Diabetes and Your Eye Sight

By Sadiq N. Syed, MD

Maryland Retina

. http://www.marylandretina.com

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Diabetes and Your Eye Sight

Recent statistics show that 25.8 million individuals in the United States suffer from diabetes mellitus, a chronic disease causing vascular complications throughout the body due to increased blood glucose. Uncontrolled diabetes causes slow damage to the retina, which is the “nerve tissue” of the eye, and damage to the retina is referred to as diabetic retinopathy.
Diabetic retinopathy comes in 2 general types, background diabetic retinopathy, and proliferative diabetic retinopathy.
Background diabetic retinopathy is the earlier stage of damage to the retina. In many cases background diabetic retinopathy can lead to leakage and swelling in the retina called diabetic macular edema. Diabetic macular edema is a frequent cause of vision loss. The primary treatment for background diabetic retinopathy is to prevent further damage by improving diabetic control with lifestyle measures and medications. If background diabetic retinopathy worsens and diabetic macular edema (macular swelling) occurs, then retina laser treatments or eye injections of anti vascular endothelial growth factor (VEGF) agents or steroids may be required to treat DME and prevent vision loss.
In proliferative diabetic retinopathy (PDR) there is poor blood flow in the eye (ischemia) due to widespread damage to retinal capillaries. The body's response to ischemia is new blood vessel growth or neovascularization. These fragile new blood vessels can leak blood in the center of the eye, which is called a vitreous hemorrhage. A vitreous hemorrhage will prevent light from entering the eye causing severe vision loss. In many cases PDR can be treated with a retinal laser to reduce ischemia of the eye. Surgery is often needed for advanced cases of vitreous hemorrhage. This surgery is called vitrectomy, which means removal of the vitreous gel from the eye.
Advanced PDR can lead to scar tissue formation in the eye. In some cases the scar tissue will pull the retina away from the wall of the eye, which is called traction retinal detachment (TRD). TRD frequently requires vitrectomy surgery to repair the retina, however vision may not improve even with surgery in these advanced cases.
It is recommended that all individuals diagnosed with diabetes have a retinal exam at the time of diagnosis and on at least a yearly basis thereafter. More frequent retinal exams or retinal treatment may be recommended based on the findings of your retinal exam. Early detection and treatment of diabetic retinopathy can prevent blindness.