Diabetes and Diabetic Retinopathy
Diabetes is a very serious condition that affects hundreds of thousands of people every year throughout the world. A person with diabetes suffers from higher than healthy blood sugar levels as a result of the body's inability either to produce a sufficient amount of insulin or properly absorb the insulin being produced. Unfortunately, beyond the high blood sugar that is a direct result of diabetes, many complications arise as an indirect result of diabetes, particularly when it comes to a person's eyes.
Diabetic retinopathy is an eye disease that only affects diabetics. It occurs when the fragile vascular network that supplies the retina – the light sensitive tissue at the back of the eye that helps us see – begins to swell or leak. During the beginning stages of the disease, there may be no noticeable symptoms, so it’s important to have your eyes checked at least once a year, if you have diabetes.
Diabetes and Your Eyes
Dr. Schlussel of Drs Alan B. Schlussel and Christine Law, O.D. in Manhattan explains, “Diabetic retinopathy is possibly the most serious eye condition related to diabetes. This occurs as a result of extended periods of high blood sugar. Diabetic retinopathy comes in two types: nonproliferative and proliferative.”
Nonproliferative diabetic retinopathy is the earliest stage of retinopathy. This occurs when damaged blood vessels in the retina begin leaking fluids and blood into the eye. In some cases, deposits of cholesterol from the blood may leak into the retina. Although diabetic retinopathy at this stage is rarely sight threatening, sometimes swelling or thickening of the macula caused by fluid leaked into the eye causes the macula to function improperly. This is called macular edema and is the leading cause of vision loss caused by diabetes.
Proliferative diabetic retinopathy is a more advanced stage of retinopathy in which many blood vessels in the eye have closed themselves off, preventing proper blood flow to the eyes. As a result, the retina begins to grow new blood vessels to attempt to make up for blood not being carried to the eyes through the now closed blood vessels. These new blood vessels are abnormal, however, and are not able to supply the retina with proper blood flow.
At the same time, the new blood vessels often create scar tissue that may cause the retina to wrinkle or detach. Proliferative diabetic retinopathy is generally more serious and sight threatening than non-proliferative retinopathy because of the possibility of very serious complications such as traction retinal detachment, in which the wrinkling of the retina causes distortions in vision and may become very severe if large parts of the macula or retina become detached.
Symptoms and Signs of Diabetic Retinopathy
Once symptoms of diabetic retinopathy do develop, they can include: dark or black spots in your visual field, or blurry vision, and it increases over time. This is a result of bleeding at the back of the eye, which prevents a clear image from being transmitted from the retina to the brain.
Diabetes and Increased Risk of Eye Disease
People with diabetes are also at significantly increased risk of developing cataracts, a clouding of the vision caused by clumps of protein forming in the lens of the eye. Although cataracts usually affect people in their elderly years, diabetics tend to develop cataracts at a younger age, and their condition progresses much faster. In cataracts that cause significant blockage of the lens, the lens must be removed and replaced by an artificial lens in order to restore vision. This is not without risks, however. Studies have shown that a person's retinopathy can worsen and glaucoma may start to develop as a result of removing and replacing the lens.
In reference to another serious condition resulting from diabetes, Dr. Schlussel comments, “People with diabetes are at a 40% higher risk for contracting glaucoma, and this risk increases as a person ages. This condition occurs when fluid pressure inside the eye builds up and damages the optical nerve. With glaucoma, damage is done slowly, and a person may not realize they are losing their vision until significant damage has been done.”
Treating Diabetic Retinopathy
Whether you have type 1, type 2, or even just gestational diabetes, you are at risk for developing diabetic retinopathy. The longer you have had the disease, the greater the risk. It is essential to keep your blood sugar levels under control to prevent vision loss, and this may require a trip back to your primary care physician.
Treating diabetic retinopathy can include vitrectomy, replacing the inner gel-like substance that supports the eyeball structure, and laser surgery.
It is important to have regular eye exams to monitor for warning signs of these and other conditions that result from diabetes. For more information, contact us at Drs Alan B. Schlussel and Christine Law, O.D. 646-480-6832 today.
Special thanks to the EyeGlass Guide, for informational material that aided in the creation of this webpage.