Treatment:

To prevent diabetic retinopathy:

• Keep tight control of your blood sugar (glucose), blood pressure, and cholesterol levels
• Stop smoking

People with the earlier form (nonproliferative) of diabetic retinopathy may not need treatment. However, they should be closely followed by an eye doctor who is trained to treat diabetic retinopathy.

Treatment usually does not reverse damage that has already occurred. However, it can help keep the disease from getting worse. Once your eye doctor notices new blood vessels growing in your retina (neovascularization) or you develop macular edema, treatment is usually needed.

Several procedures or surgeries are the main treatment for diabetic retinopathy.

Laser eye surgery creates small burns in the retina where there are abnormal blood vessels. This process is called photocoagulation. It is used to keep vessels from leaking or to get rid of abnormal, fragile vessels.

• Focal laser photocoagulation is used to treat macular edema.
• Scatter laser treatment or panretinal photocoagulation treats a large area of your retina. Often two or more sessions are needed.

A surgical procedure called vitrectomy is used when there is bleeding (hemorrhage) into the eye. It may also be used to repair retinal detachment.

Drugs that prevent abnormal blood vessels from growing, and corticosteroids injected into the eyeball are being investigated as new treatments for diabetic retinopathy.

If you cannot see well:

• Make sure your home is safe so you do not fall
• Organize your home so that you can easily find what you need
• Get help to make sure you are taking your medicines correctly

See also:

• Cataract removal
• Retinal detachment repair

Support Groups:

American Diabetes Association - www.diabetes.org

National Diabetes Information Clearinghouse - www.diabetes.niddk.nih.gov

Prevent Blindness America - www.preventblindness.org

Expectations (prognosis):

You can improve your outcome by keeping good control of your blood sugar and blood pressure.

Treatments can reduce vision loss. They do not cure diabetic retinopathy or reverse the changes that have already occurred.

Once proliferative retinopathy occurs, there is always a risk for bleeding. You will need to be monitored regularly, and you may need more treatment.

Complications:

Other problems that may develop are:

• Cataracts
• Glaucoma -- increased pressure in the eye that can lead to blindness
• Macular edema -- if fluid leaks into the area of the retina that provides sharp vision straight in front of you, your vision becomes more blurry
• Retinal detachment -- scarring may cause part of the retina to pull away from the back of your eyeball

Calling your health care provider:

Call for an appointment with an eye doctor (ophthalmologist) if you have diabetes and you have not seen an ophthalmologist in the past year.

Call your doctor if any of the following symptoms are new or are becoming worse:

• You cannot see well in dim light.
• You have blind spots.
• You have double vision (you see two things when there is only one).
• Your vision is hazy or blurry and you cannot focus.
• You have pain in one of your eyes.
• You are having headaches.
• You see spots floating in your eyes.
• You cannot see things on the side of your field of vision.
• You see shadows.