Treatment of Retinopathy

The treatment of retinopathy depends upon the stage at which the retinopathy exists.

At the stage of background retinopathy there is no such immediate treatment as it is first carefully assessed by the ophthalmologist (eye specialist). The specialist studies the progression of the stages. The patient is advised to get an annual checkup of the eye so as to check and monitor the progression of the conditions.

If the pre-proliferative stage is reached and detected in the screening process, then it requires a complete and detailed examination of the eye.There is bleeding in this stage of retinopathy, so it is the amount of bleeding that assesses the treatment to be given to the patient. If it is minimal then there is no need to give the treatment to the patient. However there is a need for regular ophthalmic examinations at least once in a year or twice that depends upon the severity of the conditions of the eye for a better monitoring of the disease progression.

At this stage it is strongly recommended that the diabetic patient should control the symptoms of the diabetes rather than the eye conditions itself, as it is glycemic state that leads to the disease progression and its complications in the diabetics. So the treatment here is treating and controlling the diabetes rather the ocular state. It should be noted here that the glycemic control slows the progress of the ocular conditions and complications slows down.When the stage has progressed far and the bleeding is excessive then it is recommended to have a laser treatment for this condition.

Maculopathy and proliferative retinopathy are the progressed stages of retinopathic complications. Here the need of laser treatment is usually recommended for prevention of loss of treatment.

In the advanced stages of complications of proliferative retinopathy the treatment by lasers may not be possible and ineffective. Here the need of eye surgery arises that is called vitreous surgery.

Laser treatment
The treatment of diabetic retinopathy by the use of lasers is called Photocoagulation. It involves use of a laser to burn away any abnormal blood vessels in the eye. Drops are put into your eyes to numb the surface. A special contact lens is then placed on your eye to hold your lids open and to focus the laser beam on your retina.

This treatment is done in the outpatient settings as it involves one or more visits to a laser treatment clinic. The procedure of Focal laser treatment involves usually a single session while that of Scatter laser treatment that is also known as pan retinal photocoagulation requires two or more sessions.
The patient might feel occasional sharp pricking sensation when certain areas of your retina are being treated but it is still not usually painful. Thus to numb the surface it requires the use of eye drops. To hold the eyelids open and focus the laser beam onto the retina it requires the use of special contact lenses.

In certain cases, the patients who have already been treated with the lasers in past, there might be a certain discomfort during the course of treatment. The patient should also ask the doctor to give mild sedatives or painkillers.

After treatment there might be blurred vision that normalizes in a few hours. There also might be ache in the eyes with a lot of treatments. To help relieve this pain the patient should take Over-the-counter (OTC) painkillers such as paracetamol. Photocoagulation can also damage the outer retina which occurs with a chance of affected night and peripheral visions. Almost 50% of people having laser treatment for diabetic retinopathy may notice some difficulty with their night vision, and 3% may notice some loss of peripheral vision. In these cases professional advice must be sought.

Vitreous surgery
The surgery is an option only if the complications of the eye have progressed to an alarming situation. Thus Vitreous surgery is required if:There is a large amount of blood that collects in the centre of the eye that is obscuring the vision of the person. There becomes an extensive scar tissue that is more likely to cause or have caused in many cases the detachment of retina.The surgery involves an incision in the eye before the vitreous el of the eye is removed which collects in the front of retina. Any scar tissue will be removed from your retina and, in some cases, the retina may be strengthened in position using tiny clamps. The vitreous gel will be replaced with a gas or liquid to help hold the retina in place.

The gas or liquid will gradually be absorbed by your body, which will create new gel to replace the gel that was removed during surgery. The gas is placed as a gas bubble while a salt solution is used in case of liquid. Then any scar tissue that is present on the retina is removed in some cases as well. By the use of small clamps the retina is strengthened in its position. The vitreous gel is then replaced with a gas or liquid that holds the retina in its place. These gas or liquid entities are then absorbed in the body which is replaced by new gel created by the body. This procedure usually is performed using local anesthetics and sedatives. Thus the patient will feel no pain and will have no or little awareness of the surgical procedure. Mostly the person treated can go home the same day after surgery.

As the activity immediately after the eye surgery can tire the eye quickly, it is often recommended that the treated person should wear an eye patch so that the patient can gradually make more and more use of your eye. The use of eye drops is also important during this course of recovery.In case of the use of gas in the surgical procedure, it is advised to the patient by the surgeon not to travel by air until all the gas is absorbed in the body. It is normal to have blurred vision for several weeks after the surgery. This should begin to improve gradually, though it may take several months before the vision returns to normal.

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