Thought I'd paste a copy of an email I wrote to someone after they posted about retinopathy on another forum I use (not diabetes related!). His girlfriend had just been told they'd found changes at a routine screening appointment. It's general background as well as my experiences of extensive treatment.
I've been diabetic (type 1) for 26 years, and have retinopathy in both eyes. I've had treatment for it over the last 5 years or so.
In summary:
It's treatable, though scary.
Good control of blood sugars helps control the retinopathy, though beware of rapid changes in control (starting on a pump is initially what triggered mine - very rapid improvement in control).
If the objects have been found at the routine screening then it's likely they're not yet at a stage to cause direct damage to sight. Initially the consultant may decide not to treat anything but to keep a close eye on developments and review the progression over the next few months or year - it depends on the severity of what was found.
Treatment is likely to involve many 100s of laser burns put onto the retina. This cuts off the tiny blood vessels that are likely growing where they shouldn't be at the back of her eye. The laser treatment is done while she's awake, with a local anaesthetic drop applied to the eye. I recommend taking ibuprofen or paracetemol an hour or so before the appointment, and expect the eye to feel gritty and slightly sore for the rest of the day. She would also have the drops that dilate the pupils for it too.
She may find at some point that she experiences a haemmorhage within her eye. This is VERY scary but again is treatable. It's not immediate or short term, but the blood does clear over time - a small bleed can clear within a week or so, a large or recurring bleed may take months. If she does experience a bleed, she needs to see her consultant or emergency eye unit as soon as she can. They will normally check her vision for any blurry or blank patches. There's nothing she can do at the time to prevent or minimise the bleeding, it's just a case of riding it out I'm afraid.
If she goes on in the future to experience heavy bleeding that doesn't clear, she may be recommended a vitrectomy. I had one of these (in one eye only) 2 years ago. Under a general anaesthetic the surgeon cuts into the eye, removes the gel from inside it, performs more laser surgery, replaces the gel with saline and stitches it all up. It's a day-surgery case and I was home later the same day. I had a month of antibiotic and other eye drops and while awake I had to stay upright to prevent my retina wrinkling. There are different positions you are given - either lying flat, on one side, and so on depending on retina condition.
One complication I was warned of with vitrectomys is that they are likely to cause early cateracts (within about 5 years of the surgery). It's a small price to pay for having good vision again and doesn't happen to everyone - I seem to have escaped this.
She will have to notify the DVLA once she has had laser treatment for retinopathy (assuming she holds a driving license), the DVLA may send her for a field vision test, this involves looking into a machine and pressing a handheld buzzer thing when she sees a small green light flash up. After 5 years treatment and over 3000 laser burns on each eye I still hold my driving license - I hope that's reassuring!
