blood and repair the retina.

Under the leadership of Dr. Deepankur Mahajan, our experienced retina specialist with over 18 years of expertise, our team is dedicated to providing cutting-edge care for diabetic retinopathy patients. Dr. Mahajan’s extensive training at the Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, ensures that you are in the best hands. Our centre offers state-of-the-art technology for these procedures, ensuring precise, effective treatments to manage diabetic retinopathy

At Mahajan eye Centre, we provide comprehensive care for diabetic retinopathy, from early diagnosis

Why Mahajan Eye Centre?

Expertise and Experience

Our experienced surgeons have been managing diabetic retinopathy cases for decades, ensuring high success rates and patient satisfaction.

Advanced Technology

Our investment in latest technology (OCT, FFA, Retinal Laser, Vitrectomy etc.) enables us to provide safer, precise, and efficient treatment and surgeries.

Personalized Care

We customize every aspect of your diabetic retinopathy management, from diagnostic tests to selecting the treatment that best suits your condition and vision needs.

Comprehensive Post-Op Care

Our team will guide you through a smooth recovery process, ensuring that any post-surgery issues are promptly addressed as needed.

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Frequently Asked Questions

Diabetic retinopathy is a complication of diabetes that affects the retina, the light-sensitive tissue at the back of the eye. High blood sugar levels damage the blood vessels in the retina, leading to vision problems and, if untreated, vision loss.
Anyone with diabetes (Type 1 or Type 2) is at risk, particularly if blood sugar levels are poorly controlled. Additional risk factors include high blood pressure, high cholesterol, smoking, pregnancy, and having diabetes for many years.
In the early stages, diabetic retinopathy may have no noticeable symptoms. As it progresses, symptoms may include:Blurred or fluctuating vision, Dark spots or floaters, Difficulty seeing colors, Vision loss or a dark curtain-like effect in your vision. Regular eye check-ups are crucial for early detection.
Diagnosis involves a comprehensive eye exam, which may include:
Dilated Eye Examination: To check for retinal abnormalities,
Fundus Photography: High-resolution images of the retina,
Optical Coherence Tomography (OCT): For detailed imaging of retinal layers,
Fluorescein Angiography (FFA): To detect leaking or blocked blood vessels.
While it cannot always be prevented, the risk can be significantly reduced by: Controlling blood sugar, blood pressure, and cholesterol levels. Avoiding smoking. Having regular eye exams, at least once a year, or as recommended by your doctor.
Treatment depends on the severity and may include:
Intravitreal Injections: Anti-VEGF agents or steroids to reduce swelling and block abnormal blood vessel growth.
Laser Photocoagulation: To seal leaking blood vessels and prevent further damage.
Vitrectomy Surgery: To remove blood or scar tissue from the vitreous and repair retinal damage.
Panretinal Photocoagulation (PRP): To treat proliferative diabetic retinopathy and reduce the risk of severe vision loss.
While early stages can be managed and progression slowed with proper treatment and control of diabetes, advanced stages often result in irreversible damage. Early detection is key to preserving vision.
Diabetic patients should have a comprehensive dilated eye exam at least once a year. If diabetic retinopathy is detected, more frequent exams may be required based on the severity.
Untreated diabetic retinopathy can lead to complications such as macular edema, retinal detachment, and severe vision loss or blindness. Regular monitoring and timely treatment can prevent these outcomes.
The need for ongoing treatments depends on the severity of your diabetic retinopathy and how well your condition is controlled. Some patients require periodic injections or laser treatments to manage the disease effectively.
Strict control of blood sugar, blood pressure, and cholesterol can help slow the progression of diabetic retinopathy and improve overall retinal health. However, any existing vision loss caused by advanced retinopathy may not be reversible.
Moderate exercise is generally beneficial, but strenuous activities like weightlifting or high-impact sports should be avoided, especially if you have proliferative diabetic retinopathy or severe macular edema. Always consult your eye doctor before starting a new exercise regimen.
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