Contributing Editor: Debbie Sokol-McKay, OTR/L, CVRT, CDE, CLVT, vision rehabilitation therapist, diabetes educator, low vision therapist, and licensed occupational therapist

The first step in any treatment for diabetic eye disease is to maintain blood glucose, blood pressure, and blood cholesterol levels as close to normal as possible. Other options for treatment are the following:

Laser treatment

This technique is used by retinal surgeons to treat a number of eye conditions, one of which is diabetic eye disease. A beam of high-intensity light is directed into the eye to seal off leaking blood vessels and prevent additional blood and fluid from leaking into the vitreous. The doctor administers eye drops to dilate the pupil and numb the eye before treatment begins.

Because lasers cannot restore lost vision, it is critical to maintain regular eye examinations so that treatment can be initiated as soon as diabetic eye changes are detected. There are two types of laser treatments for diabetic eye disease:

• Scatter laser treatment for proliferative retinopathy.
• Focal laser or grid laser treatment for macular edema.

Eye Injections

Retinal surgeons have recently started using medication that is injected into the eye to treat certain types of diabetic eye disease. One type of medication is a steroid to reduce inflammation and another type of medication, which was developed initially for the treatment of wet macular degeneration, helps stop the abnormal blood vessels from growing.

The eye injection is done in the retina specialist's office and is usually painless. Often, drops are given before and after the injection to prevent an infection from developing.

Vitrectomy

This surgical procedure removes blood and fluids that have accumulated in the vitreous as a result of retinal bleeding, and is performed under local or general anesthesia. During a vitrectomy, the doctor makes an incision in the eye and uses a small instrument to remove the vitreous gel that is clouded with blood. The gel is then replaced with a saline (or salt) solution.