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<blockquote data-quote="Dark Horse" data-source="post: 2211859" data-attributes="member: 52527"><p><span style="font-size: 22px">Using laser treatment to treat severe diabetic retinopathy is a trade-off - some peripheral vision and night vision is sacrificed to try and maintain the central vision that is important for tasks such as reading, watching television or looking at people's faces.</span></p><p><span style="font-size: 22px"></span></p><p><span style="font-size: 22px">Just to explain: -</span></p><p><span style="font-size: 22px">When the small capillaries in the retina have been badly damaged by high blood glucose levels, they start closing down and can no longer supply enough blood (and therefore nutrients) to the surrounding retina. The retina responds by producing VEGF (vascular endothelial growth factor) which causes new blood vessels to grow. Unfortunately, these blood vessels are very fragile and can rupture which leaks blood into the eye (vitreous haemorrhage). This blood obscures the retina, causing visual loss, until the blood clears, either naturally (over a period of months) or during a vitrectomy operation.</span></p><p><span style="font-size: 22px"></span></p><p><span style="font-size: 22px">PRP (pan-retinal photocoagulation) laser destroys parts of the retina in order to stop them from producing VEGF. This reduces the risk of further sight-loss from more new vessels growing. PRP laser is targeted in the periphery (edges) of the eye, leaving the central part clear to preserve central vision. Ophthalmologists try to use the minimum effective dose as they are well aware that too much laser damage in the periphery can mean that people may lose their driving licence if their peripheral vision is too bad. However, sometimes the diabetic retinopathy is so advanced that the maximum amount of laser needs to be given, thereby sacrificing peripheral vision in order to maximise the chances of preserving central vision.</span></p><p><span style="font-size: 22px"></span></p><p><span style="font-size: 22px">Unfortunately, despite the best treatment, the diabetic retinopathy can be so bad that the central vision also becomes poor. At this point, becoming registered as SI (sight-impaired) of SSI (severely sight-impaired) can be useful as it makes various benefits available. <a href="https://www.rnib.org.uk/eye-health/registering-your-sight-loss" target="_blank">https://www.rnib.org.uk/eye-health/registering-your-sight-loss</a></span></p><p><span style="font-size: 22px"></span></p><p><span style="font-size: 22px">I understand that you may feel that the treatment process has failed you but I would urge you to still attend your ophthalmology appointments. One possible consequence of having had new vessels is a retinal detachment. Although an SSI registration means that your vision is poor, it is still useful vision. A retinal detachment could lead to a complete loss of sight. Your ophthalmology department may have an ECLO (eye clinic liaison officer) and it would be worth talking to them - they are often better at explaining things in laypersons' terms than the ophthalmologists are.</span></p></blockquote><p></p>
[QUOTE="Dark Horse, post: 2211859, member: 52527"] [SIZE=6]Using laser treatment to treat severe diabetic retinopathy is a trade-off - some peripheral vision and night vision is sacrificed to try and maintain the central vision that is important for tasks such as reading, watching television or looking at people's faces. Just to explain: - When the small capillaries in the retina have been badly damaged by high blood glucose levels, they start closing down and can no longer supply enough blood (and therefore nutrients) to the surrounding retina. The retina responds by producing VEGF (vascular endothelial growth factor) which causes new blood vessels to grow. Unfortunately, these blood vessels are very fragile and can rupture which leaks blood into the eye (vitreous haemorrhage). This blood obscures the retina, causing visual loss, until the blood clears, either naturally (over a period of months) or during a vitrectomy operation. PRP (pan-retinal photocoagulation) laser destroys parts of the retina in order to stop them from producing VEGF. This reduces the risk of further sight-loss from more new vessels growing. PRP laser is targeted in the periphery (edges) of the eye, leaving the central part clear to preserve central vision. Ophthalmologists try to use the minimum effective dose as they are well aware that too much laser damage in the periphery can mean that people may lose their driving licence if their peripheral vision is too bad. However, sometimes the diabetic retinopathy is so advanced that the maximum amount of laser needs to be given, thereby sacrificing peripheral vision in order to maximise the chances of preserving central vision. Unfortunately, despite the best treatment, the diabetic retinopathy can be so bad that the central vision also becomes poor. At this point, becoming registered as SI (sight-impaired) of SSI (severely sight-impaired) can be useful as it makes various benefits available. [URL]https://www.rnib.org.uk/eye-health/registering-your-sight-loss[/URL] I understand that you may feel that the treatment process has failed you but I would urge you to still attend your ophthalmology appointments. One possible consequence of having had new vessels is a retinal detachment. Although an SSI registration means that your vision is poor, it is still useful vision. A retinal detachment could lead to a complete loss of sight. Your ophthalmology department may have an ECLO (eye clinic liaison officer) and it would be worth talking to them - they are often better at explaining things in laypersons' terms than the ophthalmologists are.[/SIZE] [/QUOTE]
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