The first and main option is to decrease the leakage from blood vessels and destroy new abnormal blood vessels by focusing a laser beam on the damaged retina. Pancoagulation of the retina involves 2000-4000 burns of the eye. This treatment is performed in an outpatient setting, but is often recurrent. Laser therapy is necessary for preserving vision, not for improving it. It is possible to prevent loss of sight in 80-90% of cases. Laser therapy is necessary when an ophthalmologist detects new abnormal blood vessels in the retina or if it is clear that they are occurring after some time. Usually these new blood vessels occur when diabetes has lasted for 10-15 years, but can occur also faster when diabetes has been in significant decompensation. Laser therapy is also indicated in case of leaking blood vessels around the macula.
Does surgery (vitrectomy) improve vision?
Vitrectomy is an operation where vitreous body is removed with microsurgical instruments under a microscope, and it also involves cleaning of the eyes. Replacement of a dimmed vitreous body with a transparent medium makes it possible for the light to reach the retina again and it also partly restores vision. Still, the quality of sight will not be equal to normal vision. It can take weeks and months before vision gets better. In case of severe retinopathy even stopping the progression of the disease can be considered as a major achievement.
Are there any aids that could help with reading when vision is impaired?
It is possible to help diabetic patients whose visual acuity has decreased so much that they can see objects only from a couple of meters. Both a simple magnifying glass and special electronic devices may be used in order to cope with everyday activities. The employees of the Tallinn Rehabilitation Centre of Blind People can help those with significantly impaired vision with advice, learning and special training.