Reader: My mother is 58 years old and has been suffering from diabetes for more than 10 years. Although she has been taking medication, her blood sugar is still not well controlled. Last week she suddenly lost the sight in her right eye and was diagnosed with vitreous hemorrhage in her right eye and diabetic retinopathy in both eyes at the hospital. Zheng Bin: Diabetic retinopathy is one of the major blindness-causing eye diseases, which should be taken seriously by patients, and its more serious complications include vitreous hemorrhage. Once the hemorrhage occurs, the patient will experience a sudden loss of vision. In response, clinical treatment includes conservative treatment and vitrectomy surgery. Currently, with the continuous development of minimally invasive vitreous surgery equipment and techniques, the safety and effectiveness of surgery has improved significantly, and the indications for surgery for diabetic retinopathy are being relaxed. If your mother has already completed total retinal photocoagulation, she can take conservative treatment first, if the combination of retinal detachment and other complications are excluded; if she has never undergone total retinal photocoagulation, she should be closely observed under the guidance of a doctor, and if there is no significant improvement after one to two months of conservative treatment, minimally invasive vitrectomy treatment can be considered. In your mother’s case, she can be temporarily treated with conservative observation of the right eye, actively control blood sugar, pay attention to semi-recumbent rest, and timely outpatient review, and if the blood accumulation does not improve, she should be actively treated with surgery. Reader: I am 45 years old, I have been suffering from diabetes for 2 years. In the past 6 months, I have had macular edema repeatedly, and I have performed vitreous cavity injection of anti-neovascular drugs once, but there is no significant improvement. Zheng Bin: Most cases of macular edema in diabetes are related to blood-retinal barrier dysfunction caused by hyperglycemia, but it is found that the pulling of macular area by posterior vitreous cortex can also cause persistent edema in macular area, and in this case, vitrectomy is needed to release the pulling of macular area and restore edema. According to your condition and the results of OCT examination of macular area, you belong to persistent macular edema caused by macular traction, so you should undergo vitrectomy as soon as possible to release the traction. Meanwhile, with the continuous development of minimally invasive vitrectomy technology, the surgery has the advantages of short time, small risk and fast recovery, which is a very safe and effective surgery. Reader: My father is now 65 years old and has suffered from diabetes for more than 20 years. He was diagnosed with diabetic retinopathy in both eyes a long time ago, and recently he was found to have retinal detachment with a visual acuity of 0.3. What exactly should be done? Bin Zheng: Retinal detachment caused by diabetes is mainly retinal detachment by traction, which is caused by progressive fibrovascular proliferation and constriction. At present, for retinal detachment involving the macula, vitrectomy should be performed immediately to release the retraction, but for retinal detachment outside the macula, vitrectomy is often not performed due to slow progress, but mainly for observation. Your father needs to choose the appropriate treatment according to his condition. Zheng Bin: Deputy Chief Physician and Director of Fundus Surgery at Suzhou Eye and Vision Hospital. The specialist clinic hours are Monday afternoon and Tuesday morning.