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When the retina becomes ischemic, it releases a protein called Vascular Endothelial Growth Factor (VEGF).  The vascular endothelial growth factor (VEGF) causes abnormal blood vessels (neovascularization) to develop on the surface of the retina and on other parts of the inside of the eye such as the optic nerve and iris. Blindness may develop from massive proliferation of the neovascularization (aka abnormal blood vessels) causing either retinal detachment or, a rare type of painful glaucoma (neovascular glaucoma – NOT the regular glaucoma). So far, ischemia has caused vascular endothelial growth factor (VEGF) to be liberated.  The VEGF has caused neovascularization to develop. If we laser the peripheral retina, the portion of the retina away from the macula, we can stop the production of VEGF in most cases and arrest the proliferative phase of the diabetic retinopathy. Patients with diabetes should have a yearly eye examination to screen for diabetic retinopathy. If there are findings of diabetic retinopathy she will likely order fluorescein angiogram testing or an OCT procedure to find out if you need treatment.
Rapid changes in blood sugar can cause fluctuating vision to both eyes even if retinopathy is not present. During the first three stages of diabetic retinopathy, you do not need treatment, unless you have macular edema. Scatter Laser Treatment: Scatter Laser Treatment helps to shrink the abnormal blood vessels. Vitrectomy: Proliferative diabetic retinopathy can cause the fragile new vessels to bleed into the vitreous—the clear, gel-like substance that fills the center of the eye. Both focal and scatter laser treatment are performed in your retina ophthalmologist's office or eye clinic. Your retina surgeon will perform your vitrectomy in an operating room while you are under either local or general anesthesia.
Diabetes if not controlled can affect the eyes, the feet, the kidneys, can cause strokes as well as other problems.  The best treatment for all of the associated conditions is to tightly control the diabetes but if the eyes are finally affected with diabetic retinopathy what can be done? Ultimately this type of therapy is likely to be evolved into some sort of slow release implant that will be effective over a long period of time - say five years. It might be scary to imagine having an injection in your eye every month, but what is even scarier is the thought of going blind!
Most patients will tell you that even though the injection process is not pleasant it is far from tortuous.  They are delighted that something can be done to protect their most precious sense - THEIR VISION! Privacy Policy is in line with the government's Privacy Guidelines and Spam Act issued on 17th September 2001, and fully effective as of 11th April 2004. The type of treatment that will be recommended for your condition will depend on how advanced your diabetic retinopathy is. In the early stages, treatment may not be necessary as your doctor might opt to control the progression of diabetic retinopathy by bringing your diabetes under control. In the advanced stages of diabetic eyes, surgical treatment is usually the best resort to save the residual vision.
Scatter laser treatment or panretinal photocoagulation, works by shrinking the swollen or abnormal blood vessels. Surgical intervention can help alleviate symptoms and slow the progression of diabetic retinopathy.
There is also promising research being done into preventing the onset of diabetic eyes, this includes medication that prevents the vessels in the eye from swelling and leaking.
Singapore Medical Clinic is made up of a team of recognised health care professionals and experienced IT experts. Diabetic RetinopathyLaser Eye Centre was the first centre in East and Central Africa to offer laser treatment for diabetic retinopathy.
Due to the reduced blood circulation in the retina, new blood vessels form on the surface of the retina and optic disc. The most sight threatening diabetic problems can be prevented by laser treatment if it is detected early enough. Laser eye centre now introduces the latest innovation in Optical coherence tomography at your disposal. OCT has been routinely used in measuring retinal thickness for the evaluation of ME caused by diseases such as age-related macular degeneration, diabetic retinopathy.
OCT can be used to follow retinal thickness over time proving to be a superior diagnostic tool due to its non-invasive approach, quick imaging acquisition and safety profile, making it the gold  standard  for early detection of Macular edema. As mentioned earlier, in Proliferative Diabetic Retinopathy, the retina is not getting enough oxygen thus new blood vessels form. The principle of PAN retinal photocoagulation is that with light laser marks the laser procedure is carried out avoiding the central, important area called the macula [please see the anatomy of the eye], which is for focusing and colour vision, whilst in the remaining peripheral part laser is done so that oxygen requirement of the retina is reduced and whatever oxygen is available goes to the central important part. Patients with Proliferative Diabetic Retinopathy can have perfectly normal vision so vision is not the criteria for diagnosis or suspected Proliferative Diabetic Retinopathy.


Patients who have been diabetic for 5 years have a 25% chance of developing Proliferative Diabetic Retinopathy whilst at 10 years they have a 50% chance and at 20 years they would have a 98% chance of developing this condition. At the centre of the retina is the macula which is a small area about the size of a pinhead. This favours diabetic patient as there is less trauma to the eye so Postoperative Inflammation is minimal and astigmatism or distortion of the cornea is reduced. Diabetes can affect the small blood vessels in the back of the eye leading to leakage of fluid, bleeding and scarring. The fluorescein angiogram test is done by injecting dye into your arm and photos are then taken of your eye to detect if fluid is leaking. You should have your eyes checked promptly if you have visual changes that affect one or both eyes lasting more than a few days and that are not associated with a change in blood sugar.
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To prevent progression of diabetic retinopathy, it is important to control your levels of blood sugar, blood pressure, and cholesterol. Your retina-vitreous specialist places up to several hundred small laser burns in the areas of retinal leakage surrounding the macula. Your retina surgeon 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. A very large bleed can block out all or most of your vision, in which case your doctor may perform a vitrectomy. The retina surgeon makes a tiny incision in your eye and uses a small instrument to remove the vitreous gel that is clouded with blood. Nature has built an automated system in our body, which instinctively resists harmful substances and absorbs healthy material. Personal details provided by you to The Eye Practice through electronic responses from this site will not be forwarded, sold, or made available in any way to any third party. Your doctor might opt to send you to an endocrinologist who will be able to give you expert advice on managing your diabetes. The type of surgery recommended will depend on the specifics of your condition and what part of the eye is affected by diabetic retinopathy. During a procedure, lasers treat the affected blood vessels by repairing damage and stopping leaks.
During a scatter laser procedure, the areas of the retina that are away from the central macula, are treated with lasers. This involves removing blood or other deposits from the vitreous which is the clear jelly-like substance in the middle of the eye. It is important to recognise that managing diabetes is a lifelong process and surgery is not a cure for diabetic retinopathy. For a comprehensive eye test for diabetic retinopathy, make an appointment with our eye specialist today!
With our free medical portal, we aim to bring Singapore's private healthcare practitioners, patients and caregivers from around the world onto a common platform.
In the present era, diabetes has become one of the leading causes of irreversible blindness. It is important to realize, however, that laser treatment aims to save the sight you have – not make it better. This is the most highly specialized part of the retina and it is vital because it enables you to see fine detail and read small print. This contains the active ingredient ranibizumab, a vascular endothelial growth factor-A (VEGF-A) inhibitor. In a small number of cases, if a patient has lost vision, it can be improved by this procedure.
Because the treatment requires a large number of laser burns, your physician will often complete your treatment in two or more sessions. During this microsurgical procedure, which is performed in the operating room, the doctor removes the blood-filled vitreous and replaces it with a clear salt solution. However, The Eye Practice may communicate with you again with other information that is complimentary to your original request.
In the early to intermediate stages of diabetic eyes, effectively managing your diabetes and keeping your blood sugar levels under control can alleviate symptoms and slow down the progression of the condition. The process is sometimes known as photocoagulation and can usually be completed in one session.
During a vitrectomy, the vitreous is removed and replaced with a salt solution to help your eye maintain its shape.


Post-surgery, it will still be necessary to monitor your diabetes and to go for regular eye exams.
Through the portal, we provide a free service for medical enquires before patients decide to make an appointment for consultation. The modern method of management here is to perform PAN retinal Argon Laser photocoagulation.
Laser light is low energy, coherent light of a wavelength whose energy is non–divergent and works together in one direction. If it is detected at an early stage the PAN retinal photocoagulation works in 90% of the patients otherwise untreated Proliferative Diabetic Retinopathy leads to blindness. In diabetic Maculopathy, the macula becomes swollen due to leakage from the retinal blood small blood vessels. Cataract extraction by Phacoemulsification is the best way to remove a cataract in diabetic patients. Lucentis® specifically recognises and blocks the action of VEGF-A, and so helps to stop the abnormal growth and leakage of blood vessels in the eye.
Anderson will dilate the eye and using special equipment and lenses will look inside the eye. This treatment is usually completed in one session, although you may require this laser surgery more than once to adequately control the leaking fluid. Although you may notice some loss of your side (peripheral) vision, scatter laser treatment can save the rest of your sight.
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, although some people stay in the hospital overnight.
Each of these communications will have clear 'opt-out' instructions so you can choose not to receive further The Eye Practice communication.
Like focal laser treatment, you will experience blurred vision for a day or two after a session and usually multiple sessions are required.
The recovery period is longer than with laser treatment, you will need to wear an eye patch and use medicated eye drops for a few weeks.
Without early detection and treatment, diabetic retinopathy can permanently damage the retina.
Laser is applied to the leaking spots, sealing and preventing further deterioration of central vision, hence stabilizing it. In this new method of cataract surgery the incision is very small, and is usually self-sealing and does not require any stitches, thus there is no suture tension discomfort. This can help prevent further damage to the eye and can even repair some of the damage that has occurred. If you require focal laser treatment in both eyes, your retina specialist typically will treat one eye at a time, several weeks apart. If you need a vitrectomy in both eyes, your doctor will usually perform them several weeks apart.
You can expect that your eye will be red and sensitive, and you will need to wear an eye patch for a few days or weeks to protect your eye.
On the other hand, you may wish to receive other The Eye Practice communication, you would always be asked before such information is forwarded.
Some people do experience a loss of peripheral vision, a difficulty in seeing colours and also experience poor night vision after a scatter laser procedure. Scatter Laser Treatment works better before the fragile new blood vessels have started to bleed.
It is not in The Eye Practice's interest to continue to send you emails once you have requested to be unsubscribed. If the fluid that has leaked into your eye has affected the macula and caused it to swell, surgical intervention may not be able to restore your vision to normal, though it can help improve vision in some cases. But even if bleeding has started, this type of treatment may still be possible, depending on the amount of bleeding.
Because your pupil will remain dilated for a few hours and your vision will probably be a bit blurry for the rest of the day, you will need someone to drive you home after surgery and you should bring a pair of sunglasses. Therefore it is important to go for regular eye exams, as early detection can help restore and save your vision.



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