diabetic retinopathy faq3 Diabetic Retinopathy FAQ 3 How is diabetic retinopathy detected? Diabetic retinopathy is detected during a comprehensive eye exam that includes: Visual acuity test.  This eye chart test measures how well you see at various distances. Dilated eye exam.  Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems.  After the exam, your close-up vision may remain blurred for several hours. Tonometry.  An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test. Your eye doctor will check your retina for early signs of the disease, including: Leaking blood vessels. Retinal swelling (macular edema). Pale, fatty deposits on the retina.  These are signs of leaking blood vessels. Damaged nerve tissue. Any changes to the blood vessels. How is diabetic retinopathy treated? During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema.  To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol. Proliferative retinopathy is treated with laser eye surgery.  This procedure is called scatter laser treatment.  Scatter laser treatment helps to shrink the abnormal blood vessels.  Your eye doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment.  Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight.  Scatter laser treatment may slightly reduce your color vision and night vision. Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That's why it is important to have regular, comprehensive dilated eye exams.  Even if bleeding has started, scatter laser treatment may still be possible, depending on the amount of bleeding. If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye. What happens during laser eye treatment? Both focal and scatter laser treatment are performed in your eye doctor's office or at an eye clinic.  Before the surgery, your doctor will dilate your pupil and apply drops to numb the eye.  The area behind your eye also may be numbed to prevent discomfort. The lights in the office will be dimmed.  As you sit facing the laser machine, the doctor will likely hold a special lens to your eye. During the procedure, you may see flashes of light.  These flashes eventually may create a stinging sensation that can be uncomfortable or even painful. You will need someone to drive you home after laser eye surgery.  Because your pupil will remain dilated for a few hours, you should bring a pair of sunglasses. For the rest of the day, your vision will probably be a little blurry.  If your eye hurts, your doctor can suggest treatment. What is a vitrectomy? If you have a lot of blood in the center of the eye (vitreous gel), you may need a vitrectomy to restore your sight.  If you need vitrectomies in both eyes, they are usually done several weeks apart. A vitrectomy is performed under either local or general anesthesia.  Your eye doctor makes a tiny incision in your eye.  Then a small instrument is used to remove the vitreous gel that is clouded with blood. The vitreous gel is replaced with a salt solution.  Because the vitreous gel is mostly water, you will notice no change between the salt solution and the original vitreous gel.  You will probably be able to return home after the vitrectomy.  Some people stay in the hospital overnight.  Your eye will likely be red and sensitive.  You will  probably need to wear an eye patch for a few days or weeks to protect your eye.  You also will need to use medicated eyedrops to protect against infection. Are scatter laser treatment and vitrectomy effective in treating proliferative retinopathy? Yes. Both treatments are very effective in reducing vision loss. People with proliferative retinopathy have less than a five percent chance of becoming blind within five years when they get timely and appropriate treatment.  Although both treatments have high success rates, they do not cure diabetic retinopathy. Once you have proliferative retinopathy, you always will be at risk for new bleeding. You may need treatment more than once to protect your sight. What can I do if I already have lost some vision from diabetic retinopathy? If you have lost some sight from diabetic retinopathy, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision. Ask for a referral to a specialist in low vision.  Many community organizations and agencies offer information about low vision counseling, training, and other special services for people with visual impairments.  A nearby school of medicine or optometry may provide low vision services. What can I do to protect my vision? Everyone with diabetes should have a comprehensive dilated eye exam at least once a year. If you have diabetic retinopathy, you may need an eye exam more often.  People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate followup care. A major study has shown that better control of blood sugar levels slows the onset and progression of retinopathy.  The people with diabetes who kept their blood sugar levels as close to normal as possible also had much less kidney and nerve disease. Better control also reduces the need for sight-saving laser surgery. This level of blood sugar control may not be best for everyone, including some elderly patients, children under age 13, or people with heart disease.  Be sure to ask your doctor if such a control program is right for you. Other studies have shown that controlling elevated blood pressure and cholesterol can reduce the risk of vision loss. Controlling these will help your overall health as well as help protect your vision. As always, make sure you only take the professional advice of a licensed and board certified eye doctor.