Patients with diabetes are at a higher risk of developing eye conditions as a complication of their disease. These conditions can lead to vision loss and blindness and include diabetic retinopathy, cataracts and glaucoma. Diabetic retinopathy is actually the leading cause of blindness in the United States.
Diabetic eye conditions often develop without any noticeable loss of vision or pain, so significant damage may have occurred by the time patients notice any symptoms. For this reason, it is important for diabetic patients to have their eyes examined at least once a year. Early detection of eye disease can help prevent permanent damage.
Diabetic-related eye problems develop from high blood sugar levels, which can cause damage to blood vessels in the eye. Over 40 percent of patients diagnosed with diabetes develop some form of eye disease as a result of their disease. The risk of developing eye problems can be reduced with regular eye exams and by controlling blood sugar levels with a healthy diet and regular exercise.
Causes of Diabetic Eye Conditions
Diabetic eye conditions develop in the retina as a result of microvascular abnormalities. The tiny blood vessels within the retina develop microaneurysms that, over time, leak blood. As new blood vessels develop to replace the blood vessels that are no longer viable, they also leak blood causing hemorrhages and permanent damage to the retina.
While diabetics struggle with a high sugar count in the blood along with insufficient insulin production, it is actually the lack of oxygen in the blood that leads to loss of vision.
Diagnosis of Diabetic Eye Conditions
Diabetic eye conditions can be detected through a comprehensive eye exam. A comprehensive eye exam involves a visual acuity test to measure vision at various distances, and a dilated eye exam to examine the structures of the eye for any signs of disease. During this test, your doctor can examine the retina and optic nerve with a special magnifying lens. Tonometry may also be performed during a comprehensive eye exam to measure the pressure inside the eye with a special instrument.
Eye exams should be performed at least once a year or as soon as any potential problems are detected in order to ensure early detection of any serious conditions. Early detection is the strongest protection against diabetic eye diseases.
Treatment of Diabetic Eye Conditions
Other than controlling blood pressure, blood cholesterol and the levels of blood sugar, treatment is not needed during the first three stages of diabetic retinopathy. The fourth stage, proliferative retinopathy is treated with a laser surgery procedure known as scatter laser treatment. During the procedure the abnormal blood vessels are ablated causing them to shrink. This procedure works best once the blood vessels begin to bleed. Severe blood vessel bleeding may need to surgically corrected with a vitrectomy procedure to remove the blood from the eye.
Treatment for macular edema usually includes a laser procedure called focal laser treatment. During this procedure, several hundred small laser burns are placed in the areas of retinal leakage around the macula to prevent leakage from occurring and reduce the amount of fluid in the retina. This helps reduce the risk of vision loss and may improve lost vision in a small number of cases. Focal laser treatment is performed in your doctor's office and can usually be completed in just one session.
Frequently Asked Questions (FAQ) – Diabetic Eye Disease
1. What is diabetic eye disease?
Diabetic eye disease refers to a group of eye conditions that can affect people with diabetes. These conditions include diabetic retinopathy, cataracts, and glaucoma. High blood sugar levels from diabetes can damage the blood vessels in the eyes, leading to vision problems and, if untreated, potential vision loss.
2. What is diabetic retinopathy?
Diabetic retinopathy is the most common form of diabetic eye disease. It occurs when high blood sugar levels damage the tiny blood vessels in the retina, the light-sensitive tissue at the back of the eye. This damage can cause blood vessels to leak, leading to swelling or scarring of the retina, which can impair vision.
3. What are the symptoms of diabetic retinopathy?
In the early stages, diabetic retinopathy often has no noticeable symptoms. As the condition progresses, symptoms may include:
- Blurry vision
- Dark or empty areas in your vision
- Seeing spots or floaters
- Difficulty seeing at night
- Sudden vision loss (in advanced stages)
4. What are the risk factors for diabetic eye disease?
Key risk factors for developing diabetic eye disease include:
- Having diabetes for a long time
- Poor control of blood sugar levels
- High blood pressure
- High cholesterol
- Smoking
- Pregnancy (for women with diabetes)
- A family history of diabetic eye disease
5. How is diabetic eye disease diagnosed?
- Dilated eye exam: The pupil is enlarged with eye drops to allow the doctor to examine the retina and optic nerve.
- Fluorescein angiography: A dye is injected into a vein, and a camera takes pictures to look for leakage or damage in the blood vessels in the retina.
- Optical coherence tomography (OCT): A non-invasive imaging test that provides cross-sectional pictures of the retina to detect fluid or swelling.
- Pt diagnosed with diabetes should be getting a yearly dilated eye exam to watch for early changes. The best way to prevent diabetic retinopathy is to control you blood sugar.
