Diabetic Retinopathy

Diabetic retinopathy is an eye disease that affects the retina and its blood vessels in people with diabetes. In the early stages, patients don’t know they have a problem; in the worst cases, this disease can blind patients.

In some cases, fluid leakage in the central area of the retina can cause distorted or blurred vision in the early stages, and central vision loss if it progresses to end stage. In other cases, new blood vessel growth in any part of the retina can scar and shrink, leading to retinal detachment causing blindness.

Treatment and Management

If left untreated, diabetic retinopathy can lead to blindness. Diabetics are encouraged to take their prescribed medication as directed by their physician, exercise regularly, watch their diet, and have regular eye examinations in order to help prevent diabetic retinopathy. A timely referral may be made to a specialist for surgery to help preserve vision.

Prevention and Detection

Schedule a comprehensive eye examination as recommended by your optometrist. Only a thorough eye examination is able to look for changes in the eye as a result of the disease. Maintaining good blood sugar control can delay or prevent the serious consequences of diabetic retinopathy.

Diabetes and the Eye – Don’t Lose Sight of Diabetic Eye Disease

• People with diabetes can delay the onset of vision problems and blindness by strictly controlling blood glucose levels.
• Uncontrolled diabetes can create problems in the visual system long before a person notices pain or symptoms.
• People with diabetes are strongly encouraged to have at least annual comprehensive eye examinations by their optometrist.

Learn more about the prevalence of diabetic eye disease. More…

Common Questions Asked About Diabetes:

Why is it important to have routine periodic eye exams:

• Severe diabetic retinopathy occurs more commonly in patients who have had diabetes for a longer period of time (i.e. 10 or 20 yrs). However, diabetic retinopathy can also occur early.
• The level and quality of diabetic control may not be related to the severity of the retinopathy
• The severity of the diabetic retinopathy may not be related to the degree of other complications (e.g., kidney, neurological, etc.)
• The exact duration of the diabetes is unknown when diabetes is diagnosed in an adult
• Diabetes has been shown to have a significantly increased incidence of other eye diseases (e.g., cataracts and glaucoma)

Why do I need retinal photography & laser imaging of my eye?

Although eye examinations for diabetic retinopathy are performed by eye care professionals, certain stages of the disease (e.g., early proliferative diabetic retinopathy, i.e. abnormal blood vessels), may be very subtle in their appearance and difficult to diagnose. With the help of state of the art imaging these subtle findings are being detected early and appropriate follow-up care or referrals are being undertaken promptly. If subtle changes go undetected and appropriate testing and treatment is not carried out, patients may present at their next visit with diabetic changes which are now untreatable. It is prudent to have the most thorough and accurate eye examination currently available to ensure early detection and appropriate treatment.

What treatment can be done?

A referral to a retinal specialist will be made. This specialist will decide if there is a need for treatment. Laser treatment is most common.

Diabetic laser treatment (photocoagulation) uses powerful light rays directed into the eye and focused on a tiny spot on the retina. The light produces heat, which destroys abnormal tissue and cauterizes or seals off the abnormal blood vessels. Photocoagulation is usually not painful and is performed as an outpatient procedure.

A test called a fluorescein angiogram may need to be done to help your retinal specialist determine the best way for the treatment to be applied.

Patients with severe bleeding into the vitreous or detachment of the retina may require a major eye surgery called vitrectomy.

What changes should I watch out for?

The diabetic patient should be aware that eye symptoms of blurred or decreased vision, an increase or new floaters, flashing lights, distorted vision, etc., any of which may indicate serious eye disease. Fluctuating vision may indicate changes in blood sugar levels and which may indicate better blood sugar control is required. It may also mean that there is a problem occuring at the level of the retina such as the presence of macular edema or hemorrhaging. If any change is noticed go see your optometrist or eye care professional as soon as possible.