Frequently Asked Questions
Macular Degeneration Treatment FAQs
Why do I need to have these treatments?
Wet Macular degeneration is from abnormal blood vessels in the back of the eye at the center of vision. The abnormal blood vessel does not belong there, it is fragile, breaks, oozes blood and fluid. The blood and fluid cause distortion or blind spots in the vision. The medications close abnormal blood vessels and help them shrink away.
How does the medicine work?
The abnormal blood vessels need a special protein to form. The medicine “blocks” the special protein. If the blood vessel does not have this protein, the blood and fluid will dry up, the blood vessel will disappear, and the vision may improve.
What are the possible risks, or side effects of the treatment?
One in 250,000 chance of severe infection and a one in a million chance of severe bleeding or retinal detachment. In rare cases, the medicine may potentially affect your general health (see below).
Why does the doctor ask me about my general health, aren’t we talking about my eyes?
A microscopic amount of the medicine will leave the eye and enter the rest of your body through the bloodstream. The medicine affects all abnormal blood vessels, not just those in the eyes. If you have a history of heart disease, stroke, or blood clot, your retina specialist may choose a different medicine that may be safer for you. It’s very important to give the doctor a complete medical history, and to let her know about any changes to your health or changes in the medicines you take.
Will the treatment hurt?
The doctor and her assistants will give you eye drops to numb your eye for the procedure. You will feel a slight pressure sensation as the doctor prepares your eye for the medicine, but most do not feel the microinjection of medicine. Often people experience a dry and scratchy eye after having a treatment. We highly recommend using artificial teardrops every few hours after your treatment for the first day or two.
How many treatments will I need to have?
It’s different for every person. It’s very difficult to predict how many treatments a person will need. We will continue to give you the treatments until all the blood and fluid has cleared and the abnormal blood vessel has disappeared. If we stop treatment all together, 95% of the time, the abnormal blood vessel will return and the vision will decline. Most of the time, we can eventually limit the number and frequency of treatments and still protect your vision.
How often do I need to have the treatments?
We will start by giving you the treatments every 4-6 weeks. Often after several treatments, we can space out the visits farther to 6-8 weeks. If a person comes in after 8 weeks and their vision has declined, we ask them to return to 4-6 week intervals. If a person can go 8 weeks without losing any vision, then we will stretch the visits out farther to 8-10 weeks, and so on. Some people may only need to come in every 3-6 months to get a “booster” treatment. It is difficult to predict how each individual will respond to the medicine and your RSN specialist will tailor the treatment to your eye.
Why is it important for me to return when the doctor asks me to?
If you do not follow up for treatment in the given time frame, you may lose vision. Our goal is to keep you seeing well. If you do not return for treatment, you may have irreversible vision loss or blindness. Eventually, if left untreated, the abnormal blood vessel will form scar tissue. The scar tissue can cause permanent distortion or blind spots in the vision. We cannot treat or remove the scar tissue; it will cause permanent damage.
How do I know if the treatments are working?
The purpose of the treatment is to maintain and improve your vision. You should notice an improvement in your vision, or at least notice that it is not getting worse. Your RSN doctor uses certain measurements to track your progress. We use a picture test called an OCT to measure the amount of blood and fluid in the back of the eye. We also use another picture test called an FA or ICG to look at the leaky blood vessel in the eye. The FA / ICG shows the doctor exactly where and how much the abnormal blood vessel is leaking.
What if I don’t want to have the treatments?
It is always your choice whether or not to get the recommended treatment. It is your right to refuse treatment if you choose. Please understand that often the damage to the vision is permanent, and we may not be able to regain vision that has been lost. We strive to keep you seeing as well as possible, so that you can continue to live an active life and do the things that you enjoy.
Diabetic Retinopathy - The best treatment for diabetic retinopathy is PREVENTION
What is Non-proliferative Diabetic Retinopathy?
Diabetes damages the small blood vessels and causes bleeding, leakage of fluid, and lipids. This occurs in all the small blood vessels throughout the body but is readily visible in the eye. Diagnostic pictures using angiogram techniques can help determine the extent of diabetic eye disease and guide observation intervals.
What is Diabetic Macular Edema?
Swelling, lipid leakage, and bleeding in the macula caused by damaged blood vessels close to the central vision which can t cause a decrease in vision. If the central vision becomes impaired or is at risk, your RSN doctor may recommend medications to be placed within the eye to reduce the swelling. Laser treatment near the center area can also help close microaneurysms to reduce further leakage. Recent developments have greatly improved our ability to protect the central vision and improve it in most cases. Even so, this can require frequent treatment intervals.
What is Proliferative Diabetic Retinopathy?
When diabetes damages the blood vessels so much that the abnormal blood vessels begin to grow on retinal surface, this is called Proliferative Diabetic Retinopathy. This form of diabetic eye disease needs to be treated promptly. Peripheral retinal laser is used to stop the ischemic retina from signaling to produce abnormal blood vessels. Laser treatment can now be limited with the use of other medications that your RSN doctor may place in your eye. However, these medications are temporary and laser is needed to provide permanent stability.
Why is my vision getting worse after treatment?
If diabetic eye disease is treated late, it’s much more difficult to control. Sometimes your eye disease may worsen before it improves. It is common to require multiple types of therapy over longer periods of time. Patience and team effort between you, your diabetologist, and your RSN doctor can most often lead to stabilized, improved vision. In rare cases, the vision may deteriorate despite all of our advances. This is usually when care has been delayed and diabetes is uncontrolled.
Why do I have to keep coming back?
Diabetes and diabetic eye disease are chronic, meaning it’s long-term. It’s very important that your doctor monitor your eye for improvement or worsening because changes can occur silently until it’s too late and vision is lost. Your RSN doctor will keep you and your medical doctors updated on the status of your eye health and the treatments that may be needed.