DIABETES AND THE EYE

Diabetes is a systemic disease that affects many organs in your body.  The eye may become involved primarily through changes in the blood vessels of the retina, the inner lining of the eye. Diabetic retinopathy,as this is called, develops typically 5-15 years after the diagnosis of diabetes.  In fact 80% of people who have had diabetes for 15 years or more have some blood vessel damage to their retina and diabetic retinopathy is the leading cause of new blindness among adults in the United States.

Diabetic patients are also more at risk for fluctuating vision, cataracts and glaucoma.

 Types of Diabetic Retinopathy

1.  Background retinopathy- This is the earliest stage of diabetic retinopathy.  In this stage, tiny blood vessels within the retina become damaged and leak blood or fluid.  This fluid causes the retina to swell.  When the swelling affects the central retina, the macula, it is called macular edema.  If macular edema affects vision, it can be treated with laser called focal macular photocoagulation.  Laser treatment is an office procedure that takes approximately five minutes.  Laser works by sealing the diabetic leaks in circulation giving the eye a chance to absorb the edema.  Vision frequently improves weeks to months after treatment.  Because early detection of leaks and prompt treatment yield better long term vision, we encourage all diabetic to have at least annual dilated eye exams.

normal

abnormal

2.  Proliferative retinopathy- This is the advanced stage of diabetic retinopathy.  It occurs when abnormal, new blood vessels grow from the optic nerve or retinal surface.  These new blood vessels, called neovascularization, are weak and prone to breaking which can lead to bleeding within the jelly cavity of the eye called vitreous hemorrhage.  This blood produces spots in the vision called floaters and may cause very blurry vision.

neovascularization

vitreous hemorrhage

Occasionally the eye is able to absorb the blood so that treatment to the new blood vessels can be instituted.  Treatment is with laser photocoagulation called PRP.  Laser treatment is an office procedure taking about ten minutes.  When vitreous hemorrhage does not absorb spontaneously, vitrectomy surgery can be performed to restore a clear visual pathway. 

Dr Brent is fellowship trained in the management of diabetic eye disease.  Call Premier Eye Care to schedule your diabetic exam soon.