Diabetic Eye Care
Diabetes is a disease that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. Patients with diabetes are at a higher risk of developing eye conditions as a complication of their disease. Diabetic-related eye problems develop from high blood sugar levels, which can cause damage to blood vessels. When diabetes affects the blood vessels in the eyes, it is called diabetic retinopathy.
What is Diabetic Retinopathy?
As diabetic retinopathy develops new blood vessels grow. These new vessels are your body’s attempt to overcome and replace the vessels that have been damaged by diabetes. However, these new vessels are not normal and may bleed, cause the vision to become hazy, and occasionally result in a complete loss of vision. In addition, abnormal blood vessels on the iris can lead to glaucoma and diabetic retinopathy can also cause the formation of cataracts.
What Is The First Sign Of Diabetic Retinopathy?
Diabetic Retinopathy Symptoms
- Blurred or double vision
- Seeing flashing lights, blank spots or dark floaters
- Pain or pressure in either or both eyes
- Problems with peripheral vision
- Severe vision loss if left untreated
- Irreversible blindness in advanced stages
What Causes Diabetic Eye Disease?
Stages of Diabetic Retinopathy
- Mild nonproliferative retinopathy – Small areas of balloon-like swelling in the retina’s tiny blood vessels characterize this earliest stage. These “microaneurysms” may leak fluid into the retina, leading to the development of floaters. But in many cases, they don’t and the patient has no symptoms.
- Moderate nonproliferative retinopathy – Now the blood vessels that nourish the retina may swell and distort. They may also lose their ability to transport blood. Both conditions cause characteristic changes in the appearance of the retina and will likely lead to diabetic macular edema, a build-up of fluid in the macula. The macula is the area of the retina used for sharp, straight-ahead vision.
- Severe nonproliferative retinopathy – As more and more blood vessels in the retina become blocked, blood is deprived to areas of the retina. These areas respond by secreting growth factors that signal the retina to grow new blood vessels
- Proliferative retinopathy – The most advanced stage accelerates the growth of abnormal new blood vessels. They now grow along the inside surface of the retina and into the vitreous gel that fills the interior of the eye. These abnormal vessels are weak/fragile, and they are likely to leak and bleed. Scar tissue that has formed as vessels become blocked can contract at this point and pull on the retina, causing retinal detachment. This is where the retina pulls away from the back of the eye, and it can lead to permanent vision loss.
Who Is Likely To Get Diabetic Retinopathy?
- Longer duration having diabetes
- Poor control of your blood sugar levels
- High cholesterol
- High blood pressure
- Tobacco use
- Being African American, Hispanic, or Native American
How Can I Prevent Diabetic Eye Disease?
Diagnosing Diabetic Retinopathy
An eye examination is often the only way to diagnose changes in the eye vessels and diabetic retinopathy, especially due to the lack of symptoms early on. Therefore, it is important for patients with diabetes to have routine eye examinations. During the examination, your Central Valley Eye Medical Group eye doctor may perform certain tests. This includes a visual acuity test, a dilated eye examination, tonometry test, and retinal exam.
Additionally, a fluorescein angiogram can test for diabetic retinopathy. This test involves an injection of orange-red dye, fluorescein, into the patient’s arm. The dye travels to your eye vessels and can be seen under a special filter. Our staff will take photographs of the retina through a green filtered camera with a flash of blue light. The pictures allow us to analyze and identify any damage to the lining of the retina or atypical blood vessels.
Diabetic Retinopathy Treatment at Central Valley Eye Medical Group
These are the treatments used to treat diabetic retinopathy:
- Anti-VEGF injection therapy — In this treatment, drugs are used to block a protein called vascular endothelial growth factor (VEGF), which stimulates the growth of the abnormal blood vessels. The drugs are injected into the vitreous gel of the eye. These drugs have proven to be effective for reversing abnormal blood vessel development and decreasing fluid in the eye. Brand names are Avastin, Lucentis, and Eylea.
- Focal laser treatment — In this procedure, laser energy is used to either stop or slow the leakage of blood and fluid in the eye. Also called photocoagulation, laser burns close the leaking vessels. This laser surgery may involve just a few small laser burns or up to hundreds, depending on the patient’s condition.
- Scatter laser treatment — Also known as pan-retinal photocoagulation, here the areas of the retina away from the macula are treated with 1,000 to 2,000 tiny scattered laser burns. These burns cause new abnormal blood vessels to shrink and scar. Scatter laser surgery works best before new, fragile blood vessels have started to bleed.
- Vitrectomy — This surgical procedure is used to treat severe bleeding into the vitreous. In the procedure, a tiny incision is made in your eye to remove blood from the vitreous, as well as the scar tissue that is pulling on the retina creating detachment.
These surgeries are very successful in preventing blindness in most people with diabetic retinopathy. Additionally, if your body has cataracts due to diabetic retinopathy, we can correct them with cataract surgery.
Can Diabetic Retinopathy Go Away Without Treatment?
That’s why it is imperative if you have diabetes that you get a comprehensive eye exam with dilation with the team at Central Valley Eye Medical Group at least once each year.
Complications Of Diabetic Eye Disease
- Vitreous hemorrhage — When the abnormal blood vessels bleed into the vitreous it may cause you to see a few dark spots if the bleeding is slight. But if the bleeding becomes more severe the vitreous cavity can fill with blood and completely block your vision. Vitreous hemorrhage won’t cause permanent vision loss, as the blood can clear or be removed.
- Retinal detachment — The abnormal blood vessels formed stimulate the growth of scar tissue, which can pull the retina away from the back of the eye. In slight detachment, this will cause flashes of light and floaters. In severe detachment, vision loss can result.
- Glaucoma — As abnormal blood vessels grow, they can interfere with the normal flow of fluid through and out of the eye. This causes pressure to build in the eye, and this is glaucoma. If untreated, this pressure can eventually damage the optic nerve, permanently damaging vision.
- Blindness — Complete vision loss is the end result of untreated diabetic retinopathy.