DIABETIC RETINOPATHY

Transcription

1 11 THE UK GUIDE TO DIABETIC RETINOPATHY Everything you need to know when considering Diabetic Retinopathy Treatment in the UK Mr Jaheed Khan BSc (Hons) MBBS MD FRCOphth, Consultant Ophthalmic Surgeon Mr Jaheed Khan is a Moorfields trained cataract surgeon and retinal diseases expert. He works full time as an NHS Consultant Ophthalmic Surgeon at Moorfields Eye Hospital NHS Foundation Trust and an Honorary Consultant Ophthalmic Surgeon at Hinchingbrooke Hospital. He is a Fellow of the Royal College of Ophthalmologists, a Member of the General Medical Council (GMC), and a Fellow of the Royal College of Ophthalmologists (FRCOphth). He is also a member of the UK and Ireland Society of Cataract and Refractive Surgeons (UKISCRS), the European Society of Cataract and Refractive Surgeons (ESCRS), the Association for Research in Vision and Ophthalmology (ARVO), and the European Society of Retina Specialists (EURETINA).

2 Table of Contents Introduction 2 Diabetic Retinopathy at a glance 3 What is Diabetic Retinopathy? 4 Why should I consider private Diabetic Retinopathy treatment? 5 Does Diabetic Retinopathy need urgent treatment? 6 If you have Type 1 Diabetes 6 If you have Type 2 Diabetes 6 Can I go blind from Diabetic Retinopathy? 7 How do eye surgeons treat Diabetic Retinopathy? 8 Pain when treating types of Diabetic Retinopathy 8 Why should you choose me to treat your Diabetic Retinopathy? 9 Final words 10

3 Introduction My name is Jaheed Khan and I am a Consultant Eye Surgeon at Moorfields Eye Hospital and Clinica London. My special expertise is in cataract surgery and conditions affecting the back of the eye (the retina), including AMD, Diabetic Retinopathy, and various other diseases of the retina. I have over 15 years experience in treating people with eye problems just like you. That is why I know the concerns and most common questions of patients when they are looking into their eye treatment options. In this guide, I will give you the answers to those questions. I will explain to you the benefits and risks of the different surgeries, the advantages of a private treatment, and all the different steps you will take from the first appointment to the day of your surgery. My ethos is to deliver the best treatments in the safest environment with the latest technology. The needs of my patients always come first. I would be more than happy to consult you personally; the easiest way is to book an appointment so that we can discuss the options and questions specific to you. This guide was created out of conversations I ve had with patients. I ve recently sat down and answered similar questions on video so I could share this information online as well as here in written form. I hope you like the conversational and straight forward nature of this guide. Best regards, Jaheed Khan BSc (Hons) MBBS MD FRCOphth 2

4 THE UK GUIDE TO DIABETIC RETINOPATHY Mr Jaheed Khan Diabetic Retinopathy at a glance What is it? A condition of the retina. What are the symptoms? The back of the eye is nourished by blood vessels which can grow and bleed - causing blurred vision. Sometimes there are no symptoms. Get a bleed in the eye and a sudden loss of vision. Gradual blurring of your vision, or a sort of blotchy vision. Who is at risk? People with Diabetes People with family history What causes it? Diabetes Type 1 and 2 How is it diagnosed? What is the treatment? What is the prognosis? Diagnosis usually follows a full ocular history and exam, dilated fundal exam, OCT imaging, fundus fluorescein angiography, and electrophysiology. Laser or injections, to block the blood vessels growth. If a bleed already occurred then we have to do an operation. If diabetic retinopathy is left untreated it can cause blindness. 3

5 1 What is Diabetic Retinopathy? Diabetic Retinopathy refers to the effect of diabetes on the retina (the light sensitive part of the back of the eye). Not everyone with diabetes gets Diabetic Retinopathy, Just keep up the good work Dr Khan. My wife, who accompanied me, and I were both very impressed by the care and consideration shown by the whole team when I had surgery. I just hope they haven t lost the knack by the time I get my other eye fixed. Joking apart the care of this team has made it a wonderful experience for me. - Patient but the longer you have diabetes, the more likely you are to develop Diabetic Retinopathy. Diabetic Retinopathy is only a problem, if it looks as if it s going to affect your vision. If left untreated, it can cause blindness. 4

6 2 Why should I consider private Diabetic Retinopathy treatment? With diabetes and Diabetic Retinopathy, there are a lot of emerging treatments that are only available privately because the National Health Service doesn't have the money to fund newer drugs until they are governmentally appraised and approved. Another major advantage of going private is that you ll see your eye surgeon, who is a consultant, at every visit. You ll be treated by your eye surgeon at every step - and not by nurse practitioners, juniors or trainees as it often happens in the National Health Service. In contrast to the National Health Service, you won't have to wait long. For peace of mind, it's a good idea to see someone quickly and to discuss the options quickly so that you don't worry too much. An excellent Doctor who puts the concerns of his patients first which does not always occur. I can rely on his advice as the best for me. - Patient 5

7 3 Does Diabetic Retinopathy need urgent treatment? The treatment for Diabetic Retinopathy depends on what type of diabetes in the eye you have. IF YOU HAVE TYPE 1 DIABETES In Type 1 diabetes, the main problem is the formation of new blood vessels growing out at the surface of the retina or the optic nerve head, and that s called proliferative retinopathy. These new vessels unfortunately have a tendency to bleed into the eye. Quite often, the first time you might notice it is when you get a bleed in the eye and a sudden loss of vision. This type of Diabetic Retinopathy needs urgent treatment. IF YOU HAVE TYPE 2 DIABETES In Type 2 diabetes, the main problem initially is maculopathy. The macula is the central part of the retina, which serves the central vision. The symptoms you might experience with diabetic maculopathy would be a gradual blurring of your vision, or a sort of blotchy vision. This type of Diabetic Retinopathy does not need urgent I came away from the consultation feeling as informed as I could be, all my questions answered, and that I had made the right decision to fly all the way from New Zealand to have this consultation. - Patient treatment, but you need to monitor it regularly. The aim of your eye surgeon should be to detect the problem, before it gets to a symptomatic stage. If retinopathy is identified in its early stages, you can prevent it from getting worse just by controlling your diabetes. 6

8 THE UK GUIDE TO DIABETIC RETINOPATHY Mr Jaheed Khan 4 Can I go blind from Diabetic Retinopathy? If left untreated, Diabetic Retinopathy can cause blindness. If you don't see a doctor or an optometrist or anyone who can diagnose Diabetic Retinopathy, you are at risk of losing your vision in the long term. It does depend on how well you are controlled and whether you have any other associated conditions. But if you come and see an eye surgeon, they should reassure you that Diabetic Retinopathy can be graded and that they can do the necessary imaging techniques to make sure there's no significant leakage. Your eye surgeon should discuss the lifestyle changes that you need to employ to reduce the chance of losing your vision. Many thanks to Mr Khan. His prompt diagnosis and explanation was very reassuring indeed. - Mr. R, Patient 7

9 5 How do eye surgeons treat Diabetic Retinopathy? The mainstay of treatment for Diabetic Retinopathy is laser treatment. Usually laser treatment is carried out as an outpatient procedure, or day case. The procedure is fairly simple. Firstly your pupils will be dilated with drops, and you ll sit at a special instrument with a slit lamp attached to it, which has a laser. The main treatments for this condition include laser photocoagulation and injections of medicines, called anti-vegf, into the vitreous of your eye. There are injections of many different substances: Steroids can be injected in certain cases, but the majority of patients respond very well to the new medicines that block blood vessel growth. Sometimes eye surgeons have to treat associated cataracts and that's done by surgery. In very advanced cases of Diabetic Retinopathy, where unfortunately a bleed has already occurred, eye surgeons have to proceed to an operation. This is a major operation which involves removing the blood from that eye and your eye surgeon should take some time to discuss it with you. You won t get to this point, if you arranged an appointment in a timely fashion, it was picked up early and you didn't develop any sight-threatening complications before. PAIN WHEN TREATING TYPES OF DIABETIC RETINOPATHY Maculopathy: It s very rare to feel anything at all when treating maculopathy Proliferative Retinopathy: Some patients report discomfort. If that is the case, then local anaesthetic can be administered to numb the pain. It is also possible to deliver the treatment under general anaesthetic. Usually the vision improves over the next hour or two after treatment, after experience a period of blurriness. Usually after a day or two, your vision will be back to the way it was before the problem was treated. 8

10 6 Why should you choose me to treat your Diabetic Retinopathy? I am a highly experienced Moorfields Eye Hospital Consultant Ophthalmic Surgeon and I will personally perform your treatment for Diabetic Retinopathy. I will incorporate the latest advanced proven technology in your treatment for Diabetic Really impressed with his high level of knowledge and professional manner. I was really taken back by the high level of service which Dr. Khan gave. - Patient Retinopathy. Your treatment for Diabetic Retinopathy will be pain-free and safe and I will restore your vision where I can with minimal risk. 9

11 Final words I know from experience that it is not always easy to decide - there are lots of things to consider and this guide can only give a general overview. That is why I recommend you to have a personal appointment with an eye surgeon where you can discuss your needs in detail. You will recognise soon if you feel comfortable. For me in particular, it is tremendously important that you are happy during the whole process. The needs of my patients always come first. To simplify your decision to arrange an appointment, I would like to conclude with 10 reasons to call me: 1. I am a top London cataract and retinal specialist surgeon 2. I have lower than average complication rates for cataract surgery 3. I offer personal and customised attention at every step 4. I have access to cutting-edge technology and everything Moorfields Eye Hospital has to offer 5. My fees are fully covered by insurance and transparent pricing models 6. My results are better than the national average for clinical outcomes 7. I am highly trained as a consultant ophthalmologist who specialises in diseases that affect the retina 8. I have 15 years of experience at one of the world's most respected eye hospitals 9. You'll receive the best care, as an individual 10.My private practice is overflowing with testimonials and 5-star ratings If you would like to discuss your particular eye concerns please call us on to make an appointment. We'll explore the best treatment options for your eyes so you can get back to doing what you love. Clinica London 140 Harley Street W1G 7LB London Moorfields Hospital 9-11 Bath Street EC1V 9LF London Phone: