Don’t Let Diabetes Steal Your Vision

By Ahmed Nasrullah, MD

Dulles Eye Associates

. http://www.dceyedr.com/

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Don’t Let Diabetes Steal Your Vision

People with diabetes can develop an eye disease called diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal new blood vessels grow on the retina. This can destroy your vision and lead to blindness

There are two stages of diabetic eye disease Non-proliferative (NPDR) and proliferative retinopathy (PDR).

NPDR is an earlier stage of diabetic eye disease. This is common amongst diabetics. With NPDR, tiny blood vessels leak, making the retina swell. When the macula (central retina)swells, it is called macular edema. This is a common reason why people with diabetes lose their vision. Also with NPDR, blood vessels in the retina can close off causing retinal ischemia. When that happens, blood can’t reach the macula. Sometimes tiny particles called exudates can form in the retina. These also reduce vision.

PDR is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels. This is called neovascularization. These fragile new vessels often bleed into the vitreous (the gel that fills your eyes). If they bleed mildly, you might see a few dark floaters. If they bleed profusely, it might block all vision. These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or lead to a detached retina. PDR is extremely serious, and can steal your vision quickly.

To diagnose diabetic eye disease, drops must be put in your eye to dilate (widen) your pupil. This allows your ophthalmologist to look through a special lens to see the inside of your eye.

Your doctor may also do fluorescein angiography to see what is happening with your retina. Yellow dye (called fluorescein) is injected into a vein, usually in your arm. The dye travels through your blood vessels. A special camera takes photos of the retina as the dye travels throughout its blood vessels. This shows if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing.

Optical coherence tomography (OCT) is another way to look closely at the retina. A machine scans the retina and provides detailed images of its thickness.

Controlling your blood sugar and blood pressure can stop vision loss. Carefully follow the diet your nutritionist has recommended. Take the medicine your diabetes doctor prescribed for you. Sometimes, good sugar control can even bring some of your vision back.

New treatment options include anti-vascular endothelial growth factor (VEGF) medication. This helps to reduce swelling of the macula, slowing vision loss and perhaps improving vision. Steroids are another option to reduce macular swelling.

Laser surgery might be used to help seal off leaking blood vessels. This can reduce swelling of the retina. Laser surgery can also help shrink blood vessels and prevent them from growing again.

By the time you notice symptoms, you may have severe diabetic damage, so see your ophthalmologist regularly.