Diabetic Eye Diseases & Problems

Diabetic Retinopathy

Diabetic retinopathy is the most common diabetic eye disease and one of the leading causes of blindness in adults. Damaged retinal vessels leak fluid and blood into retinal tissue; diabetic macular edema is retinal thickening from this leakage. The two types of diabetic retinopathy include non‑proliferative and proliferative retinopathy.

Diabetic macular edema can occur at any retinopathy stage and can impair central/reading vision; management depends on edema, retinopathy severity, visual acuity, and follow-up reliability. The most important thing is to have regular eye exams to monitor any progression. Strict control of blood sugar, blood pressure, and cholesterol levels can greatly reduce or prevent diabetic retinopathy.

Proliferative retinopathy is when the illness has advanced. In this stage, new vessels grow or proliferate in the retina. These new vessels are the body’s attempt to overcome and replace the vessels which have been damaged by diabetes. These new vessels are not normal and they may bleed and cause your vision to become hazy. These new vessels can also damage the retina by forming scar tissue and by pulling the retina away from its proper location. Thankfully, any damage to the blood vessels in the eye can be slowed with treatment. For advanced proliferative retinopathy, laser surgery is often helpful. For abnormal blood vessel growth, the laser treatments are delivered over the peripheral retina.

A large majority of people who have diabetes will develop diabetic retinopathy, but with the available medical treatments, only a small percentage of people have serious vision problems. Early symptoms of diabetic retinopathy include floaters, blurriness, dark areas of vision, and difficulty perceiving colors. Retina problems are often treatable, and early detection increases the chances for success. Even if you haven’t experienced any vision problems, it’s essential to get a retina exam with pupil dilation once a year.

Macular Edema

Macular edema describes the condition where retinal blood vessels can develop tiny leaks. When this occurs, blood and fluid seep from the blood vessels and fatty material deposits in the retina. This causes swelling of the retina and is called diabetic macular edema. Symptoms can include reduced or blurred central vision, difficulty reading and colors will begin to fade and appear less vivid. Laser treatment can be used to reduce macular edema, focusing laser light on the damaged retina to seal leaking retinal vessels. The small laser scars that result will reduce abnormal blood vessel growth and help bond the retina to the back of the eye, thus preventing retinal detachment. Laser surgery can greatly reduce the chance of severe visual impairment and should be considered early in the course of the disease to prevent serious vision loss rather than to try and treat after vision loss has already occurred.

Who is at Risk for Diabetic Eye Disease?

All diabetics are at risk and need an annual dilated eye exam, but those with poor blood sugar control are at highest risk and may need more frequent exams. Additionally, the longer you have diabetes, the higher risk you have of vision loss. Patients with type II diabetes should begin getting annual eye exams as soon as they are diagnosed, while those diagnosed in childhood with type I diabetes should begin getting eye exams within five years of being diagnosed.

Diabetes is not a death sentence for your vision. With good control of your blood sugar, blood pressure, cholesterol and regular eye exams, most patients can do very well and retain very good vision, even normal vision.