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Vitreous Hemorrhage/PDR

Discussion in 'Diabetic Retinopathy' started by Frankf300, Sep 6, 2019.

  1. Frankf300

    Frankf300 · Newbie

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    Hi all! I’m from the US, but decided I had to post here because I haven’t found any other forum as active as this one! So some things may be different regarding how healthcare works, etc. I’m wondering what other people have experienced when dealing with bleeds that are visible. Quick history: I’m 29 and control has always been a rollercoaster for me, but I’m trying my best. In November of 2018 a floater in my eye got me nervous and I rushed to the Dr. Was diagnosed with moderate NPDR with macular edema in both eyes. Had 1 round of micro pulse laser done in each eye. My left eye is better and has perfect vision. The laser did improve my right eye a little as I did make progress on the chart and I know laser does not promise any improvement at all. Right eye is not what it once was, but it’s still good vision.

    At my last follow up I was told it had moved to proliferative in a matter of no time. Here’s where I’ve found a HUGE difference between US and UK. The doctors here LOVE to push anti-VEGF. My problem and it’s embarrassing and makes no sense even to myself considering I do daily injections since 4 years old is that I have severe anxiety when it comes to needles. I couldn’t even stand him talking about the treatment, it’s really bad and controlling what I choose for treatment. He wanted to treat my edema with injections and I refused that’s the only reason I had micropulse done.

    Now I have a bleed in my left eye which has me petrified because it’s my better eye. But I’ve read horrible stories on here that the hemorrhage basically blocks all vision. That is not the case for me at all. I have a spider like shape in the upper left corner of my vision. It moves with my eye movements. Dark blob like a body of a spider and than legs coming off of it which are thinner and more transparent. That’s all I see when inside, but once I step outside into sunlight I see hundreds of tiny little spots all over my vision. Still quite transparent though. Almost like a very thin layer of dust on a lens. My visual acuity has not suffered and I can still read and see but with this dancing spider in the corner. The oddest thing to me is that even with my eyes closed I can still see it dancing around!

    I called my Dr and he told me it must be a bleed and to come in within a week. I now have an appointment set up with a new Dr who is said to be much more thorough with his patients and is willing to listen to their concerns. My other Dr is very set in his ways and would not take the time to explain anything to me or understand how I was feeling and he’s still pushing anti-VEGF for the PDR.

    I’m sorry this post ended up so long I am just petrified of where it all goes from here. It absolutely kills me than an anxiety is so bad that it’s making life changing decisions for me and I don’t know what’s normal and what’s not with this bleeding! Thank you to anyone who reads this novel and has any input lol. :)
     
    • Hug Hug x 2
  2. mr_cat

    mr_cat · Well-Known Member

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    Sorry to hear about your troubles i have a great deal of sympathy for what you are going through.
    Needle phobia indeed does not help, myself the thought of lasers in the eye would worry me more.
    I have had plenty of anti vegf injections and they seem to work well.
    I concur with your doctor about this.
    I wont lie the first time i had the procedure i was very very tense about it.

    Here is my description of the procedure i gave from another thread on this:

    Make sure you insist they wash out all the iodine after the procedure.
    I am very sensitive to iodine , the first time i had the procedure once the anaesthetic wore of it was as my eyes were filled with broken glass for hours, not nice.
    The procedure itself is not painful , but it is not exactly relaxing!
    The process is lots of drops of anaesthetic and antibiotics [the a for mentioned iodine] into the eye , when numbed the eyelids are help open with a clip you are then asked to look sideways or up at a target [the doctor will keep you informed what is going on all the time so no surprises] the injection itself feels like a pressure and brief ache , you will even see the liquid go in.
    After the injections you may see black dots which are bubbles these go in a few hours.
    Your vision may blur completely after 10-15 mins ,it varies with me longest i had was first time near 2 days last one it never got fully blurred.
    Do ensure you have transport available to get you home after the procedure as driving is a no no.
    Obviously the above is only my own personal experience .

    I hope the above info helps. please try to build up your resolve to go ahead with this procedure it leaves no scaring on the retina and is very low risk.
    Good luck:)
     
  3. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    I believe the licensing and treatment criteria between UK/US is different. My understanding is that in the UK, anti-VEGF prescriptions are more rigorously scrutinised, with laser being the default treatment.

    All that aside for a moment, if you can overcome the anxiety of the procedure then I think you'd be well advised to opt for the anti-VEGF. Speaking from experience, I won't sugar coat it - it's not pleasant. But personally I found laser treatment painful, and more uncomfortable than the injections. Anti-VEGF is more of a psychological hurdle.
     
  4. Dark Horse

    Dark Horse · Well-Known Member

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    Although the haemorrhage does not obscure your vision at the moment, unless the new vessel growth is treated, you may get further bleeds that do.

    This page discusses both anti-VEGF and PRP laser treatment for proliferative diabetic retinopathy:-
    http://www.diabeticretinopathy.org.uk/proliferative.html
    This article discusses anti-VEGF versus PRP (free sign up):- https://www.medscape.com/viewarticle/901310_1

    You need to discuss the pros and cons of each treatment with your ophthalmologist. It may be that they are prepared to give you PRP as an alternative to intra-vitreal injections. (In the UK, PRP is currently the preferred treatment.)

    If you decide that anti-VEGF injections would be the best treatment for you, you could ask about getting treatment for your anxiety to allow you to undergo the necessary procedure. However, treatment needs to be soon as there is currently a risk of further haemorrhage.

    Information leaflet re PRP laser:- https://www.swbh.nhs.uk/wp-content/uploads/2012/07/INTRANET-ML5542.pdf
     
  5. PenguinMum

    PenguinMum Type 2 · Well-Known Member

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    @Frankf300 I also have had a course of 3 antiVEGF injections this summer and of course I was anxious about the first one. The thing you need to know is that the needle bit only takes seconds. Its mostly about drops, washing out, etc. I am allergic to Lobster (only) so I dont have iodine drops I have preservative free drops. Thats another consideration for you. My sight in affected eye has improved incredibly so I do recommend this treatment. I hope you will find a way through. Best wishes.
     
  6. Frankf300

    Frankf300 · Newbie

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    Went to see my retina specialist this morning. My eyes have gotten very bad. Severe proliferative in both eyes, partial detached retina in both, macular edema in both, and vitreous hemorrhage. He explained everything to me in great detail and listened to what I had to say. He said this is very severe and needs treatment right away. He said in 2019 I can’t possibly recommended the use of laser for this when I know injections will not cause you damage like laser will. He said injections will also get your vision back! He has amazing bedside manner and made me feel at ease and luckily had my wife there to get me through it. They did gave me some Valium as a precaution. But I can officially say I’ve had my first eye injection! As everyone here said, it’s really not bad...you were right! I didn’t feel a thing. It’s a little sore now, but I can deal with that knowing that there’s still a good chance of seeing my kids and doing what I love for a long time. Take it from the guy who was sweating and trembling just sitting in the office talking about it, it’s not that bad! I guess I should be happy that it’s the method of choice here and since I have to use insurance in the US, that my insurance does cover this costly drug.
     
  7. PenguinMum

    PenguinMum Type 2 · Well-Known Member

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    Hi I am so pleased that you were able to have the anti vegf injection and coped. So well done on that. I dont know where your Diabetes is at right now but I was told by the eye specialist treating me that keeping BG levels low and blood pressure low were the best things to support eye health. If either of those things are a challenge take a look at LCHF which has reversed me and many others on this forum.
     
  8. Frankf300

    Frankf300 · Newbie

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    Thank you so much! I’m definitely going to check this out. My control definitely needs improvement so your advice is greatly appreciated!! :)
     
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