Diabetes is a medical condition that can have devastating effects on a patient’s vision. According to the American Diabetes Association, diabetes is the leading cause of vision loss in adults aged 20 to 74. The reason behind vision loss in diabetes sufferers is uncontrolled blood sugar levels, which affect every major organ in the body, including the eyes. Although keeping blood sugar levels close to normal may slow the onset or the progression of eye disease, it may not completely prevent formation of diabetic retinopathy.
Diabetic retinopathy may be detected during routine eye exams. Routine annual dilated eye exams are recommended. If you have diabetes, it is essential to disclose this information to your eye doctor. Please contact us today to schedule your eye exam.
Diabetic retinopathy is the most common eye disease in patients who have type 1 or type 2 diabetes. In diabetic retinopathy, high blood sugar levels caused by diabetes affect the blood vessels in the retina (light-sensitive tissue in the eye), thereby affecting vision.
Symptoms in patients with diabetic retinopathy may include:
Eye floaters and spots
Cloudy vision and formation of cataracts
Scotoma (shadow in the field of view)
Diabetic retinopathy has four stages:
Mild nonproliferative retinopathy
Moderate nonproliferative retinopathy
Severe nonproliferative retinopathy
Mild nonproliferative retinopathy is characterized by swelling of the blood vessels in the retina. As the condition progresses to moderate and severe nonproliferative retinopathy, the blood vessels become blocked, depriving the retina of its much-needed blood supply. The body then tries to compensate for lack of retinal nourishment through the formation of new blood vessels, leading to proliferative retinopathy. Proliferative retinopathy occurs when the newly formed vessels, which are abnormal and fragile, begin to leak blood into the eye.
Diabetic retinopathy may also lead to macular edema (swelling). This occurs when fluid from newly formed blood vessels leaks into the macula (the part of the eye responsible for central vision) causing the macula to swell. Macular edema can occur at any stage of diabetic retinopathy and can cause temporary or permanent vision loss.
In addition to routine eye exams, diabetic retinopathy and its severity level can also be determined through advanced diagnostic testing such as fluorescein angiography or optical coherence tomography (OCT). Each method focuses on providing clear images of the retina.
Diabetic retinopathy cannot be cured; therefore, all treatment efforts are focused on slowing the progression of the disease. Mild to severe nonproliferative retinopathy can be managed effectively through controlled blood sugar levels as well as blood pressure and blood cholesterol levels.
The most common treatments used to manage proliferative retinopathy or macular edema include laser surgery, injections of steroids or the drug Avastin and vitrectomy surgery. Laser surgery can be used to seal off leaking blood vessels and may require more than one treatment session. Steroid injections help control certain chemicals in the eye, thereby reducing fluid accumulation. Avastin or similar medications also have been shown to decrease such swelling. Vitrectomy is a procedure performed in severe cases to remove blood from the center of the eye.