Having diabetes not only requires maintaining blood glucose at a normal level but also avoiding its complications. One of the most common complications is diabetic retinopathy, an eye condition that causes vision loss or blindness when the blood vessels in the retina, the light-sensitive layer of tissue at the back of the eye, are damaged due to a high concentration of glucose in the blood. In the U.S., more than 2 in 5 people with diabetes experience diabetic retinopathy.
At the early stage, diabetic retinopathy does not manifest alarming symptoms. Some people may experience trouble when reading or difficulty seeing objects from afar, which may come and go. The damage to the eyes starts when sugar blocks the tiny blood vessels connected to the retina. As a result, the eyes will grow new blood vessels that don’t work properly, causing them to leak or bleed easily.
People with Type I, Type II, and gestational diabetes (a type of diabetes that occurs during pregnancy) are at risk for developing diabetic retinopathy. According to a review article by Sabrosa (2009), almost 100% of patients with Type I diabetes experienced signs of diabetic retinopathy after 20 years. The same is for more than 60% of patients who have Type II diabetes. However, the risk is higher for those who have had diabetes for a long time, have high cholesterol and high blood pressure, and smoke regularly.
If you have diabetes, experts suggest getting an annual dilated eye exam to help protect your vision. But if you are already diagnosed with diabetic retinopathy with leakage or bleeding present, certain surgical treatments are available. The two most common treatments are laser photocoagulation and vitrectomy surgery.
During the laser treatment, the retinal surgeon targets reduction of swelling in the retina by sealing off blood vessels to stop them from leaking. This also helps shrink the blood vessels and prevent them from growing abnormally again.
For some patients, the bleeding can result in vitreous hemorrhage, where blood may accumulate in the center of the eye. When this occurs, vitrectomy surgery will be required to restore the vision because the blood clot blocks the laser from reaching the damaged areas. This procedure may also be necessary when there is retinal detachment caused by the abnormal blood vessels that grow into the vitreous gel. This type of surgery involves the removal of the vitreous from the eye using a suction tool.
After the surgery, your eye may be swollen and red for several weeks. In general, the full recovery process takes up to 6 weeks, but vision typically improves in about a week. After the surgery, some people may go home the same day, while some may be asked to stay overnight in the hospital. Here are some tips to help patients recover quicker and manage the pain and blurry vision:
After-surgery activities to avoid
- Driving: Immediately after the surgery, your vision may become blurry. Find someone to drive you if you need to go around in the next two days following your surgery to avoid getting into a car accident.
- Taking a shower: Taking a shower might cause water to enter your eyes. Exposure to water increases the risk of infection or irritation until your eyes have completely recovered from the surgery. Experts recommend using a bathtub from two days onwards following the surgery. The same goes for other activities like swimming which could expose the eyes to water.
- Putting on makeup: Avoid any form of chemicals such as makeup and soap to get into your eyes as this may cause itchiness, and rubbing the eyes may lead to irritation and infection.
- Smoking: While your doctor may ask you to take a break from smoking before the surgery, the same applies during the post-surgery recovery period. This is because smoking delays the healing process and increases infection risk on the wounded site due to a distorted immune system.
- Heavy physical activities: Sports, working out, and other high-impact activities should be avoided for up to two weeks or until the wound has healed. Spikes in the heart rate can raise eye pressure, which delays healing.
Other care tips
- Put an eye patch or shield when sleeping for the first three nights post-surgery to avoid touching the eyes directly while sleeping. Accidentally touching or rubbing the eyes may lead to irritation or infection.
- Wear dark glasses when going out in the day or looking at a bright light as your eyes will most likely be sensitive to light. This may take a few months after the surgery. When watching TV or using the computer, you should take a break from looking at the screen every 20 minutes to avoid bright light exposure and strain your eyes.
- Use eye drops to speed up the recovery. Eye drops can reduce swelling and avoid eye infections. In case you forget or run out of eye drops, putting an ice or cold pack over the eye can also ease the swelling.
- If your eye surgeon used a gas bubble to hold the retina in place during vitrectomy, keep your head in an upright position as much as possible for about 1 to 3 weeks after the surgery. Lying on your back may cause the bubble to move to the front of your eye and create pressure against the lens. Taking the airplane should also be avoided in this case because the bubble expands at high altitudes, creating pressure inside the eye.
- You can resume eating your regular diet right after the surgery, but if you have an upset stomach, try bland, low-fat foods such as broiled chicken, plain rice, toast, and yogurt.
- Take some time off work. The time off from work depends on your type of job. Ask your doctor when exactly you can resume working.
- Be sure to go to all your post-surgery doctor’s appointments.
If you consider getting your diabetic retinopathy treated, contact Arizona Retinal Specialists. Its eye doctors can help restore your vision and guide you all the way to recovery.