Diabetic Retinopathy

What is Diabetic Retinopathy?

Diabetic retinopathy, also known as diabetic eye disease, is caused by a complication of diabetes (both type 1 and type 2). Persistently high blood sugar levels cause damage to the blood vessels in the retina and can, if left untreated, cause blindness. The length of time you have had diabetes and how the maintenance of the condition are both significant factors in the progression of this eye disease. Fortunately, there is a lot that can be done to monitor, slow down and treat diabetic retinopathy. Controlling your blood sugar levels, blood pressure and cholesterol are very important factors, as is to partner with a medical retina specialist, to regularly assess your eyes and perform appropriate treatment.

Before diabetic retinopathy treatment

The appearance of floating spots or bleeding from abnormal retinal blood vessels.

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After diabetic retinopathy treatment

The suspended spots no longer exist, the bleeding stops and the vision becomes clear.

How do I know if I need the help of an Ophthalmologist specialist for diabetes?

Quite simply, if you have diabetes or are at risk (often called pre-diabetes) then you need to use the services of an ophthalmologist specializing in diabetes. Good management of the condition is the key to keeping optimal vision throughout your life. Only with regular checks by an ophthalmologist experienced in the monitoring and treatment of diabetic retinopathy you will be able to undergo early intervention should further complications arise.

While anyone who has diabetes is at risk of developing diabetic retinopathy, there are additional factors that increase the likelihood or speed of their progression.

These are:

  • Smoking-Hypertension (high blood pressure)
  • High cholesterol
  • Poorly controlled blood sugar-Some ethnicities
  • Hispanic, Native American, and African American
  • During pregnancy

In addition, the longer you have diabetes, the greater your chances of developing diabetic retinopathy. Complications of diabetic eye disease are many, and ophthalmologists specialized in diabetes are well trained to identify the first symptoms during regular eye checks.  The retina is the light-sensitive cell layer at the back of the eyethat carries light into electrical signals and transmits it through the optic nerve to the brain. To function effectively, the retina needs a constant source of oxygen-rich blood, which it receives through a network of tiny blood vessels. When blood sugar is uncontrolled for long periods, it weakens and destroys these blood vessels. If left untreated, this can, in severe cases, lead to permanent loss of vision.

There are two stages of diabetic eye disease – early diabetic retinopathy and advanced diabetic retinopathy. At the initial stage, you are unlikely to notice any obvious symptoms. However, the anatomical changes occurring inside the eye will be detected during a regular diabetic eye examination by your ophthalmologist. 

If you experience any of the following symptomsyou should immediately visit your diabetic ophthalmologist:

  • New floaters (shapes floating in your field of vision)
  • Blurred or fragmented vision
  • Pain in the eyes
  • Redness
  • Any deterioration of vision
  • Sudden loss of vision
Diabetic Retinopathy - eye clinic
Diabetic Retinopathy - eye clinic
Diabetic Retinopathy - eye clinic
Diabetic Retinopathy - eye clinic

The treatments used to treat worsening diabetic retinopathy include:

Laser treatment

There are several types of laser treatment. The first is called photocoagulation or focal laser treatment. It stops or reduces the leakage of blood vessels by sealing them with a laser burn. The second type is panretinal photocoagulation or scatter laser treatment. This uses a laser to shrink abnormal blood vessels, thus preventing their leakage. This treatment is carried out in multiple sessions. All laser treatments are generally performed under local anesthesia and take around 30-40 minutes per session.

 

Eye injections

These are used to treat severe diabetic maculopathy, a condition where the central part of the retina is damaged. The injections, called VEGF inhibitors (vascular endothelial growth factor) or anti-VEGF inhibitors help prevent the growth of new, abnormal blood vessels and edema in the retina. The treatment is quick and usually pain-free. Initially it will be carried out once a month until vision stabilizes. After this, they may be more infrequent or stop altogether. In some cases, if treatment with VEGF fails to have an effect, steroid medications may be injected.

 

Eye surgery

Known as vitreoretinal surgery, this is performed when a large amount of blood has leaked into the eye or if extensive scar tissue has or is likely to cause retinal detachment. It involves the creation of a small incision and removal of part of the vitreous from the eye. It is carried out under local anesthesia with sedation, so it is pain free and you will be unaware of it being carried out.

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