[fgummett]

Originally Posted by Stacman

Fortunately, during my eye exam on Tuesday the retinopathy examination showed no damage caused by diabetes, even though I'm blind as a bat at the moment...

Glad to hear the no retinopathy... my eye specialist advised me to take a daily multivitamin to help protect my eyes... I'm not sure it helps but I don't think it can hurt.

[belyro]

Originally Posted by fgummett

One of the (many) complications of Diabetes is retinopathy... which can be caused by a proliferation of extra blood vessels in the eye. These extra vessels tend to be fragile and bleed easily. Laser is often used to cauterize these little bleeders.

Just to clarify (and I realize I'm splitting hairs here)....

In my case, the laser treatments for Proliferative Diabetic Retinopathy were not to cauterize bleeders, they were essentially to kill off the less important parts of my retina so that these parts wouldn't need as much oxygen, and the oxygen in my eye can be directed to the important central part of my eye (i.e. the macula). This is why people who have this type of laser treatment often lose some of their peripheral vision. The result of the treatment, if all goes well, is that the brain sees that the macula is getting enough oxygen and stops sending signals to produce new (weak) blood vessels - i.e. proliferation.

Sorry to nitpick.

[xMenace]

Bethany, I think it is important to understand what's happenning. There is a significant sacrifice made, and the more you know about it, the better decision you can make. Though IMO the decision to get it is a no-brainer.

It's an interesting condition. Here's an explanation in point form.
- eye vessels are tiny and most susceptible to damage
- vessels grow from optic nerve and branch out around the eye
- damaged vessels result in the periphery not getting enough food
- starving tissue releases proteins that tell the brain "feed me!"
- body responds by growing new blood vessels to supply dying tissue (neo-vascularization)
- vessels do not grow around the eye but into it never reaching their target.
- eyes don't get fed
- vessels grow
- repeat: proliferation!
- vessels are unsupported and weak
- vessels eventually bleed
- scar tissue builds on retina
- scar tissue is inherently unstable and damages weaker retina resulting in tearing
- by now it's pretty hard to see

Because of their position in the optic nerve and macula, zapping them is too dangerous. The most useful central vision areas are immediately damaged by doing this.

The standard way to stop this cycle is to kill off the starving tissue - it will die anyway - using a technique called pan-retinal photocoagulation. This sacrifices some peripheral vision for prolonged macular health. After killing a bunch of tissue, the proteins stop, and the new vessels shrivel up, hopefully. Sometimes they don't and end up bleeding anyway. My laser started in 1994 and I hemmed in 2006 followed by a vitrectomy.

These pics show the pattern.



photocoagulation - Google Search

[fgummett]

Originally Posted by belyro

In my case, the laser treatments for Proliferative Diabetic Retinopathy were not to cauterize bleeders, they were essentially to kill off the less important parts of my retina so that these parts wouldn't need as much oxygen, and the oxygen in my eye can be directed to the important central part of my eye (i.e. the macula). This is why people who have this type of laser treatment often lose some of their peripheral vision. The result of the treatment, if all goes well, is that the brain sees that the macula is getting enough oxygen and stops sending signals to produce new (weak) blood vessels - i.e. proliferation.

Thanks Bethany... I am so glad you did clarify this. I was only going by what little I know and I was hoping someone who knew more would jump in. I realised even as I wrote the above that it sounded clinical and all too simple... not really doing justice to the reality or seriousness of retinopathy at all. I learned from what you have shared as well. Thanks and to John as well

[xMenace]

Originally Posted by fgummett

I was only going by what little I know

As Bethany and others can attest, it is a very stressfull situation. When it was my turn, my optho told me most of this. I was shocked that I was going to possibly lose some vision. I had no knowledge of this condition and I had two days to make a decision about it. The look of panic when I asked if I really needed this is imprinted firmly in my brain. It was gut wrenching. I now know a lot more about the procedure and retinopathy in general.

[RobiJo]

I didn't know anything about retinapathy or treatments either. I'm not sure that if I'd have known I would have changed my irresponsible college years or not, as hindsight is always 20/20 or even 20/10! I agree with John that it was an extremely stressful time and very scary. I still can't speak about it verbally without choking up, and it's nice to have folks in an online world that know exactly what I mean. I wish I would have found this forum during the process instead of after, I could have used the information then. But as it goes, better late than never.