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Diabetes and Eye Disease in Houston

Causes, Symptoms, Exams and Treatment

Causes
Diabetic retinopathy is caused by damage from diabetes to blood vessels of the retina. The retina is the layer of tissue at the back of the inner eye. It changes light and images that enter the eye into nerve signals, which are sent to the brain. Diabetic retinopathy is a main cause of blindness in Americans 20 to 74 years old. People with type 1 or type 2 diabetes are at risk of this condition.

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There are two stages of diabetic retinopathy:

  • Nonproliferative develops first
  • Proliferative is more advanced and severe

The chance of getting retinopathy and having a more severe form is higher when:

  • You have had diabetes for a long time
  • Your blood sugar (glucose) has been poorly controlled

Other eye problems that can develop in persons with diabetes include:

  • Cataract - cloudiness of the eye lens
  • Glaucoma - increased pressure in the eye that can lead to blindness
  • Macular edema - blurry vision due to fluid leaking into the area of the retina that provides sharp central vision
  • Retinal detachment - scarring that may cause part of the retina to pull away from the back of your eyeball.


Symptoms
Most often, diabetic retinopathy has no symptoms until the damage to your eyes is severe.
Symptoms of diabetic retinopathy include:

  • Blurred vision and slow vision loss over time
  • Floaters
  • Shadows or missing areas of vision
  • Trouble seeing at night

Many people with early diabetic retinopathy have no symptoms before bleeding occurs in the eye. This is why everyone with diabetes should have regular eye exams.

Exams
Your eye doctor (ophthalmologist) will examine your eyes. You may first be asked to read an eye chart. Then you will receive eyedrops to widen the pupils of your eyes. Tests you may have involve:

  • Measuring the fluid pressure inside your eyes (tonometry)
  • Checking the structures inside your eyes (slit lamp exam)
  • Checking and photographing your retinas (fluorescein angiography)

If you have the early stage of diabetic retinopathy (nonproliferative), the eye doctor may see:

  • Blood vessels in the eye that are larger in certain spots (called microaneurysms)
  • Blood vessels that are blocked
  • Small amounts of bleeding (retinal hemorrhages) and fluid leaking into the retina

If you have advanced retinopathy (proliferative), the eye doctor may see:

  • New blood vessels starting to grow in the eye that are weak and can bleed
  • Small scars forming on the retina and in other parts of the eye (the vitreous)

Treatment
Persons with early diabetic retinopathy may not need treatment. But they should be closely followed by an eye doctor who is trained to treat diabetic eye diseases. Once your eye doctor notices new blood vessels growing in your retina (neovascularization) or you develop macular edema, treatment is usually needed. Eye surgery is the main treatment for diabetic retinopathy. Laser eye surgery creates small burns in the retina where there are abnormal blood vessels. This process is called photocoagulation. It is used to keep vessels from leaking or to shrink abnormal vessels. Surgery called vitrectomy is used when there is bleeding (hemorrhage) into the eye. It may also be used to repair retinal detachment.
Medicines that are injected into the eyeball may help prevent abnormal blood vessels from growing. Follow your eye doctor's advice on how to protect your vision. Have eye exams as often as recommended.

Source: nytimes

11-July-2014

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