diabetic retinopathy treatment melbourne

Diabetic Retinopathy Treatment – Everything You Need To Know

Diabetes mellitus is a metabolic disease arising from a deficiency in the production or function of a hormone known as insulin. As insulin is responsible for the absorption of glucose from the bloodstream into the tissues of the body, problems with this hormone results in elevated blood glucose, which then damages blood vessels. Other organs and tissues reliant on receiving this blood supply also suffer, resulting in a myriad of diabetes-related complications, including:

  • Diabetic retinopathy and other diabetic eye diseases
  • Kidney disease
  • Dental disease
  • Nerve damage, also called neuropathy, typically in the legs and feet
  • Reduced blood circulation to the legs and feet
  • Increased risk of heart attack and stroke

While diabetes is present in the Australian population at a prevalence of around 5%, experts estimate a significant number of people are living with undiagnosed diabetes; it is thought that for every 4 diagnosed diabetics, there is 1 adult with undiagnosed disease. As the risk of experiencing diabetic retinopathy increases with longer duration of diabetes and poorer blood glucose control, it’s important to be aware of your risk factors for developing diabetes, such as obesity or a family history, and what can retinal surgery do to treat this condition, and to keep on top of your general health. 

 

Diabetic Retinopathy

A retinopathy is any disease affecting the sensory tissue lining the back of the eyeball, known as the retina. The retina is responsible for receiving incoming light into the eye and sending neural signals onward to the brain to form vision. Because the cells of the retina are constantly working to process light into neural impulses, they are supported by a branching network of tiny blood vessels in order to meet this energy demand. Increased blood glucose levels from diabetes mellitus can damage these retinal blood vessels, resulting in diabetic retinopathy

Diabetic retinopathy is divided into two broad categories, proliferative and non-proliferative disease. Non-proliferative retinopathy can be further classed from minimal to severe. In the mild stages of non-proliferative retinopathy you may experience no symptoms and be entirely unaware of you have any ocular complications, however, an eyecare practitioner examining your retina may notice signs such as haemorrhages, yellowish deposits called exudate, areas of swelling, and white patches caused by restricted blood supply. If any of these signs occur close to the macula, the part of the retina responsible for central vision, you may be aware of a distortion or blur to your vision even if you only have mild retinopathy.  

Proliferative retinopathy is defined by the development of new blood vessels in the retina, which occur in response to compromised blood circulation from the diabetes. These new vessels are fragile and poorly formed, and are at risk of causing a large haemorrhage in the eye. Depending on the size and location of the bleed in the eye, your sight may be partially or fully obscured until the blood clears away. Although vision loss directly from a haemorrhage is temporary, the proliferation of these leaky new blood vessels can lead to other complications, including permanent scarring and distortion of the retinal layers, a retinal detachment, or glaucoma.

Diabetic retinopathy usually occurs in both eyes, though may be asymmetrical in its severity. 

 

Diabetic Retinopathy Treatment

If you have mild to even moderate non-proliferative diabetic retinopathy, treatment is not always necessary and your eyes and vision can simply be monitored, particularly if you are asymptomatic. The early signs of diabetic eye disease can often be managed by improving blood glucose control, whether through diet and exercise or medications as directed by your endocrinologist or diabetes educator. Conversely, diabetic retinopathy treatment is always required for proliferative disease, usually in the form of retinal surgery

Patients with either proliferative or non-proliferative retinopathy may experience swelling around the macula known as macular oedema. This is often readily noticeable and can interfere with your daily activities by causing blurred vision or even distortions to your sight such as objects appearing smaller than compared to the unaffected eye or altered colour vision. Macular oedema can be observed until it self-resolves under the care of an experienced eyecare clinician if the impact to your vision is low; alternatively, you may be recommended diabetic retinopathy treatment in the form of either a laser retinal surgery procedure or eye injections to help the eye to heal more quickly. 

Photocoagulation is a type of laser retinal surgery used to seal damaged blood vessels that are leaking blood and fluid into the retina. The application of the laser to these affected vessels effectively seals the leak. Laser retinal surgery may also be used in the proliferative stage of the disease to reduce the oxygen demand of select areas of the retina, thereby removing the stimulus for the growth of those new fragile blood vessels. This procedure effectively burns and scars parts of the retina to achieve this and so is usually performed as far into the periphery of the retina as possible to avoid damaging your important central vision. 

Macular oedema and proliferative retinopathy can also be managed using diabetic retinopathy treatment in the form of eye injections. A drug class known as anti-vascular endothelial growth factor (anti-VEGF) blocks the chemicals released by oxygen-deprived tissues that trigger new vessel growth. 

 

Keeping your diabetes under good control is the ideal way to avoid needing diabetic retinopathy treatment. Patients with diabetes are recommended to maintain regular eye tests with their optometrist or ophthalmologist, even if they haven’t noticed any changes to their vision. Call us today at (03) 9070 3580.

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

is laser eye surgery safe melbourne

Is Laser Eye Surgery Safe? – What You Need To Know

Glasses and contact lenses can be inconvenient – they fog up, fall off, slip down, need cleaning, need constant maintenance – for people highly dependent on optical correction, vision correction with laser eye surgery can be a tempting solution. But any sort of operation to the eye can be a daunting thought and before you go under the metaphorical knife, you really want to know is laser eye surgery safe and what are the risks?

 

Laser Eye Surgery

It helps to know what laser eye surgery actually is and how it achieves vision correction. Laser eye surgery refers to a group of refractive operations of varying techniques – surgical procedures designed to change the way light passes through the eye so that rays come to a clear focus on the retina to form sharp vision. Although not all refractive procedures actually involve a laser tool, those that do mostly concentrate on reshaping the front surface of the eye known as the cornea.

This reshaping process involves the removal of select areas of the cornea, literally changing its shape. The result is that light is bent along a different pathway as it passes through this tissue to come to a point at the back of the eye where we perceive vision as being clear, thereby providing vision correction without the need for external optical aids such as glasses or contacts.

As with any surgical procedure that involves an incision in the body, laser eye surgery does come with a degree of risk. Although certain techniques are associated with particular risks and complications that other methods may be able to ameliorate, surgical vision correction techniques are recommended to individuals on a case by case basis – which laser eye surgery method is safest for you and your eyes.

 

factors consider is laser eye surgery safe melbourneIs Laser Eye Surgery Safe?

Before any medical device or operation is approved for clinical application in Australia, it must first go through a strict process of approvals to ensure the safety of the public. Overall, laser eye surgery is considered to be a very safe procedure with a very low rate of complications; success rates are typically quoted around 98-99% in the developed world.

Complications from surgical vision correction resulting in a loss of more than one line on the visual acuity letter chart sit around 0.4% and more comfortingly, total loss of sight from laser surgery has never been reported in an Australian clinic. One of the most well-known, popular refractive techniques, LASIK is known to provide perfect 20/20 vision for over 90% of patients. Extensive studies into the safety of other refractive methods including PRK and SMILE® also tend to demonstrate that these techniques are comparable in safety and efficacy.

As mentioned earlier, when it comes to laser eye surgery each patient is assessed on a case by case basis by their ophthalmologist and clinical team. This determines the level of your risk of complication as well as guides your eye doctor in deciding which procedure is the best and safest for you. There are several factors your refractive specialist will take into consideration:

  • Your prescription – Each laser vision correction method will have been assessed for effectiveness and safety within a certain prescription range. Although this parameter is not considered in isolation, there are general rules of thumb when it comes to the treatable prescription range for each refractive technique, whether it’s astigmatism, or short- or far-sightedness. For example, LASIK and SMILE® can often be used to treat degrees of short-sightedness even into the double digits.
  • Your corneal thickness – Refractive techniques that require reshaping of the cornea rely on a minimum corneal thickness. As the reshaping process involves removal of tissue and the higher the script, the more tissue that needs to be removed, an adequate amount of tissue is needed to begin with in order to address the presenting prescription. In addition to this, there is a minimum residual corneal thickness that needs to remain after the reshaping process to maintain the mechanical integrity and stability of the eye. Compared to LASIK, PRK tends to be a safer option for patients with thinner corneas.
  • Lifestyle factors – Certain laser surgery techniques tend to be recommended for different types of lifestyles. While one aspect of this relates to a person’s visual demands, such as whether they have presbyopia and need treatment for both distance and reading vision, certain hobbies and vocations can also exclude certain surgery methods on the basis of safety. An example of this is a patient who serves in the armed forces or who undertakes wrestling as a pastime – LASIK surgery involves the formation of a hinged corneal flap before the underlying cornea can be reshaped. Although rare, this corneal flap may become dislodged in the event of physical trauma, making LASIK an unsuitable solution for such a patient. Another technique such as PRK or SMILE® would be more appropriate.
  • Pre-existing eye conditions – Some patients may be counselled against any type of laser eye surgery due to a pre-existing eye disease such as keratoconus or an active corneal infection. In many cases, manipulating the corneal tissue may exacerbate such conditions, which either need to first be treated and resolved, or may simply exclude the patient from refractive surgery altogether. Pre-existing dry eye, although not a complete contraindication to refractive surgery, may guide the surgeon to recommending a technique less likely to worsen the dryness, such as SMILE® instead of LASIK.

 

If you’ve been wondering ‘is laser eye surgery safe?’, the answer is yes. Of course, there are still risks involved but a discussion with your ophthalmologist will help to ensure you are counselled to the most appropriate technique for your situation. Call us now at (03) 9070 3580 for a consultation.

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.