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What is diabetes?
Diabetes is a chronic disease that occurs when the pancreas is no longer able to make insulin or when the body cannot make good use of the insulin, leaving sugar (glucose) in the bloodstream. These elevated glucose levels affect the microscopic blood vessels in the eyes, kidneys and limbs. Diabetes is classified into type 1 and type 2. A strict follow-up of the disease is essential. This follow-up must be insured by your GP or your diabetes specialist. Aside from a strict diet, medicinal therapy will often be required.
Diabetes and the eyes
No diabetic retinopathy
Diabetic retinopathy: diagnosis
What to do if you suffer from diabetes?
The chances of developing diabetic retinopathy increases the longer a patient suffers from diabetes or if the disease is not properly controlled. The ability to keep sugar levels in check will largely depend on the extent to which the patient sticks to his diet and a closely monitored drug therapy. That being said, there are a number of risk factors that accelerate the onset of retinopathy:
- High blood pressure: it is essential that patients suffering from diabetes keep their blood pressure under control. More often than not, patients will need to take medication.
- Rapid transition to insulin
Regular screening tests by an ophthalmologist are crucial for any patient suffering from diabetes. Screening will involve a fundoscopy and, if necessary, a fluoangiographic examination.
Patients suffering from diabetes, type 1 will need to have a first screening five years after the initial onset of diabetes. In the case of type 2 diabetes the first screening must take place within the first six months of the diagnosis. In function of the damage to the retina, the ophthalmologist will screen the patient either on a biannual or on an annual basis.
It is extremely important that the patient sticks to his diet and religiously takes his medication. Also risk factors such as hypertension must be monitored. Patients often underestimate the importance of this.
During laser treatment, a powerful beam of light (laser) is directed at the retina. The beam cauterises the micro-blood vessels to stop the leaking and stabilises the patient’s retinopathy. Different types of laser treatment are available, i.e. local or focal laser treatment and the more extensive panretinal photocoagulation laser treatment. Diabetic retinopathy is treated in our consultation rooms. In other words, it is not a surgical procedure but a treatment.
Focal laser treatment
This laser treatment is used to cauterise minor leakages. It is especially indicated for patients who have developed diabetic maculopathy. Cauterising these leakage points stops fats, blood or fluid leaking from the blood vessels. As this treatment is performed at macula level, extreme precision is required and the patient’s cooperation will be essential. In most patients, this treatment will stabilise the condition. A number of patients will see their visual acuity improve.
This extensive laser treatment is used to treat the lack of oxygen in the retina in cases of pre-proliferative and proliferative retinopathy. Once the lack of oxygen has been addressed, no more new blood vessels will form (neovascularisation) and the risk of the retina scarring will have been halted. In this particular treatment, the whole retina, with the exception of the centre, is treated. This particular treatment is performed over several sessions in our consultation rooms.
This surgery is indicated when laser treatment is unsatisfactory. It is used for patients who have suffered a vitreous haemorrhage because the blood makes laser treatment impossible. A vitrectomy is also indicated if neovascularisation of the retina is in an advanced stage or if the retina is showing signs of scarring. In that case, this neovascularisation and scarring will have to be surgically removed.
The first step in a vitrectomy is creating 3 microscopic incisions in the eye’s sclera (= white outer layer of the eyeball). These incisions are required for the surgeon’s instruments. Via the first incision, the eye is infused with water to ensure that it retains its shape during surgery. Next, the endolight is inserted via the second incision so that the surgeon can see everything clearly. The vitrectomy probe is inserted via the third incision. This probe is a tiny tube that cuts away and suctions microscopic particles of the vitreous. The vitreous that has been removed is replaced with clear water. The neovascularisations and scarring are moved with tiny tweezers. The retina is also treated with the endolaser so that the progression of diabetic retinopathy is halted for good.
Personal advice from our experts
Our highly specialised surgeons thoroughly examine your eyes and make a detailed diagnosis. They discuss all the options with you in all objectivity.
Personalised eye care
Each eye has its own unique profile, just like your fingerprints. This is why we apply the ultra-personalised topo-guided technique.
We continuously invest in the latest, most reliable technology. We have the most comprehensive and modern technological platform for laser eye treatment and lens surgery.
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Our laser centre combines experts in their field with a warm welcome in a stylish setting so that you get to have your treatment in all peace and comfort.