For Spider Lily

Macular degeneration – the wet form that they use the injections for – is basically the development of small leaky blood vessels around the central part of the retina that we use for detailed, straight ahead vision. This makes the area soggy, and kind of like a fluid blister, lifting the retina off the inside surface and causing distortions in the vision. The injections are a chemical that inhibits the formation of the leaky vessels. If you are lucky the injections ‘kill off’ the faulty vessels, the body dries everything out and you either get a bit of improvement (the miracles do happen, but are few and far between) or at least hold what vision you’ve got. They don’t work for everyone.

In long term diabetes, and more commonly in Type 1 than in Type 2, the blood vessels in the retina as a whole become a bit leaky causing trouble throughout the retina. They do something called pan retinal laser, which is an uncomfortable application of hundreds of little laser burns all over the retina. But not at the macula. As far as I know, no-one knows yet why this works, but it dries things out and preserves what vision you’ve got. In diabetes there can also be actual small bleeds in the retina, not just fluid leakage.

There is also something called diabetic macular oedema, where a fluid buildup at the macula messes with your vision. In the last couple of years some bright sparks suggested the macular degeneration injections might be useful for diabetics too, and this is being used gradually more widely.

Ask more questions if that doesn’t make sense. But remember each person is individual. I don’t predict for anyone. I work with what comes, and what is left.

they are individuals just like everyone else ;).

the lasering is a very strange experience for the first time. Doesn’t hurt but is uncomfortable. Much prefer it over the injection. The injection hurts going in, and every part of your being wants to flinch away.

I have varying descriptions of the injections from patients. I think there is a lot of practitioner variability. I’ve had patients plead for a referral to a different practitioner because of the pain. And I have others who, while not happy psychologically with the idea of an injection in the eye, never-the-less tell me that the physical pain is minimal.

I’ver only had two, one in each eye. The first time I was prepared for it to hurt but it wasn’t quite that bad. So the second one I went in all relaxed and was a little surprised by how much it did sting.

party_pants said:

I’ver only had two, one in each eye. The first time I was prepared for it to hurt but it wasn’t quite that bad. So the second one I went in all relaxed and was a little surprised by how much it did sting.

What was the lasering for Mr Pants?

i haven’t had the injections, but plenty of lasering.
I found it to be fairly painful, but very short lasting, microseconds of pain. I think the amount of pain is dependant on the area that they are working on.

Speedy said:

party_pants said:

I’ver only had two, one in each eye. The first time I was prepared for it to hurt but it wasn’t quite that bad. So the second one I went in all relaxed and was a little surprised by how much it did sting.

What was the lasering for Mr Pants?

Diabetes stuff as outlined by Buffy above. The doctor described it as patches of swelling on the retina. Was giving me patches of blurry vision.

party_pants said:

Speedy said:

party_pants said:

I’ver only had two, one in each eye. The first time I was prepared for it to hurt but it wasn’t quite that bad. So the second one I went in all relaxed and was a little surprised by how much it did sting.

What was the lasering for Mr Pants?

Diabetes stuff as outlined by Buffy above. The doctor described it as patches of swelling on the retina. Was giving me patches of blurry vision.

Sounds unpleasant :(

I asked because I thought you may have had something similar to Mr Speedy. He has been diagnosed with glaucoma (but not related to diabetes). The specialist told him that he would likely need laser one day to open up a closing gap which keeps eye pressures normal.

Thanks Buffy, appreciate any info that helps me to understand. Macula degeneration has effected nearly all of Dad’s brothers and sisters so it’s something that I am extremely aware of and am reminded (by Dad) every time I get my eyes tested. Interesting though out of 13 in the family, Dad and his younger brother are the only 2 to have diabetes. Dad was diagnosed back in ’02 and spent 9 years controlling it with diet then medication and eventually insulin in ’11. It was about the time the insulin started that the Macula degeneration started..

Dad had a vein burst which probably happened 3 – 4 days ago, it solidified and settled over the macula.. Nothing was done yesterday.

As he is heading to Launceston this Friday for his injection they will add another 2 injections to try and liquify the clot and then move it.. It may work it may not.

Funny story, when I’m driving with Dad he is very good at telling me the speed limits around town. Even though I see the sign he lets me know that there is a ‘70’ sign coming up etc… and also reminds me when my foot slips that I’m in a 50 zone. So coming back from Launceston last night, it’s dark and he cannot see. It’s 110k most of the way and we were just coming into a little town and all of a sudden he goes “there should be a 90 sign coming up”.. Sure enough in my lights was the sign.. :D

Spider Lily said:

Thanks Buffy, appreciate any info that helps me to understand. Macula degeneration has effected nearly all of Dad’s brothers and sisters so it’s something that I am extremely aware of and am reminded (by Dad) every time I get my eyes tested. Interesting though out of 13 in the family, Dad and his younger brother are the only 2 to have diabetes. Dad was diagnosed back in ’02 and spent 9 years controlling it with diet then medication and eventually insulin in ’11. It was about the time the insulin started that the Macula degeneration started..

Dad had a vein burst which probably happened 3 – 4 days ago, it solidified and settled over the macula.. Nothing was done yesterday.

As he is heading to Launceston this Friday for his injection they will add another 2 injections to try and liquify the clot and then move it.. It may work it may not.

Funny story, when I’m driving with Dad he is very good at telling me the speed limits around town. Even though I see the sign he lets me know that there is a ‘70’ sign coming up etc… and also reminds me when my foot slips that I’m in a 50 zone. So coming back from Launceston last night, it’s dark and he cannot see. It’s 110k most of the way and we were just coming into a little town and all of a sudden he goes “there should be a 90 sign coming up”.. Sure enough in my lights was the sign.. :D

>>Macula degeneration has effected nearly all of Dad’s brothers and sisters<<

Don’t be conned into taking supplements yourself. The AREDS and AREDS2 studies showed they are useful if you already have moderate degeneration There was no prophylactic benefit shown. On the other hand, there is good evidence that smoking increases the odds a lot – but I’m pretty sure you are not a smoker. My advice to people, all people, is to use the same things you would use for heart health in the way of food – in particular, make sure you eat a pretty, colourful plate of food. Make sure you have veggies of every hue. Often.

>> It was about the time the insulin started that the Macula degeneration started..<<

I’d be inclined on clinical intuition to say this was probably a coincidence.

>>Dad had a vein burst <<

Probably another separate, cardiovascular thing, more likely to do with the diabetes. And I hate to say it, but that one is probably not going to go away. Usually they just watch and hope the body does its tidying up routine.

Oh, and macular degeneration is usually patchy. You can see sort of patchy stuff. That’s why with two eyes they are often actually quite good – its different patches missing in each eye and when you put them together you get nearly a whole picture. Of course, the bleed is now going to be in the way, so he has lost this effect. He may also have learnt a bit of eccentric viewing. If the middle is missing, you look just to the side of what you want to see – like finding very faint stars in the night sky. A suggestion we make to mac degen people who have trouble seeing faces is to tell them to concentrate on looking at the person’s ear. We usually look at about the nose level. If you look to the ear, it still looks to them as if you are looking at them, but you can move the image off the really damaged mid central area onto a bit of retina that might still work. You have to experiment about which ear, maybe forehead, maybe chin, to see if there is a bit that still works.

buffy said:

make sure you eat a pretty, colourful plate of food.

Divine Angel said:

buffy said:

make sure you eat a pretty, colourful plate of food.

!http://www.sweetcitycandy.com/blog/wp-content/uploads/2015/06/Skittles.jpg

Nay. She meant this sort of snacky.

Morning Forumites

Well here I am back at the eye specialist but in Ulverstone this time.. My Dad had a procedure to try & liquidfy the clot that was sitting over his macular. This consisted of having a gas injected into his eye to try and move the clot. He had this done last Friday and since then he has had to keep his eyes pointed at the floor.. Most uncomfortable for him & due to other aches and pains he cannot sleep on his stomach as recommended so has been sleeping in his chair.. Again most uncomfortable..

So has it worked? Has all this discomfort been worth it? He says yeah it’s “a little” better, but then the next day he just shakes his head (carefully). They never gave him any promises & I’m tending towards Buffy’s suggestion that it more than likely will not work :(

Spider Lily said:

Morning Forumites

Well here I am back at the eye specialist but in Ulverstone this time.. My Dad had a procedure to try & liquidfy the clot that was sitting over his macular. This consisted of having a gas injected into his eye to try and move the clot. He had this done last Friday and since then he has had to keep his eyes pointed at the floor.. Most uncomfortable for him & due to other aches and pains he cannot sleep on his stomach as recommended so has been sleeping in his chair.. Again most uncomfortable..

So has it worked? Has all this discomfort been worth it? He says yeah it’s “a little” better, but then the next day he just shakes his head (carefully). They never gave him any promises & I’m tending towards Buffy’s suggestion that it more than likely will not work :(

My sympathies, sounds awful.

Spider Lily said:

So has it worked? Has all this discomfort been worth it? He says yeah it’s “a little” better, but then the next day he just shakes his head (carefully). They never gave him any promises & I’m tending towards Buffy’s suggestion that it more than likely will not work :(

:( Oh that’s no good.

Still, it’s best to have tried and to not have it work than to have not tried at all.

Can they try to shift the clot again at a later time?

Actually all is good :)

Eye sight is remarkably better and Dr Vote is very pleased with the result. Just need to stem the very mild leakage that is still happening from the vein that burst and he tells me that the regular injections that he gets will do that.

Oh and he is now ok to lift his head, reckon he might be looking forward to his bed tonight :D

Sounds good at this stage.