Diagnosing Diabetic Retinopathy

Case study ( 3895 views as of February 23, 2024 )

Jim is a 31 year old male whose last exam was 8 months ago. He feels his vision has worsened. He reports good health and currently takes not medication.

Current glasses provide 20/40 acuity and this can be improved to 20/20 with an increase in the myopic correction. On retinal examination, numerous haemorrhages were found int the mid periphery and the periphery of both eyes.

He was referred to a retinal specialist to confirm the diagnosis of diabetic retinopathy. He should be seen by his family doctor and possibly an Endocrinologist. He might also benefit from seeing a Diabetic Nurse Educator and a Dietitian, as sudden changes in his vision can be a result of fluctuations in blood glucose levels. He should also visit his local pharmacist to discuss blood glucose monitors for self monitoring at home.

Diabetes is the leading cause of blindness int he western world. It can affect all organs in the body but is commonly detected first in the eyes.

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Conversation based on: Diagnosing Diabetic Retinopathy

Diagnosing Diabetic Retinopathy

  • Laser treatment is a conventional approach used for diabetic retinopathy for various reasons. The laser treatment is typically performed around the edges of the eye. During the procedure, you will be seated at a slit lamp, which is similar to the machine used during regular eye examinations. To begin, anesthetic eye drops will be administered, followed by the placement of a contact lens on the eye. This contact lens helps control blinking and directs the laser treatment. It allows the doctor to examine the inside of the eye. Within the eye, the doctor will apply controlled and fine laser spots, measured in sizes of 100, 200, or 300 microns, for a brief duration. These laser spots appear as flashes of light entering the eye. The main discomfort reported by patients is the brightness of the light, but the light itself is not damaging. The laser creates small cauterizations or burns in the areas of the retina that are not functioning well. This laser treatment can be compared to pruning a tree, where unwanted branches are removed to help the rest of the tree thrive. Similarly, the laser is applied to areas of the retina that are not functioning properly to promote the survival and health of the remaining retina. Another type of laser treatment, known as focal laser, focuses on areas closer to the center of vision. The procedure is similar to the laser treatment described above, with the administration of anesthetic eye drops, placement of a contact lens, and flashes of light. However, in focal laser treatment, there are fewer laser spots applied, and they are done more gently to address specific issues such as controlling leakage that causes vision loss. While laser treatment has been a common approach, injections have become a preferred alternative, especially for the central part of vision. However, there may be cases where laser treatment is necessary in addition to injections or when injections are not available. For more detailed information about laser treatment for diabetic retinopathy, it is best to consult with your eye doctor. They will provide you with specific information about the procedure, its benefits, and any potential risks or considerations based on your individual situation.
  • In the context of treating a condition such as diabetic retinopathy, the frequency of injections and the length of treatment can vary depending on the individual's specific situation and the severity of the disease. Initially, treatments often start out being administered monthly. As the condition progresses and the doctor observes the response to treatment, they may adjust the frequency and duration of the injections. Over time, as the eye responds well to treatment and the condition stabilizes, it is possible that the treatments may be extended, and the intervals between injections may become longer. However, it's important to note that because diabetes is a chronic condition and high blood sugar levels can contribute to ongoing damage, treatments may still be required, albeit with reduced frequency. Regular eye exams are crucial for monitoring the progression of the disease and determining the appropriate treatment plan. The frequency of these exams will be determined by the severity of the disease and the observations made by the eye doctor. Even if your vision is good and your blood sugar is under control, it is important to understand that the damage caused by diabetic retinopathy may have occurred years ago and that ongoing monitoring and treatment may still be necessary. It is recommended to consult with your eye doctor for more information and to discuss your specific treatment process. They will be able to provide guidance based on your individual circumstances and ensure that you receive appropriate care for your diabetic retinopathy.
  • A disease in which the small blood vessels (capillaries) in the back of the eye (retina) bleed or form new vessels. This condition usually occurs in people with long-standing diabetes. Regular eye examinations are an important part of diabetes management.
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