Diabetic Retinopathy What You Should Know

By Samuel F. Boles, MD

November marks National Diabetes Awareness Month. It's a reminder that more than 23.6 million children and adults in the United States 7.8% of the population have diabetes. In addition to getting regular medical care, it's important for all those with diabetes to make sure they are having regular eye exams to help prevent Diabetic Retinopathy(DR), the most common diabetic eye disease and the leading cause of blindness in American adults.

Between 40 and 45 percent of Americans with diabetes have some degree of retinopathy, which causes 12,000-24,000 new cases of blindness each year. By the time symptoms of this eye disease appear, it may be too late to reverse the damage. Therefore, it is important for all people with diabetes to have a professional eye exam at least once a year, or more frequently if determined by an eye doctor.

What Is It?

DR is the most common progressive eye disease resulting from long-term diabetes. Specifically, it is damage to the blood vessels in the eye. There are two types (stages).

Non-proliferative DR is the first stage. Enlarged blood vessels and fluid/blood leaking into the retina cause problems with eyesight.

Proliferative DR is the more advanced type. New blood vessels form in the eye and hemorrhage, causing scarring on the retina and other parts of the eye. This results in many problems with sight and can lead to complete vision loss.

What Are The Symptoms?

In the early stages of DR, no symptoms will occur. In fact, for people with diabetes, dangerous changes in the retina often happen before a change in sight is noticed. Symptoms may include

Blurred vision

Shadows or loss of areas of vision

Difficulty seeing at nighttime

How Is It Treated?

Prevention is the best approach, however, there are effective ways to treat diabetic eye disease, particularly in its early stages.

To prevent diabetic retinopathyfollow your doctor's orders. You must tightly regulate blood sugar and blood pressure, and refrain from smoking. Regular, comprehensive eye exams are necessary to prevent further damage.

Treatment in the earliest stage is not always necessary but must be closely monitored by a specialist. Treatment in more severe cases does not reverse damage but can slow the disease from getting worse. Laser treatment is only available if the vessels have not yet started to hemorrhage. If bleeding has occurred, a surgical treatment called a vitrectomy may be needed to remove the blood in the eye.

Message of hope New treatment options are in development as scientists work toward a better understanding of this eye disease. For now, early detection of and care by your eye doctorand primary care doctor are essential for the successful treatment of patients with diabetes.