Dad's aggresive retinopathy from type 1 diabetes..opinions badly needed

Hi everyone…this isn’t exactly going to be a cheery post…but I’m looking for some opinions from people who may have experience with retinopathy. My dad has had type 1 diabetes for a number of years…and now has a number of complications. He will be starting dialysis likely this month…he is also having some heart trouble and now the doctors have told him he has agressive retinopathy in one eye…besides the kidney trouble the complications just seemed to have hit him all at once. Now the lazered his eyes twice…but being the fiercely independent mr fixit kinda guy that he is…he has been doing heavy lifting…replacing furnices…things a lot of healthy men couldn’t do…all this heavly labour seems to have caused the fragile veins in the back of his eyes to burst…and now for the past few days he hasn’t been able to see well enough to drive or even watch t.v. everything looks blurry. Do any of u think this is fixable…he is already blind in his other eye due to a work accident and if they can’t fix that eye by replacing the lens…im afraid his “good eye” will not be able to be lazered and my dad will be blind…my dad has always been my hero and i’m afraid if he permenantly goes blind he’ll just give up on life…plus it would kill me to see a man like him who always has to be working or fixing something or helping somebody lose his sight…needless to say I’m terrified for him. so any opinions…we’re waiting for the doc to call about emerg surgery…dunno why they havent called yet…is there any hope? sorry about the loong windedness of this post.

Hi Lauren:

Sorry, to hear about your Dad’s eyes. I had my left eye lasered twice about 24 years ago because of P.Retinopathy. Both my eyes are Fine.

There is a chance that his eye vessels will heal even if the vessels are weak, if he has decent stablized blood sugars and if he stops lifting things. I’m sure he knows better. Obviously, I don’t know how his sugars have been or if he has tried to bring them down too quickly which could cause his eyes to get worse. This evidently happens to some Diabetics.

If the bleeding continues off and on he will probably have to have a Vitrectomy, if the lasering doesn’t fix it. I hope that his eyes are not too far gone for a Vitrectomy. I’ve seen quite a few Diabetics on the net go through this operation. It isn’t any Fun and neither is the recovery. People who have had Diabetes for many years plus the older a Person is, the harder it is to heal properly and in a reasonable amount of time, as you know. Patience, decent blood sugars and discipline are all needed. I have also seen 2 People(both Women)have this operation as a last resort and they both went blind anyways. But most come through it okay and stay that way for some time, as long as they take care of themselves.

http://www.stlukeseye.com/Surgical/Vitrectomy.asp

Best Wishes to your Dad. I hope that his eyes improve one way or the other. And tell him to stop lifting, etc. :o)

I have had retinal hemorrhages in both eyes, a complee detachment in one eye, and vitrectomies in both. At present, I can see okay - not extra fabulous, but well enough to read, drive, knit and recognize my friends across the street.
Each case of retinopathy is different - it is actually a very broad diagnosis of a number of different situations.
How low ago was your dad lazered? Many times, immediately following a treatment, as the vessel die they shrink and release old blood into the eye. Even a little bit of blood can mess up your vision. If it is just a one-time occurance, the body will absorb it in about 3 weeks.
If the vessels continue to bleed over a period of days or weeks, then a vitrectomy will have to be done, usually in order to provide the doc with a clear view of the retina and where to put the laser.
Nothing was ever said to me about lifting (but then, of course, I don’t look like anyone who would be doing a lot of lifting anway) but it can’t be good - at least not until things have healed.
Retinopathy is very scary. Last summer, on a Saturday morning, I had just been on the computer and forgot to take off my computer glasses. I went out to do errands and everything was blurry. I nearly became hysterical,l, thinking that it was back…
My heart goes out to you and your family. I wish your dad the best. And yes, I do feel there is hope…

thank for the responses everyone…it’s really scary to see that blank look on my dads face:( its nothing like the way he usually looks:( he’s been like this for what’s going on over a week now…he likely won’t even be able to get a holf of the doc until tuesday because of monday’s holiday…the doc was in emerg surgery for 2 days solid…good testament to canada’s now crappy health care system :@ grr…do u guys think it has a much much higher probibility of becoming non reversable due to the long wait…i’m assuming he should have been in surgery right away …i mean he can’t see! i’m so mad/terrified

I had laser treatments for neovascularization, or new blood vessel growth in one of my eyes. While technically speaking, that is really not considered proliferative retinopathy, however, because the new vessels are more prone to leaking and or hemorraging, my opthamologist recommended having them destroyed with laser treatment to prevent problems. That part is pretty easy and should not create vision problems, short of losing some peripheral vision in the eye which is treated with laser treatment (but it sure beats having no sight). I really would not worry too much about that, as it has become so common that most eye doctors are pretty good at doing it.

One thing you mention is that your Dad is on dialysis … if he hasn’t already done so with regards to his organ network registration (usually with UNOS), he should definitely consider a simultaneous kidney and pancreas transplant. I don’t understand why any doctor can in good conscience, recommend putting a transplanted kidney into the destructive environment of diabetes with wide variations in blood glucose levels which is damaging to organs, yet many do and patients remain unaware that both can be done. Certain transplant centers specialize in doing simultaneous transplants (like University of Minnesota, for example), but if he has to take immunosuppressants for a new kidney, there’s really no good reason he shouldn’t get another pancreas which makes its own insulin as well. For more information on that, check out my post where I include some links for more information on that subject.

I had a bleeder in mid-May. I was down to 20/60 vision. It was pretty useless. It’s tough to be able to laser new ones. It was a month before it was clear enough to laser, but he couldn’t where it was bleeding. He did find another ready to go, so he zapped that one. Another month later I’m 99.9% clear and my optho gave me the go-ahead to return to normal activities.

My great A1C over the past two years has hopefully really helped. He has to get that sub-6 and he has to follow the doctors’ orders. I know it’s tough. Let me know if I can help in any way. I’m not far away.

Also inquire about avastin shots.

I’ve had vitrectomies in both eyes. As others have said, it takes the old blood out of the clear gel inside your eye and replaces it with saline solution, clearing up the vision and allowing the dr to see to do more laser.

Typically the surgery doesn’t have to be done immediately, although the sooner, the better. I know how depressed your father could be. The thought of being blind in both eyes is a very scary thought, along with the kidney and heart problems.

After my diagnoses, I was told not to be lifting any heavy objects that could strain my blood vessels (weight lifting, etc).

Best of luck to you and your father.