Retinopathy

[bonerp]

Hi all,
I have been having a problem with bleeds lately. For prob the last 6 yrs I've had laser treatment but last year was the first bleed.

however since 29th Aug I have now had 4 bleeds, the last one last night. I went to Swindon GWH last week and unsuprisingly the said I need to go back for more laser on 1st Oct. I'm pretty annoyed they left it as I feared another bleed would occur. This one has been slightly more significant than the others.

Now, I was put on a pump in Jan and there was a fear that within the first 3-6 months my eye problem might get worse before it gets better so the nurse tried to get me under control gradually. Now I have managed quite good control, last HBA1c went up slightly to 8.9 but is to be expected when starting a pump apparantly) but latest averages look to be around 7.3 according to my test result averages. I will get a HBA1c done next month to check.

So, anyone have any ideas why so many bleeds lately? Previously 3 months ago another check up looked good so it has come a bit unexpectedly. I'm really quite disappointed and worried now.

Is there anything I can do to minimise further damage ? I think I read somewhere that a short term high dose (1200-1500mg) of vit E can help stop further bleeds until things are corrected.

I'm stopping the aspirin temporarily too.

At the moment all I can see is lots of bloody lines and hazyness.

Also when it bleeds is there anything I should do - or rather do nothing!?

thanks
Paul

 

[Katharine]

The only thing I can think of is are you doing anything that could aggravate the bleeding eg jarring activities, heavy weight training, yoga postures with your head down eg shoulder stands?

 

[bonerp]

Nope - I do weight training but not for over a week!

At the time I leant forward to pick up my trainers!

Not happy that hospital have delayed laser by a week since eyes were checked last week. If Id had it done then this wouldnt have happened. Needless to say I've lodged a complaint.

Paul

 

[johnoswaldallan]

Hi Bonerp
I posted something similar on 6th May. As soon as I started to low carb (20-30 grams of carbohydrate per day) I started to get near normal B’S’s. I also managed to more than halve my insulin intake. I was need less to say overjoyed at these results. I then started to get bleeds in the eyes that I was aware of, quite often after a fit of sneezing or coughing a big blob would appear in my eye it would change shape and then more often than not disappear. The first time it happened it frightened the living day lights out of me and I got an appointment to see an ophthalmologist who told me I would need extensive laser treatment. I then found out that if you stabilise your B,S to quickly this is very likely to happen. I was constantly being told by the eye clinic how important it was to maintain good B,S’s but they didn’t bother to mention that if you do it too quickly it will exacerbate the condition. I have quoted a couple of paragraphs on this subject and the link I got them from below.
A sudden improvement (lowering to normal) of glucose levels in a person whose diabetes has been poorly controlled for sometime may cause rapid and often uncontrollable retinopathy. This is a very common problem in clinical practice. Good diabetic control is essential in the long term, but unfortunately in the short term may cause a rapid deterioration in retinopathy. A lot of laser may be needed, and usually stabilises the condition.
A typical scenario: a patient has poorly controlled diabetes (HbA1c 9%) for many years, and gradually develops retinopathy. She may have mild retinopathy, is told how important it is to control her retinopathy, and then becomes very frightened, starts to control the diabetes very well, and the retinopathy starts to get rapidly worse. She develops macular oedema that becomes diffuse and will not respond to laser. Gradually the retinopathy becomes under control but there will have been permanent macular damage and her sight is markedly reduced.

http://medweb.bham.ac.uk/easdec/retinop ... ession.htm

As a matter of interest I declined the offer of “extensive laser” treatment, as I wanted to see how things pan out. I have had several bleeds since May (which I have become quite blasé about) they usually disappear quite quickly and luckily I have not had much happen for about six weeks. My GP who agreed with me not rushing in to laser treatment did say that although the bleeds that you are aware of can be quite disturbing but they are not as bad as the bleeds at the back of the eyes. I do hope it works out well for you.


Regards

John