Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of diabetes. All can cause severe vision loss or even blindness.
Diabetic eye disease may include:
- Diabetic retinopathy—damage to the blood vessels in the retina.
- Cataract — clouding of the eye’s lens. Cataracts develop at an earlier age in people with diabetes.
- Glaucoma — increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults.
What is diabetic retinopathy?
Diabetes mellitus can damage blood vessels in the retina, causing diabetic retinopathy. Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina.
How is diabetic retinopathy diagnosed?
When Dr. Thom suspects your symptoms are pointing toward possible diabetic retinopathy, he’ll likely perform one or both of these imaging tests to verify your condition — fluorescein angiography and optical coherence tomography. Here’s what is involved with each.
- Fluorescein angiography — After dilating your eyes to widen your pupils, Dr. Thom will inject yellow dye (fluorescein) into a vein in your arm. The dye travels through your blood vessels. A special camera takes photos of the retina as the dye travels through the blood vessels in the eye. This shows if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing.
- Optical coherence tomography — After dilating your pupils, a machine scans your retina providing detailed images of its thickness. This allows Dr. Thom to find and measure swelling occurring in the macula.
What are the different types of diabetic retinopathy?
As diabetes progresses, a person’s blood sugar levels rise. Too much sugar in the blood can lead to the blockage of the tiny blood vessels that nourish the retina. This cuts off blood supply. In response, the eye grows new blood vessels, but they don’t develop normally and can leak.
There are two types of diabetic retinopathy:
- Nonproliferative diabetic retinopathy — This is the more common form. New blood vessels aren’t growing. Instead, the walls of the blood vessels in the retina weaken. Smaller vessels may develop bulges that can leak blood and other fluid into the retina. Larger vessels can become irregular in diameter. This early form of diabetic retinopathy can progress to the advanced form as more blood vessels become blocked.
- Proliferative diabetic retinopathy — In this more severe form of retinopathy, damaged blood vessels close off, instigating the growth of new, abnormal blood vessels in the retina. These can leak into the vitreous, the jelly-like filling of the center of the eye. Scar tissue will often form due to the new blood vessel growth, and this can cause the retina to detach from the back of the eye. The abnormal blood vessels may also interfere with the flow of fluid out of the eye, increasing pressure in the eyeball. This is glaucoma and the increased pressure can damage the optic nerve.
Who’s most at risk for developing diabetic retinopathy?
If you have diabetes, you can develop diabetic retinopathy. These factors increase your risk:
- 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 should I take care of my eyes?
Often there are no symptoms in the early stages of the disease, nor is there any pain. Don’t wait for symptoms. The most important thing is to have your eyes checked regularly. Be sure to have a comprehensive dilated eye exam at least once a year. Using an ophthalmoscope, Dr. Thom can diagnose and treat serious retinopathy before you are aware of any vision problems. He can also perform other operations to treat diabetic eye disorders.
Is it possible to still develop diabetic retinopathy even if your diabetes is always well controlled?
If you have either type 1 or type 2 diabetes, it is still possible to develop diabetic retinopathy, but early intervention with Dr. Thom and our team can help prevent serious vision loss and other unwelcome effects. The longer a
person has had diabetes the higher his or her chances of developing retinopathy.
How is diabetic retinopathy treated?
Diabetic retinopathy can develop and damage the eyes before it really shows any signs. But it can be spotted early, before this happens. That makes early diagnosis the best treatment. That’s why if you have diabetes you need to be sure to see Dr. Thom for regular yearly eye exams.
His treatment approach will depend on if you have nonproliferative (early stage) or proliferative (advanced) diabetic retinopathy. In early stages, simply managing your blood sugar effectively can slow the progression of diabetic retinopathy. Medications are showing promise in preventing abnormal blood vessels from forming in the eye, but they are under study at this point. Some patients may qualify to take part in these studies, but that is not a sure bet.
If you have proliferative diabetic retinopathy, you’ll need surgical treatment. Dr. Thom may use these surgeries and one other treatment, depending on your situation:
- Focal laser treatment — In this procedure, a laser is used to either stop or slow the leakage of blood and fluid in the eye. Also called photocoagulation, the laser energy closes the leaking vessels.
- Scatter laser treatment — Also known as panretinal photocoagulation, here the areas of the retina away from the macula are treated with scattered laser burns. These burns cause the new abnormal blood vessels to shrink and scar.
- Vitrectomy — This surgical procedure creates a tiny incision in your eye to remove blood from the vitreous, as well as the scar tissue that is pulling on the retina creating detachment.
- Eye injections — Injections can be made into the vitreous in the eye. These medications, called vascular endothelial growth factor (VEGF) inhibitors, may help stop growth of new blood vessels by blocking the effects of growth signals the body sends to generate new blood vessels.
These surgeries are very successful in preventing blindness in most people with diabetic retinopathy. Anti-VEGF therapy is often combined with scatter laser treatment. This method of treatment isn’t yet considered standard, although it is showing promise.
Does having diabetic retinopathy always lead to vision loss?
Diabetic retinopathy is the leading cause of blindness among working-age Americans. That correlates to the fact that the U.S. has the highest rate of diabetes among 38 developed countries, and approximately 30 million Americans have diabetes.
Once diagnosed with diabetes, it’s critical that you see Dr. Thom at least once each year for a complete eye exam. That gives us the best chance of slowing the progression of any developing retinopathy.
It’s high blood sugar rates that lead to the blockage of the tiny blood vessels that nourish the retina, causing the cutoff of blood supply and the response of growing new abnormal blood vessels. Keeping your blood sugar in check is the best way to prevent vision loss.
Call Thom Eye and Laser Clinic if you:
- Have blurry vision for more than 2 days
- Suddenly lose vision in one or both eyes
- See floaters (black or gray spots, cobwebs or strings that move or drift when you move your eyes)
- See flashing lights that aren’t really there
- Have pain or pressure in your eye(s)
- Or have any other questions about your eyes.
Schedule a client consultation
If you are interested in Diabetic Eye care and treatment in Fargo, ND, please give us a call at (701) 235-5200 today!