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Diabetes of the Eye



DiabetesWHAT IS DIABETES?

Diabetes is a disease that is caused by too much glucose (sugar) in the blood for extended periods of time.  When glucose levels are high, this can damage many different organs including the heart, kidneys, feet, blood vessels, and even your eyes.

WHAT CAN I DO TO PREVENT DIABETIC PROBLEMS?

The most important thing to do is to obtain medical care on a regular basis and follow the advice of your doctors and other health care workers.  It is also important to exercise on a regular basis and take your diabetic medications at the prescribed times and dosages.  Also, check your blood sugar every day and keep a written record of the time the blood sugar was tested and the results.

HOW DOES DIABETES AFFECT THE EYE?

Diabetes can harm many different parts of the eye including the cornea, lens, vitreous, optic nerve and retina.  The retina is most commonly affected structure and the medical term for this is called DIABETIC RETINOPATHY.

WHAT IS DIABETIC RETINOPATHY?

Diabetic retinopathy is an eye disease that is caused when blood sugar levels are high.  The high blood sugar levels weaken the blood vessels causing some to swell and become leaky and others to become clogged.  When this occurs, it can damage the structures within the retina that sense light and lead to vision loss.  As this process continues, new blood vessels can grow to replace the damaged vessels.  These new vessels are very weak and can break easily spilling blood into the vitreous blocking light from reaching the back of the eye.  These new blood vessels can also result in the retina pulling away from the back of the eye and becoming detached.  This can result in profound vision loss.

WHAT ARE THE SYMPTOMS OF DIABETIC RETINOPATHY?

In the early stages of the process, there are usually no symptoms or mild blurring of the vision.  As the retinopathy progresses, the vision can become quite blurred and you may see spots floating in your vision.  In severe cases where the retina has started to become detached, many floating spots and flashes may be seen, as well as a loss of part of your side vision.  If the retina becomes totally detached or if bleeding occurs in the vitreous, you my experience complete loss of vision.    

CAN DIABETIC RETINOPATHY BE TREATED?

Yes, diabetic retinopathy can be treated but there is no cure.  The treatments are aimed to stop or slow the progression of leaky blood vessels or abnormal blood vessel growth that are affecting vision.  Laser treatment is the most common form of therapy and usually can be done in the office.  If a lot of blood has leaked into the vitreous cavity or if a retinal detachment is involved, you may need a vitrectomy.  A vitrectomy is a surgical procedure that removes blood and fluid from the vitreous and replaces it with clear fluid.  Another treatment method for diabetic retinopathy includes injections of medicine in to the back of the eye.  These medications work by inhibiting the hormone that is causing the growth of abnormal vessels or by reducing the swollen and damaged tissue in the back of the eye.

HOW CAN I PREVENT DIABETIC PROBLEMS FROM OCCURING IN MY EYE?

As with any other diabetic related disease, the most important form of prevention is tight control over your blood sugar levels.  Try to prevent large fluctuations in glucose levels since this has been correlated with increased retinopathy.  It is also important to maintain good control over blood pressure and cholesterol levels.

It is also very important to have a dilated retinal examination once a year.  This is important even if you are not having any vision problems.  The eye doctor will use dilating drops to make the pupil larger to obtain a clear view of the retina and other structures inside of the eye.

Often, problems with the retina or other part of the eye can be detected before they effect the vision and can be treated.  Detecting problems at an early stage can reduce the chance that they will become more serious later on and thereby reduce the risk of vision loss.

HOW OFTEN SHOULD I HAVE MY EYES EXAMINED?

We recommend yearly exams for all diabetic patients.  If any retinal or other problem is detected, more frequent exams may be needed.