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Diabetes
can affect sight
If you have diabetes mellitus, your body does not use and
store sugar properly. High blood-sugar levels can damage
blood vessels in the retina, the nerve layer at the back
of the eye that senses light and helps to send images to
the brain. The damage to retinal vessels is referred to
as diabetic retinopathy. The Halpin-Poweleit Eye Center
in Cincinnati Ohio, specializes in the detection and treatment
of diabetic retinopathy. |
NORMAL EYE |
CLOSE-UP OF RETINA WITH DIABETIC RETINOPATHY |
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Types
of diabetic retinopathy
There are two types of diabetic retinopathy: nonproliferative
diabetic retinopathy (NPDR) and proliferative diabetic retinopathy
(PDR).
NPDR, commonly known as background retinopathy, is
an early stage of diabetic retinopathy. In this stage, tiny
blood vessels within the retina leak blood or fluid. The
leaking fluid causes the retina to swell or to form deposits
called exudates.
PDR is present when abnormal new vessels (neovascularization)
begin growing on the surface of the retina or optic nerve.
The main cause of PDR is widespread closure of retinal blood
vessels, preventing adequate blood flow. The retina responds
by growing new blood vessels in an attempt to supply blood
to the area where the original vessels closed.
Unfortunately, the new, abnormal blood vessels do not resupply
the retina with normal blood flow. The new vessels are often
accompanied by scar tissue that may cause wrinkling or detachment
of the retina.
PDR may cause more severe vision loss than NPDR because
it can affect both central and peripheral vision.
How is diabetic retinopathy diagnosed?
A medical eye examination is the only way to find changes
inside your eye. Our physicians at Halpin-Poweleit Eye
Center can often diagnose and treat serious retinopathy
before you are aware of any vision problems. The physician
dilates your pupil and looks inside of the eye with an ophthalmoscope.
If the physician finds diabetic retinopathy, he or she may
order color photographs of the retina or a special test
called fluorescein angiography to find out if you need treatment.
In this test, a dye is injected in your arm and photos of
your eye are taken to detect where fluid is leaking.
How is diabetic retinopathy treated?
The best treatment is to prevent the development of retinopathy
as much as possible. Strict control of your blood sugar
will significantly reduce the long-term risk of vision loss
from diabetic retinopathy. If high blood pressure and kidney
problems are present, they need to be treated.
Laser surgery: Laser surgery is often recommended
for people with macular edema, PDR and neovascular glaucoma.
For macular edema, the laser is focused on the damaged retina
near the macula to decrease the fluid leakage. The main
goal of treatment is to prevent further loss of vision.
It is uncommon for people who have blurred vision from macular
edema to recover normal vision, although some may experience
partial improvement. A few people may see the laser spots
near the center of their vision following treatment. The
spots usually fade with time, but may not disappear. |
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PDR, the laser is focused on all parts of the retina
except the macula. This panretinal photocoagulation
treatment causes abnormal new vessels to shrink and
often prevents them from growing in the future. It
also decreases the chance the vitreous bleeding or
retinal distortion will occur. |
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Multiple
laser treatments over time are sometimes necessary. Laser
surgery does not cure diabetic retinopathy and does not
always prevent further loss of vision.
Vision loss is largely preventable
If you have diabetes, it is important to know that today,
with improved methods of diagnosis and treatment, only a
small percentage of people who develop retinopathy have
serious vision problems. Early detection of diabetic retinopathy
is the best protection against loss of vision.
You can significantly lower your risk of vision loss by
maintaining strict control of your blood sugar and visiting
your ophthalmologist regularly.
When to schedule an examination
People with diabetes should schedule examinations at least
once a year. More frequent medical eye examinations may
be necessary after the diagnosis of diabetic retinopathy.
Pregnant women with diabetes should schedule an appointment
in the first trimester because retinopathy can progress
quickly during pregnancy.
If you need to be examined for glasses, it is important
that your blood sugar be in consistent control for several
days when you see your ophthalmologist. Glasses that work
well when the blood sugar is out of control will not work
well when sugar is stable.
Rapid changes in blood sugar can cause fluctuating vision
in both eyes even if retinopathy is not present.
You should have your eyes checked promptly if you have visual
changes that:
- affect only one eye;
- last more than a few days;
- are not associated with a change in blood sugar.
When you are first diagnosed with diabetes, you should have
your eyes checked:
- within five years of the diagnosis if you are 30 years
old or younger;
- within a few months of the diagnosis if you are older
than 30 years. |
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