What is Diabetic Eye Disease?
Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of this disease. All can cause severe vision loss or even blindness. Diabetic eye disease may include diabetic retinopathy (damage to the blood vessels of the eye), cataract (a clouding of the eye’s lens), and glaucoma (an increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision).
What is the most common Diabetic Eye Disease?
Diabetic retinopathy is a leading cause of blindness in American adults. It is caused by high blood sugar which damages the tiny blood vessels of the retina. In some people with diabetic retinopathy, retinal blood vessels may swell and leak fluid. In other people, abnormal, fragile new blood vessels may grow on the surface of the retina, which in turn leads to bleeding and fibrin formation on the surface.
Who is most likely to get Diabetic Retinopathy?
An estimated 18 million American children and adults have diabetes. Within 10 years of diagnosis, 75 percent will have some degree of diabetic retinopathy. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy.
What are the Symptoms of Diabetic Retinopathy?
Often there are no symptoms in the early stages of the disease. It is possible that the vision will not change until the disease becomes more advanced. There usually in no pain. Common symptoms may include blurred vision, changes in the central vision, floating spots, and even sudden vision loss.
What are the Types of Diabetic Retinopathy?
The most common form of retinopathy involves microaneurysms (small dilations of the capillaries), very small hemorrhages, lipid leakage from the vessels, and areas of poor circulation of blood in the retina. This type is called Background Diabetic Retinopathy or Non-proliferative Diabetic Retinopathy. This form frequently causes blurring of the central vision because of macular edema.
Proliferative Diabetic Retinopathy is caused from the growth of new fragile blood vessels from the surface of the retina into the vitreous gel of the eye. When these abnormal blood vessels (neovascularization) bleed into the eye (vitreous hemorrhage), a patient’s vision may become blurry or completely blocked. This form of retinopathy is less common, yet causes more severe visual loss. Progression of this disease can lead to fibrin formation and retinal detachment.
How is Diabetic Retinopathy Detected?
If you have diabetes, you should have your eyes examined by an eye care specialist at least once a year. Your eyes should be dilated during the exam. This means eye drops are used to enlarge your pupils. This allows the eye care professional to see more of the inside of your eyes to check for signs of the disease.
Can Diabetic Retinopathy be Treated?
If you are found to have diabetic retinopathy, you must have tight control of your blood sugar. A fluorescein angiogram (an injection of a small amount of dye in the vein of the arm) may be ordered to determine the extent and location of leaking and abnormal vessels in your retina. If indicated, argon laser photocoagulation (a strong, focused light beam) might be recommended to close the leaking vessels and reduce the stimulus for the growth of new blood vessels. Laser surgery has been proven to reduce the risk of severe vision loss from proliferative diabetic retinopathy by 60 percent. If blood inside the eye does not clear, a surgical procedure called a vitrectomy, might be required to clear the blood from the inside of the eye. However, laser surgery often cannot restore vision that has already been lost. That is why finding diabetic retinopathy early is the best way to prevent vision loss.
What can I do to Prevent Vision Loss from Diabetic Retinopathy?
Diabetic retinopathy can be delayed and often prevented through tight blood sugar control. It might also lessen the need for laser surgery for severe retinopathy. Studies have found that patients who kept their blood sugar levels as close to normal as possible had much less eye, kidney, and nerve damage. Your local medical doctor will monitor your blood glucose and hemoglobin A1c levels, to help you maintain glucose levels in the normal range. Use of oral medications and insulin injections are the cornerstone of diabetic care. Maintaining a proper low sugar diet and controlling your weight are also key factors in helping to control diabetes.
It is also very important to keep your blood pressure under control. High blood pressure increases the risk of vision loss from diabetic retinopathy.
One must schedule annual dilated eye exams by your eye care specialist. Early vision loss from diabetic retinopathy may be so subtle that you do not notice, but an eye doctor will.