Diabetes is a condition whereby the pancreas does not produce a sufficient amount of insulin to properly regulate the body’s blood sugar level. Diabetes can, over time, affect multiple organ systems such as the kidneys, heart, nervous system (both peripheral and central), the circulatory system, and the eyes.
Diabetes most commonly is seen in adults (adult-onset diabetes) but is not uncommonly encountered in children (juvenile-onset diabetes). Therapy for diabetes revolves around trying to maintain a blood glucose level within an acceptable range to minimize damage to the above organ systems. Treatment involves proper nutrition and diet, exercise, and the use of medications such as insulin or oral agents to lower blood sugar.
Millions of Americans lose vision yearly due to diabetes. The retinal circulation can be affected by diabetes in multiple ways that can cause moderate to severe loss of vision.
Diabetic retinopathy can be separated into two main categories: background retinopathy and proliferative retinopathy.
Background diabetic retinopathy may occur after having diabetes for several years and may be totally asymptomatic (without recognizable symptoms). On examination, the retina is dotted with small hemorrhages and microaneurysms (dilated capillaries). Most patients do not describe any functional visual loss, but the microaneurysms may leak fluid or lipids into the central retina (macula) and cause macular edema. This causes blurry or distorted vision. Treatment involves applying a laser to the dilated capillaries to prevent further leakage and promote reabsorption of the edema.
Proliferative diabetic retinopathy is less commonly encountered but is a more sight-threatening condition. In this case, abnormal blood vessels develop over the retina and optic nerve. These blood vessels are very frail and tend to bleed easily. Excessive bleeding (vitreous hemorrhage) leads to a sudden loss of vision. This hemorrhage may take months to reabsorb and can occasionally be associated with retinal detachments. A laser treatment directed at the peripheral retina often causes regression of these abnormal blood vessels before they bleed. Once a hemorrhage occurs, intraocular surgery may be required to remove the blood and repair the retina, if necessary, so that laser treatment may be applied.
Early detection is the most important prognostic factor in diabetic retinopathy. Treatment may begin before the disease moves into advanced stages. Early treatment decreases the chances of developing profound vision loss. We recommend a yearly dilated eye examination for all diabetic patients so the retina may be evaluated for the presence of retinopathy.
Contact Prado Vision Center in Tampa, Florida, today for more information about diabetic eye care.
