Diabetic retinopathy is a common eye condition that occurs in patients with diabetes.
Diabetic retinopathy (DR) is the most common cause of blindness in America. It can cause damage to the retina in both insulin-dependent patients or patients on medications to control their blood sugars. Diabetic eye disease occurs when small blood vessels in the retina are damaged due to chronically elevated blood pressure and blood sugars.
Damaged blood vessels become “leaky” and spill fluid into the retina. Diabetic macular edema or DME occurs when this fluid develops in the area of the retina responsible for central vision – the macula. Diabetics commonly complain of trouble reading or difficultly seeing street signs while driving. Prolonged damage over the years can lead to the production of chemical factors within the eye that cause abnormal blood vessel formation or “neovascularization.” This process causes tension on the retina and can lead to retinal detachment or bleeding inside of the eye (vitreous hemorrhage). High eye pressure can cause eye pain and glaucoma due to abnormal blood vessel formation at both the front and back of the eye. The most severe stage of diabetic retinopathy is called PDR or proliferative diabetic retinopathy. It is identified by the growth of abnormal blood vessels and scar tissue within the eye. If untreated, it may result in retina tear or retinal detachment. A common symptom is the sudden onset of eye floaters or blurred vision.
Patients with diabetes are often on many different medications. Sometimes, medications can cause or worsen macular edema. Vitamin supplements (e.g. Niacin), cancer therapies, and medications for glaucoma are some of the more common medicines which may worsen macular edema.
The absolute best way to diagnose diabetic eye disease is with dilated examination by a qualified retina specialist. The retina specialist will look for swelling at the back of the eye (edema), retinal hemorrhages (bleeding), and lipid exudates (fat deposits in the retina). Abnormal blood vessel formation is an advanced eye finding and may prompt emergency eye care or treatment with laser or eye injection. Your retina specialist will use modern techniques like fundus photography, B-scan ultrasonography, or optical coherence tomography (OCT) to determine the stage and severity of your diabetic retinopathy. A fluorescein angiogram (FA) is rarely used to identify areas of leaking blood vessel formation.
Luckily, if caught early, diabetic eye problems are usually very treatable.
A few things that patients can do to prevent diabetic retinopathy are: stopping smoking, controlling blood pressure, tracking and treating high blood sugar, and lowering cholesterol. Early detection is key in this preventable eye disease. There are many good treatments for diabetic eye disease including: eye injections, eye laser, or retina surgery. Many treatments are available in the ophthalmologist’s office.