If laser treatment is needed, the risk factors of not being treated are much higher than the risk of being treated. In addition, when the main problem is not growth of abnormal new blood vessels, but rather leakage from previously normal capillaries causing waterlogging of the central retina, reading vision may be stabilized in some cases by using laser to help stop the leakage and dry out the retina. In cases when laser treatment is not successful in preventing hemorrhage into the eye or when a retinal detachment from scar tissue has occurred, a type of surgery call vitrectomy is often helpful. A special microsurgical instrument is inserted into the eye and the blood-stained vitreous is removed and replaced by a clear sterile solution. Fibrous bands which may cause retinal detachment are removed to allow the retina to flatten out and return to a more normal configuration.
Vitrectomy remains an operation performed only on eyes in which no other treatment is useful.
Persons with diabetes of six or more years duration, whether or not they have visual symptoms, should have regular periodic eye examinations every six months by an ophthalmologist. Persons found to have new vessels, with or without vision changes, should be considered for laser treatment. If pregnancy occurs, the patient should be followed by an ophthalmologist throughout the pregnancy. Although perfect solutions are not available for the prevention of visual loss in diabetes, the outlook for maintenance of useful vision is favorable. Early detection and appropriate therapy can be sight-saving.