Diabetic (Non-macular) Retinopathy

Non-proliferative Retinopathy 
No treatment is required for mild, moderate, and severe Non-proliferative Retinopathy, other than through control of levels of blood sugar, blood pressure, and serum cholesterol to retard early disease progression.

Proliferative Retinopathy
Treatment options for Proliferative Retinopathy include forms of laser surgery called scatter photocoagulation and focal photocoagulation. In photocoagulation, tiny burns are placed on the retina with a special laser. These burns seal the blood vessels and stop them from growing and leaking. In scatter photocoagulation, abnormal blood vessels are shrunk by a retina specialist who applies as many as 2,000 laser burns in a polka dot pattern in areas of the retina away from the macula. While some loss of side vision may occur, scatter photocoagulation can save the rest of a person’s sight. However, it is only effective before bleeding or detachment has progressed very far. In focal photocoagulation, specific leaking blood vessels in a small area of the retina, usually near the macula, are addressed. The retina specialist identifies individual blood vessels for treatment and makes a limited number of laser burns to seal them.

Diabetic Macular Edema

Today, laser treatments are the standard of care. There are two types of laser treatment for DME; focal and grid. Focal laser treatment is used to treat focal diabetic macular edema; the aim is to close leaking microaneurysms. Grid laser treatment is used to treat diffuse DME and is applied to areas of retinal thickening in which there is diffuse leakage; the aim is to produce a retinal burn of mild to moderate intensity. The patient is rechecked several months after treatment and, if the DME is not responding to treatment, the laser treatment is repeated. With all of these laser techniques the goal of treatment is to maintain current visual acuity and reduce the chances of progressive visual loss. If bleeding in the inner eye is severe, blood is removed from the center of the eye in a surgical procedure called a vitrectomy. A small instrument is placed through an incision to remove the clouded vitreous gel and replace it with a salt solution. While this procedure does not cure the disease, it is repeatable should DME reoccur.

Glaucoma

Treatment for glaucoma may be medication or surgery, dependent on the type and degree of glaucoma being treated. Medication which reduces pressure in the eye is usually applied using eye drops. When medication is not sufficient, laser surgery is used to lower the pressure in the eye in order to prevent damage to the optic nerve caused by the elevated pressure.

Cataracts

The effects of mild cataracts can be reduced by wearing sunglasses with glare control lenses. When cataracts progress to the point that they impair everyday activities, surgery can be very successful in restoring vision. A relatively simple procedure, the clouded lens is removed from the eye and replaced with a clear plastic lens.