DIABETIC RETINOPATHY

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1 THE UK GUIDE DIABETIC RETINOPATHY Everything you need to know about diabetic retinopathy Jaheed Khan BSc (Hons) MBBS MD FRCOphth Fellow of the Royal College of Ophthalmologists Association for Research in Vision and Ophthalmology European Society of Cataract and Refractive Surgeons European Society of Retinal Specialists

2 Table of contents Introduction 1 Diabetic retinopathy at a glance 2 What is diabetic retinopathy? 3 Why should I consider private diabetic retinopathy treatment 4 Does diabetic retinopathy need urgent treatment? 6 Can I go blind from diabetic retinopathy? 8 How do eye surgeons treat diabetic retinopathy? 9 Why should you choose us to treat your diabetic retinopathy? 11 Other surgeons who treat diabetic retinopathy at Clinica London 12 Final words 13 Download all of our guides! 14

3 Introduction My name is Jaheed Khan and I am a Consultant Eye Surgeon at 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 diabetic retinopathy treatments, the advantages of private treatment, and all the different steps you will take from the first appointment to your day of treatment. 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 Call us with any question on:

4 Diabetic retinopathy at a glance What is it? What are the symptoms? Who is at risk? A condition of the retina 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 People with Diabetes People with a family history of the disease What causes it? Diabetes Type 1 and 2 How are they diagnosed? Diagnosis usually follows a full ocular history and exam, dilated fundal exam, OCT imaging, fundus fluorescein angiography, and electrophysiology What is the treatment? Laser or injections, to block the blood vessel growth If a bleed has already occurred then we have to operate What is the prognosis? If diabetic retinopathy is left untreated it can cause blindness. Call us with any question on:

5 Conditions Treated Diabetic retinopathy / Diabetic maculopathy Treatable Areas Eye / Retina Prices Contact the clinic for more informations about prices. Practitioner Doctor Downtime Vision will be hazy or blurry for about 24 hours after surgery. Your Specialists 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, 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. Jaheed Khan Ophthalmic Cataract Surgeon Medical Retinal Specialist i Diabetic retinopathy refers to the effect of diabetes on the retina Jaheed Khan Michel Michaelides Medical Retina Inherited Retinal Specialist 3

6 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. i We have access to state-ofthe-art imaging technology and the devices we need to provide the best care for patients. Michel Michaelides Call us with any question on:

7 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. You ll be treated by your eye surgeon at every step - and i not by nurse practitioners, juniors or trainees 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. Call us with any question on:

8 Does diabetic retinopathy need urgent treatment? The treatment for diabetic retinopathy depends on what type of diabetes you have. A.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 Call us with any question on:

9 sudden loss of vision. This type of diabetic retinopathy needs urgent treatment. A.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 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. Call us with any question on:

10 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. Call us with any question on:

11 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 as a 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. Call us with any question on:

12 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. It s very rare to feel anything at all when treating maculopathy. However, when treating proliferative retinopathy, some patients report discomfort. If that is the case, then local anaesthetic can be administered to numb the i It s very rare to feel anything at all when treating maculopathy. 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. Call us with any question on:

13 Why should you choose us to treat your diabetic retinopathy? I am a highly experienced Consultant Ophthalmologist and I will personally perform your treatment for diabetic retinopathy. I will incorporate the latest advanced proven technology in your treatment for diabetic retinopathy. Your treatment will be pain-free and safe and I will restore your vision where I can with minimal risk. Call us with any question on:

14 Other surgeons who treat diabetic retinopathy at Clinica London Mr Michel Michaelides treats AMD at Clinica London alongside Mr Jaheed Khan. Mr Michaelides' clinical and research interests include Diabetic Eye Disease, Age-related Macular Degeneration (AMD) and Inherited Eye Disease in adults and children. Michel Michaelides BSc MB BS MD(Res) FRCOphth FACS Medical Retina & Inherited Retinal Specialist Areas of expertise: Mr Michaelides is also involved in the development of novel treatments for Age-related Macular Degeneration (AMD), diabetic macular oedema and Medical Retina, Inherited Eye Disease and Paediatric Ophthalmology inherited retinal disease, both in the laboratory and also in terms of undertaking clinical trials to determine the safety and effectiveness of these new treatments. Call us with any question on:

15 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. 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 5. My fees are fully covered by insurance 6. My results are better than the national average 7. I am highly trained as a Consultant Ophthalmologist 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 5-star testimonials 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. Call us with any question on:

16 Download all of our guides! The UK Guide to Eyelid Surgery Understand the things you need to know when pursuing Private Eyelid Surgery Click to download this patient guide The UK Guide to Aesthetic Treatments Understand the things you need to know about Aesthetic Treatments Click to download this patient guide The UK Guide to Cataract Surgery Understand the things you need to know when pursuing Private Cataract Surgery Click to download this patient guide The UK Guide to AMD Treatment Understand the things you need to know when pursuing Private AMD Treatment Click to download this patient guide The UK Guide to Glaucoma Treatment Understand the things you need to know when pursuing Private Glaucoma Treatment Click to download this patient guide The UK Guide to Diabetic Retinopathy Understand the things you need to know about Diabetic Retinopathy Click to download this patient guide 14

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