Diabetes can produce a number of diseases, including diabetic retinopathy, a disorder that generates changes in the veins, arteries and capillaries that supply blood and nourishment to your eyes. Retinopathy results in damage to the blood vessels in the retina, the light-sensitive tissue lining the back of the eye. It is the leading cause of vision loss among diabetics.
There are two types of diabetic retinopathy. Nonproliferative diabetic retinopathy, or NPDR, is a condition is which damaged blood vessels leak fluids into the retina, causing swelling and in some cases the formation of fatty deposits called hard exudates. The blood, fluid and exudates can force the macula, which affects central vision, to inflame or thicken. Another possibility in NPDR is that blood vessels feeding the retina close off, starving the macula of blood and nutrients and causing it to malfunction. Damage to the macula can invite blurring, warping or darkening of central, pinpoint vision. “Central vision is critical in doing everything from reading to watching TV to recognizing faces,” says Lake Eye ophthalmologist Dr. Scot Holman. “It is necessary for capturing details and performing most tasks.”
The other type is proliferative diabetic retinopathy, or PDR. With PDR, blood vessels in the retina become blocked, limiting blood supply and stimulating the retina to produce new blood vessels to compensate. Unfortunately, these new blood vessels are weak and malformed, and fail to provide adequate circulation to the retina. The new vessel walls can easily rupture and leak blood into the surrounding area and create scarring, which can cause the retina to buckle or detach. PDR can also cause blockage of the channels controlling eye pressure, leading to glaucoma.
While all this may sound like a lot of gloom and doom, there are highly effective treatments to help control diabetic retinopathy. But, as with all health issues, the earlier the disease is caught and treated, the better. “A dilated comprehensive eye exam and supplementary diagnostic tests can give me a clear view of early vessel damage before it has a chance to noticeably effect vision,” says ophthalmologist Dr. Scott Wehrly. “I tell my patients with diabetes to see me at least once a year, or more often if their case requires closer monitoring. With early detection and appropriate treatment, we can keep eyes functioning optimally and prevent nearly all cases of extreme vision loss.”
Treatment for diabetic retinopathy includes injectable medications, corticosteroids and macular or retinal laser surgery, which seals off or shrinks leaking blood vessels. The surgery is typically done in your ophthalmologist’s office as an outpatient procedure using local anesthetic.
“And of course, we remind patients that the best form of protection against diabetic retinopathy is to strictly control blood sugar,” says comprehensive ophthalmologist Dr. Shelby Terpstra. “That and regular testing can help arrest the disease before it impacts vision, which is always the best possible outcome.”
If you notice any changes in your vision, you should always see your ophthalmologist immediately. Keeping your diabetes under control through routine management of your blood sugar level is the first defense against diabetic retinopathy. Additionally, exercise, healthy eating habits and avoiding tobacco can help reduce your risk.
With early detection and appropriate treatment, it is possible to preserve clear vision throughout your lifetime. If you have diabetes and haven’t seen an ophthalmologist in the past year, it’s time to call the trusted professionals of Lake Eye Associates.