Question Title: LEGALLY BLIND?Forum: The Eye Care Forum
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My Father in law has diabetic retinopathy. he had bleeding behind both eyes and new blood vessel growth in the right and also cataracts. He had laser surgery on the right eye to correct the bleeding and blood vessel growth. He is due to return to the dr. in a few weeks. My question is: I just found out that his vision is less than 20/400. He still requires more surgery for the bleeding and maybe the cataracts (this part depends on how his diabetes is being controlled) i was told by his doctor that he is considered legally blind. This crushed him. He was driving up until he went to the eye doctor for the first time. He hasn't drove since and is deeply depressed. He is clinging to the hope that they will remove the cataracts and there will be a miracle. He sits around and cries about it. Could you tell me just how good the chances are of him being able to see well enough to drive after the surgeries, providing that they do remove the cataracts? His vision is so bad that he could only see the image of his neighbor coming across his yard. He didn't see this man only an image. I would like to give him some encouragement if possible. He had been told that he had diabetes about 6 or so years ago and never treated it until Dec of 1998. he is not on insulin just on tablets. Sorry to take up too much of your time but I really would like some input. Thank you.
It is very difficult to address the specific questions you ask since I have not examined your father-in-law but I will try to give some general information. Diabetes decreases the amount of oxygen the retina receives. To try and compensate, the retina produces new blood vessels. This is not good however, since they tend to leak and bleed. The leaking can cause swelling in the macula. Bleeding can cause reduced vision. The new vessels can also lead to retinal detachments. The swelling and new vessels can be treated with laser, but the laser is more to prevent further vision loss than to improve current vision. If there is blood which is blocking his vision and if the retina under the blood is pretty healthy, then if the blood goes away by itself or is surgically removed, his vision may improve. If the blood is not blocking his vision than the retina is probably damaged and his vision is less likely to improve. His retina specialist should be able to answer this question for him. Removing the cataract will only help if the cataract is the main cause of reduced vision rather than the retina. If it is primarily the retina, then his vision will probably not improve after cataract surgery. Sometimes it is difficult to tell for sure and we discover the answer only after the cataract is removed. If the cataract is so bad that the doctor cannot see the retina to treat it with laser than it needs to be removed. Again all of these options should be discussed with his retina specialist for information which applies to his particular case. This information is provided for educational purposes only. Sincerely, HFHS MD - NI
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