Diabetic Eye Care
What is Diabetic Retinopathy?
Diabetes causes the dysregulation of blood sugar. When blood sugar is consistently high, the small blood vessels throughout the body can be damaged. The retina, located at the back of the eyes, is especially susceptible to this kind of damage. Diabetic retinopathy is classified as one of two types: nonproliferative or proliferative diabetic retinopathy. One involves microbleeds. The other involves the growth of new, weaker blood vessels and scar tissue.
How Can I Prevent Diabetic Retinopathy?
It is very important for diabetic patients to have their eyes examined once a year. Diagnosing and treating eye disease early can prevent vision loss. It is also important to maintain a steady blood-sugar level, take prescribed medications, follow a healthy diet, exercise regularly, and avoid smoking.
What Causes Diabetic Retinopathy?
People who have diabetes are at risk of developing diabetic retinopathy. Factors that increase risks include:
- Having diabetes for a long period
- Unmanaged blood sugar levels
- High blood pressure
- High cholesterol
- Tobacco use
- People of Native American, Hispanic, or African American descent are more vulnerable to this disease
What happens when you have diabetic retinopathy?
When a person has diabetic retinopathy, they have sustained damage to the tiny blood vessels in the retina of the eyes. The blood vessels weaken, which leads to microbleeds, retinal hemorrhages, and swelling in the macula, the center of the retina. This is described as nonproliferative diabetic retinopathy.
Being a progressive condition, nonproliferative diabetic retinopathy can progress to proliferative diabetic retinopathy. When a person has this disease, their body is growing new blood vessels in the eye. These new blood vessels are abnormal, though, and also lead blood and fluid into the back of the eye. Because these blood vessels are so weak, vitreous hemorrhage may result from leakage. This can lead to the formation of scar tissue on the retina, which pulls the retina from the back of the eye (retinal detachment).
Abnormal blood vessels may also develop on the iris of the eye, clogging drainage and leading to increased eye pressure. This is known as neovascular glaucoma, a condition that could cause irreparable damage to the optic nerve. Damage to the optic nerve can lead to blindness.
How is diabetic retinopathy diagnosed?
People with diabetes should maintain regular eye exams as recommended by their ophthalmologist. Additionally, an eye exam should be scheduled right away if the following symptoms occur:
- Blurred vision
- Color vision becomes irregular
- Poor night vision
- Streaks or patches that obstruct vision
- Floaters, spots that “float” through the field of vision
- Sudden, complete loss of vision
An ophthalmologist performs a comprehensive eye exam to properly diagnose the cause of symptoms.
- A dilated eye exam allows observation of the back of the eye, including the retina and new, abnormal blood vessels.
- Fluorescein angiography is an imaging test that can identify leakage from blood vessels in the eyes.
- Optical coherence tomography is special imaging that observes the thickness of the retina, indicating swelling or scarring.
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How is Diabetic Retinopathy Treated?
The early focus of treating nonproliferative diabetic retinopathy is to slow the progress of this disease. Patients work with their eye doctors as well as their primary healthcare provider to control blood sugar levels, cholesterol, blood pressure, and vascular risk factors. If patients with diabetic retinopathy smoke, they will be advised to obtain services to help them quit smoking. The proper management of diabetes is critical to the preservation of vision.
If diabetic retinopathy worsens to a point of causing macular edema (swelling in the center of the retina), medication may be injected into the eye to reduce this symptom. Laser eye treatments may also be performed. The medications that are commonly used to treat diabetic retinopathy have what are called “anti-VEGF” agents, which decrease the effects of vascular endothelial growth factor in the eye. This growth factor is what contributes to swelling in the retina and the weakening of the retinal capillaries. If more severe complications occur, such as retinal detachment or vitreous hemorrhage, surgery may be necessary.
Can diabetic retinopathy go away?
Diabetic retinopathy is not curable. For this reason, doctors focus on regulating blood sugar in diabetic patients quickly and consistently so their risk of eye damage can be decreased. It is imperative that diabetics receive adequate care to manage their condition. The abnormal growth of blood vessels in the retina can lead to serious complications such as glaucoma, retinal detachment, vitreous hemorrhage, and vision loss.