If you have diabetes, regular vision exams are important to avoid eye problems. Diabetic retinaopathy, the most common diabetic eye disease, occurs when blood vessels in the retina change. People who have diabetic retinaopathy often don't notice changes in their vision in the diseases' early stages. But as it progresses, diabetic retinaopathy usually causes vision loss that in many cases cannot be reversed.

Diabetes is an increasingly common disease in the United States and throughout the world. Elevated blood sugar levels are the hallmark of diabetes. Diabetes is also a small blood vessel disease that affects the ability of their blood to adequately supply oxygen to the body. This small blood vessel disease is responsible for kidney disease, peripheral neuropathy (numbness or abnormal sensations of the feet), and diabetic eye disease. Public health officials are so concerned with diabetes they recommend an eye examination at least annually for patients with diabetes because significant diabetic retinopathy can be present without recognizable visual disturbance. If left untreated, this can lead to significant loss of vision.

Diabetic Retinopathy

Diabetic retinopathy is damage to the light-sensitive retina at the back of the eye due to Type 1 or Type 2 diabetes. It is the leading cause of blindness among Americans under the age of 65. Currently more than 5 million Americans age 40 and older have diabetic retinopathy, and that number will grow to about 16 million by 2050, according to the U.S. Centers for Disease Control (CDC) and other researchers. Complications of diabetic retinopathy include retinal detachment and glaucoma.

Signs and symptoms of diabetic retinopathy

Signs and symptoms of diabetic retinopathy include:
• Fluctuating, blurry and/or distorted vision
• Eye floaters and spots
• Development of shadows or blind spots in your field of view
• Double vision
• Near vision problems unrelated to presbyopia

If you experience any of these symptoms, see your eye doctor immediately. If you are diabetic, you should see your eye doctor at least once a year for a dilated eye exam, even if you have no visual symptoms. If your eye doctor suspects diabetic retinopathy, a special test called fluorescein angiography may be performed. In this test, dye is injected into the body and then gradually appears within the retina due to blood flow.

Your eyecare practitioner will photograph the retina as the dye passes through the blood vessels in the retina. Evaluating these pictures tells your doctor or a retina specialist if signs of diabetic retinopathy exist, and how far the disease has progressed.

What causes diabetic retinopathy?

Diabetes damages delicate blood vessels in the retina, causing them to bleed or leak fluid. It also can cause swelling of the retina, leading to blurred and distorted vision. These early changes are called non-proliferative diabetic retinopathy (NPDR). In the advanced stage of the disease, called proliferative diabetic retinopathy (PDR), new blood vessels grow on the surface of the retina. These abnormal blood vessels can lead to serious vision problems because they can break and bleed into the interior of the eye. PDR is much more serious than non-proliferative diabetic retinopathy and can lead to blindness.

The risk of both forms of diabetic retinopathy increase the longer you have diabetes. According to the American Academy of Ophthalmology, all diabetics who have the disease long enough eventually will develop at least some degree of diabetic retinopathy, though less advanced forms of the eye disease may not lead to vision loss. As soon as you've been diagnosed with diabetes, you need to have a dilated eye exam at least once a year.

How is diabetic retinopathy diagnosed?

Retinopathy is diagnosed by an ocular examination. Visual inspection of the retina during an exam is the most common diagnostic aid. Photographs of the retina can also be taken to document retinopathy and monitor changes over time. In addition to photographs, special testing can detect any swelling in the retina due to the diabetes. At McCormick Eye Center, each of these methods is used for appropriate patients.

 How is diabetic retinopathy treated?

Diabetes varies from one person to the next. As such, treatment may be simple observation over time or require more aggressive treatment with laser, injections inside the eye and/or surgery. Diabetic patients are best served by achieving optimal weight, blood pressure and blood lipid control and leading an active life style. Diabetes is a chronic disease and needs to be managed on a daily basis.

Like many chronic diseases, early appropriate treatment is best for maintaining good vision in diabetic patients. If you have diabetes or are concerned about diabetic retinopathy, call our office at 480-948-0733 for an appointment.

There are several diabetic related videos that can be viewed by clicking on the photo above.

Prevention of diabetic retinopathy

You can significantly reduce your risk of diabetic retinopathy by using common sense and taking good care of yourself:
• Maintain a healthy diet
• Exercise regularly
• Have routine physical exams and eye exams
• If you have diabetes, monitor your blood sugar regularly and keep it under control

Following these simple guidelines can prevent many cases of Type 2 diabetes and diabetic retinopathy.

Schedule an Appointment to Discuss this Eye Condition  with Dr Johnson