| Diabetes
is a common disease that may result in complications
in the eyes. The changes occur mainly in the retina,
the light-sensitive layer at the back of the eye responsible
for vision.
As a result of prolonged elevated
sugar levels in the blood, the delicate blood vessels
in the retina become fragile and start to leak fluid
and proteins into the retinal tissue. This causes swelling
of the retina (see Fig 1) especially in the centre area
(macula) where vision is most detailed, resulting in
blurred vision. Other changes in the retinal blood vessels
lead to narrowing and closure of some of the smaller
blood vessels, causing insufficient blood supply, resulting
in parts of the retina being starved of oxygen and nutrition.
These areas of the retina, when they are starved of
oxygen can be detected by the eye surgeon during routine
eye examinations (see Fig 2), but will not be noticed
by the patient until it is too late.
The late changes that occur, which
will be noticed by the patient only when vision is markedly
reduced, include bleeding into the eye from abnormal
new blood vessel formation and swelling of the macula
(macular oedema). This is why it is ESSENTIAL when you
have diabetes to go for regular eye examinations (Regular
Diabetic Screening) to detect the earlier diabetic changes,
when there are no changes in vision yet. These can then
be treated at an earlier stage with a much better visual
outcome.
Not all changes in the retina resulting
from diabetes need to be treated. If they are very early,
improvements in diabetic sugar control over the long
term can cause those eye changes to reverse.
If your diabetic eye disease has
progressed to a later stage, then treatment may be indicated,
and Dr Khng will inform you. Treatment usually involves
the laser and are mainly of 2 types: Central (macular)
laser, and Peripheral laser (what surgeons call PRP,
or pan-retinal photocoagulation). Central laser is for
vessel leakage around the area of detailed vision (macula),
and is designed to reduce the amount of fluid leakage,
thus leading to improvement in the retinal swelling.
Peripheral laser is designed to reduce the amount of
retinal tissue that is not receiving adequate oxygen.
It does this by reducing the oxygen usage of parts of
the peripheral retina less important for vision. Both
macular laser and PRP laser will require a few sessions
on separate appointments to complete. Dr Khng has access
to and uses the new PASCAL laser from OptiMedica, which
completes the treatment in much less time and with NO
PAIN, compared to conventional Argon or standard treatment
lasers. If you have been treated with a conventional
laser for diabetic eye disease before, this is completely
a different experience. New treatments for diabetic
macular swelling Dr Khng also performs include anti-VEGF
drugs such as Lucentis and Avastin treatments. A consult
will determine your suitability for these treatments.
Please contact EyeWise Vision Clinic to arrange for an appointment. The earlier the treatment
the better.
Contact
Dr. Christopher Khng | Make an
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