Diabetic Retinopathy Treatment

• Background Diabetic Retinopathy
• Proliferative Diabetic Retinopathy
• Traction Retinal Detachment
• Vitreous Hemorrhage

Vitreous Hemorrhage

Dr. Moises A. Chica, MD, and Dr. Calvin E. Mein, MD offer treatment for diabetic retinopathy and other vitreoretinal conditions at Retinal Consultants of San Antonio, serving San Antonio, Kerrville, New Braunfels, Castle Hills, Converse, Schertz, Hollywood Park, Kirby, Somerset, Castroville, Alamo Heights and the surrounding area. Because vitreous hemorrhage is not necessarily associated with any specific activity (although it can be associated with strenuous physical activity), people with diabetes are encouraged to lead a normal life and not restrict their physical activities for the sake of their eyes. There may be exceptions to this general rule, and your doctor will help advise you. When a person does notice the sudden appearance of floaters, spider webs, spots in front of the eye, or blurred vision, they should immediately call their eye doctor.

Treatment

It is often helpful for someone with diabetes who develops a vitreous hemorrhage to remain in a sitting position so that gravity can help settle the blood to the lower parts of vitreous cavity. Once the blood settles, pan retinal laser photocoagulation can be done. Laser surgery cannot make the blood disappear, but it can cause the neovascularization that bled to shrink and thereby prevent more bleeding into the vitreous. The vitreous hemorrhage that is present usually disappears with time but can take many months to clear.

If there is so much vitreous hemorrhage that laser surgery is not possible, or if the blood does not disappear on its own, it can be removed with an operation called a vitrectomy.

Vitrectomy surgery is done in the hospital, under general or local anesthesia. The blood-filled vitreous gel is removed. It is replaced during the operation with a gas bubble or a clear fluid that is compatible with the eye. Over time, the gas bubble or fluid is absorbed by the eye and is replaced by the eye’s own fluid, although the eye does not replace the gel itself. The lack of vitreous gel does not affect the function of the eye. If the blood in the vitreous does not go away on its own, your doctor will advise you as to how long you should wait before vitrectomy surgery is considered.