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Laser Surgery - is it needed?

J

jm619

Newbie
Messages
2
Type of diabetes
Type 1
Treatment type
Insulin
Hi,

I'm 40 years old and have been type 1 diabetic for 30 years. About 2 years ago, I attended a DAFNE course, and since then have seen my HBA1C improve from in the 8%'s and 9%'s to my most recent result of 6.7% (which I was chuffed with).

For a few years now, I've been attending an opthalmologist clinic because very early changes to my eyes were detected. However 2 years ago, the opthalmologist told me that those changes had reversed themselves.

A week ago, during my most recent appointment, a different opthamologist told me that although there was no bleeding, there seemed to be a bit of 'goop' that had leaked from a vein in my eye, and that he recommended a 'bit of gentle laser therapy' (his words) to sort it out. I've been booked in to have laser surgery in a week's time.

I'm concerned that this all seems to have been done very quickly, and without much explanation. From what I read online, laser surgery is only done when things have got pretty bad. But I'm not being given the impression that things have got that bad. I know I'm not an expert, but at my stage of progression, would I expect for things to be monitored rather than lasered?

My control has got better lately. I know that this can lead to a progression of retinopathy for a while. But my control has only tightened by about 1.5 %/year for the last 2 years - everything I read online says that shouldn't cause much of a problem.

Am I being unreasonable that I'm not sure what's going on, and seek a second opinion? Or should I just accept the advice I'm being given and go in for the laser?

Thanks for any useful advice.
 
I don't think you are being unreasonable if you don't know what's going on but shouldn't you ask the people treating you currently? A second opinion could be equally unclear.

If you are hoping for a different result or a result more agreeable to you then you could be disappointed.

Still, if you think you can improve your circumstances then ask away until you understand your problem to a degree where you can make an informed decision.

Good luck. I hope all goes well for you.
 
I am having similar experiences in that my ophthalmologist thinks I am not intelligent enough to understand a detailed description of the state of my eyes, currently only referable maculopathy.....

I would go back and ask for a better and clear explanation of what has actually happened in your eye, why it has happened and what it means for the future health of your eye............

does any risk from the laser out weigh the consequence of the leak for example.......

good luck.......:)
 
Please ask for a second opinion. I speak from experience. I had one so called consultant ophthalmologist who swore blind I had every eye condition under the sun and was going blind and to save my sight she was going to have to laser my eyes.
I was shocked beyond belief as had always been clear of any problems. Two separate surgeons also operated on my eyes for cataract surgery and said I had no eye damage, There was nothing showing on any scans either yet this bleeping woman kept on saying I was going blind. Have seen yet another consultant and had more scans taken still no damage can be found. His conclusion was that the original consultant was expecting to find problems due to the length of my diagnoses (49.5 years) Couldn't find any so kept looking until she convinced herself there was a major problem.
I had a very lucky escape as could have lost a lot of my vision if I had allowed her to laser my eyes.
So 3 surgeons and 3 ophthalmologists said no problem and one says there is.
I dread to think how many people she has lasered due a wrong diagnoses. The hospital has closed ranks though and it's all been covered up.
 
I can't advise you, but I can share my husband's experience. Our local NHS hospital, seemed to be getting rather trigger happy with the laser gun. It was rare to see the same person twice and each one seemed to want to "have a go" and be following their own agenda. Nothing made sense from one consultation to the next and, despite consistent non-diabetic numbers, yet another laser treatment was booked in. It was all quite upsetting.
We are in the fortunate position of being able to go private, from time to time, so, within a few days, James was seen by the top chap in the area, at the local private hospital. HIs verdict: no need for any more laser at present, keep an eye on things, come back in three months, well done with the blood sugar numbers, carry on with the low carb diet. Now, lets face it, he could have taken a grand off us for private laser, so this was an honest answer. Three months later, a second, follow up, private appointment and the same answer, damage is gradually reversing and nothing needs doing.
I did ask, as the great man is also the top man at the NHS hospital, why there were differences in opinion. His answer was on the lines of, so many people don't turn up for NHS laser and eye appointments that, some doctors take the view that if they have got you in there, they do some laser work, while the chance is there. Terrifying!
As far as I can remember, the private consultations cost around £100 each, for which you get a half hour appointment, treated as an intelligent individual and the time and chance to ask any questions you like. To us, it was money very well spent, but I appreciate, not available to all.
So I will now advise you. Take any means available to you to get a second opinion.
Sally
 
Laser treatment is a timely intervention to try and prevent potential sight loss.

Having had maximum laser treatment on both retinas, I was told by both consultants who treated me that the decision to laser is based on clinical guidelines, it isn't a random decision made due to lack of patients to treat. It is a treatment to permanently seal off leaking vessels in a small area of the retina in the hope of protecting vision in the vast majority of the retina.

If you are unsure of why you have been told laser is necessary I would ring the ophthalmology clinic or the Consultant's secretary and express your concerns.
 
A 'goop' can only mean a bleed if it's coming from the vessels in the eye, so laser surgery to seal off the source of the bleed will hopefully prevent it from bleeding further, Ophthalmologists don't take these decisions lightly to laser someone's eyes and they will only do it in the best interests of the patient.

But if you are still unsure then certainly ask for a second opinion, on the day of the laser surgery you probably won't go straight into the laser room anyway and should have the opportunity to speak with the Ophthalmologist beforehand, hopefully then they will explain to you why there is a need to laser your eyes, after that you can then decide to go ahead or not.

The 'gentle laser surgery' that the Ophthalmologist said will probably just mean a few hundred laser burns which will only take a few minutes, if you do go ahead just be sure to take some dark glasses with you as bright lights can make vision unbearable for a few hours after the surgery, and it goes without saying that you should not drive until your vision has returned to normal.

The following website has a wealth of information on diabetic retinopathy, have a good read around as it has loads of advice that you may find useful in controlling this condition, such as keeping your bg, bp and cholesterol levels in check:

http://www.diabeticretinopathy.org.uk/Information_for_patients.html
 
Thanks for your responses so far, everyone.

A quick update - I managed to speak to a nurse at the clinic, who went through the notes with me. The 'gloops' that were mentioned were exudates, rather than actual bleeds.

So my question is, is laser surgery for exudates common? The ophthalmologist said yesterday that these 'gloops' were quite a long way from the centre of the eye, so the risk of laser surgery causing further problems was quite small.

Thanks in advance.
 
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