Diabetes is a systemic condition that affects small blood vessels throughout the body, including the eyes. In addition to visits with your primary care physician, routine eye exams are recommended to look for changes that may be visible in the retina. Treatment may be considered when vascular changes lead to macular edema, a type of fluid collection within the retina.
Other treatments may be recommended to control the abnormal growth of blood vessels from the retina, for bleeding within the eye called vitreous hemorrhage, or for a retinal detachment. Various forms of treatment may include laser therapy applied to the retina, injections of medication, or surgery.
Treatment can include two types of laser and intraocular injections of a medication. The three most frequently used medication are: Avastin (not FDA approved), Lucentis (FDA approved) and Eylea (FDA approved). All three medications work by inhibiting vascular endothelial growth factors. You Physician may start with one medication and then recommend another based on your response to treatment. Severe cases of bleeding in the eye can be addressed with an operating room procedure called a vitrectomy.
What to expect
Laser procedures are performed in the office with either topical anesthetic or a behind the eye injection of lidocaine (retrobulbar block) to keep the eye comfortable during treatment. With Injection therapy, the medication is delivered into the eye with a very fine 30-31 gauge needle. We attempt to make the treatment as comfortable as possible. You will be given a series of topical numbing agents based on your degree of discomfort during the treatment.
It is imperative to create a safe sterile injection site on your eye to minimize the risk of infection (endophthalmitis risk 1 in 10,000). Your Physician will place a small eyelid holder (speculum) in your eye to hold your eyelids open and off the surface of your eye. We ask no one to talk during the treatment so as to minimize any possible aerosol contaminant in the air. Several drops of a sterilizing agent (betadine) will be placed on your eye. This drop can sometimes burn but only for 10-20 seconds. The technician assisting will sometimes stabilize your head as you receive the injection so as to minimize the chance of head motion during the treatment. After the injection your eye will be rinsed with sterile saline and more topical numbing drops to remove any residual betadine.
Preservative-free lubricating tear drops are recommended frequently immediately following your treatment. We ask you to call the office if you are experiencing any symptoms of pain, vision loss, extra redness, or light sensitivity.