Vitreo-retinal surgery

When Gloria was in the process of giving birth to her baby, she noticed a sudden change in her vision. All of a sudden she saw dark spots floating in her left eye, and her right eye had a big black spot in the center of her vision.
She saw her eye doctor the next day, who send her to a retina specialist. There she was told that she had advanced diabetic eye disease and now was bleeding in both eyes. She knew she had a “little sugar” in her blood during her first pregnancies, but was surprised to learn about her eye disease. She saw an eye doctor every once and a while for her contact lenses, but never mentioned that she had diabetes.

After several laser surgeries in each eye her vision has come back to near normal levels in one eye; her other eye will never see well again, and she will need to see her eye surgeon regularly from now on.

John developed diabetes at a young age and his regular doctor visits included a trip to his eye doctor once a year. These visits became more frequent after early diabetic eye changes were found. Over the years he has developed certain changes which needed laser treatments; some small and some large; but his vision is holding and he functions well.

These are two true examples of eye problems that can happen to patients with diabetes. John has type one- or early onset – diabetes and is insulin dependent. His doctor made sure that his eyes were part of his check-ups. When diabetic retinopathy, developed, treatments were performed in a timely fashion and most of his vision could be preserved.

Gloria also had diabetes, but never needed insulin. She did not see an eye doctor because she felt that a little diabetes could not harm her eyes.

The lesson we can learn from all of this is that diabetes can and will cause eye damage in time. The longer one has diabetes, the higher the risk of complications. It is more predictable in juvenile or type 1 patients because the onset of diabetes is known exactly. Gloria had adult onset or type two diabetes and the start of her disease was not exactly known.

Diabetes will affect the eyes in different ways. Two changes are at the basis of most eye damage.

One is leakage from existing blood vessels; leading to localized swelling of the central vision area, resulting in vision decrease. This usually can be helped with a small laser treatment.

The other concerns the disappearance of the smallest of vessels, the capillaries. These feed the retina and their absence will lead to lack of oxygen to the retina. This in turn will lead to a build-up of new vessels, which do not benefit the retina at all, and only will lead to further harm.

Vision loss is usually not an early warning sign of diabetic harm to the eye. By the time vision is lost, the damage will not always be reversible. Timely eye checks will catch early changes and are therefore very important.

Your eye doctor will inspect the retina through dilated pupils and often additional testing will be scheduled to measure retinal blood circulation or assess the degree of swelling, to come to a better understanding of the current problems.

Everyone with diabetes needs eye exams, the frequency of which depends on the severity of the retinopathy. Whether the diabetes started at a young age and required insulin shots from the start, or was acquired at an older age without the need of insulin; eye damage can and will occur in both groups.