Other Innovations in Diabetic Eye Treatment

Users of the Noctura in the United Kingdom, where it is already available, report that it not only prevents the progression of retinopathy, it even improves sight in people who already have advanced retinopathy. It gets results in people who have either type 1 or type 2 diabetes, and many people report that after they use the device they don't need glasses for nearsightedness, or they have been able to keep their driver's licenses, or they have been able to continue working.

Devices like the Noctura 400 offer huge savings in medical costs for the uninsured. The cost of laser surgery for one eye ranges from about $10,000 to about $20,000 in the US (and is similarly expensive in the European Union, although the cost is covered by national health services). The cost of the Noctura is about $25 a week for both eyes. Expect widespread use of the Noctura in the US when it is approved by the FDA. The device will also be popular in countries where a $20,000 bill for laser surgery is simply out of reach for all but the very rich.

In the meantime, a night light actually provides some of the same benefits on a lesser scale. Just be sure your night light emits yellow-green light, not white light or blue. It's the blue wavelengths of light that keep you awake at night.

What are some other innovations in treating diabetic eye disease?

• A new injectable drug called Lucentis may be better than laser surgery for preserving sight in diabetic retinopathy. It preserves peripheral vision, and seems to prevent most (although not absolutely all) cases of advanced complications requiring surgery. An injection into the eye sounds horrific, and when I've had them myself, I was glad I had been given a sedative, but you are given anesthetic eye drops first; there is very little pain from the injection itself although your eye may be irritated (and you won't want to roll over on your stomach in your sleep) for several days.
• Maculopathy, the swelling in retinopathy, is sometimes treated with injections of steroids into the eye. A new product called Iluvien lasts for three years instead of six months to a year, and reduces the number of times you may have to have the procedure.

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• Cataracts are also common in diabetics, and they occur at earlier ages in diabetics, sometimes as early as age 45. New surgical procedures make it possible to replace the lens in the eye the need of stitching the incision. The cut through which the old lens is broken up with an ultrasound probe and to be removed by suction with replacement by a new "origami" lens is so small that it seals itself, and patients can resume their normal activities as soon as they leave the doctor's office. Most insurance plans cover some version of this procedure.