|
Patients with longstanding diabetes sometimes develop a common and often disabling condition known as Diabetic Retinopathy. This is caused when elevated levels of blood sugar damage the tiny blood vessels in the eye's retina. Usually both eyes are affected at the same time. Diabetic retinopathy can also cause increased pressure on the eye, that can further diminish vision. Untreated diabetic retinopathy can lead to complete and irreversible vision loss. This condition is the leading cause of blindness in people ages 20-60 in America today. If diabetic retinopathy is detected early on, blindness can be prevented. While most diabetics develop some vision problems only about 5% suffer severe vision loss.
The risk of developing diabetic retinopathy is directly proportionate to the length of the illness. Both type I and type II diabetes can lead to retinal damage. Retinopathy usually does not appear for up to five years after a type I diagnosis but may be already present when type II diabetes is diagnosed. After about 15 years of diabetes 98-99% of those with type I diabetes and 78-80% with type II have some degree of retinal damage.
Diabetic retinopathy is a silent attacker. Severe retinal damage can occur before any symptoms appear. Some of the most common symptoms are:
Blurred vision that does not improve with corrective glasses.
Vision that worsens, improves and worsens.
Sudden loss of vision following a coughing or sneezing attack.
Seeing spots, streaks or having cone vision.
Eye pain or strain when trying to focus (on small print or on far away objects)
Because some symptoms mimic those of normal aging, most people with macular degeneration or diabetic retinopathy do not seek medical help right away.
Macular edema (the swelling and fluid accumulations in the retina), causes the vessels to be robbed of its blood supply, causing neovascularization. These fragile vessels can bleed, creating scar tissue and separation of the retina and the back of the eye (called retinal detachment).
It is important that anyone with diabetes gets regular eye exams. Retinopathy can be detected early by an Ophthalmologist. When you visit the doctor, he or she will questiion you about any possible changes in your vision. He or she will also perform an eye exam with an ophthalmoscope to see if the retina has been damaged. Some of the features of diabetic retinopathy cannot be seen during the normal eye exam. To get a better look at the inside of your eye, the ophthalmologist may administer drops to dialate your pupils to view the retina with a special light called a slit lamp. Another test that can be performed is Fluorescein Angiography. For this test the doctor injects a special dye into your veins that outlines the eyes blood vessels. At that time he will take pictures of your retina to see if the function and structure of the retinal blood vessels has changed.
The ophthalmologist can treat your retinopathy with a laser or a surgical procedure called a Vitrectomy. Laser treatment, called Laser Photocoagulation, creates tiny retinal burns that seal off leaking vessels. The number of burns your doctor makes depends on the extent of your retinopathy. Treatment can take several months to show improvement. Your doctor may perform a Vitrectomy if you have a hemorrhage that doesnt clear, you have retinal detachment or if the laser treatment doesn't improve your condition.
During Vitrectomy, the doctor drains the inside of your eye, clearing any remaining blood and removing scar tissue.
While both of these treatments can be very effective, your exectations for recovery should be realistic. Either treatment cannot restore lost vision but they can prevent further eyesight loss.
Diabetic retinopathy can be minimized with a combination of blood sugar control and routine eye exams. Even with optimal medical care, the prevention of retinal damage is not always guaranteed. Routine screenings offer the best hope for early detection of diabetic retinopathy. People with type I diabetes should have a complete exam within five years of being diagnosed and then every year after that. Those with type II diabetes should have an exam yearly starting at the time of their diagnosis.
Research continues to be done to find new therapies for retinopathy. Your doctor can provide you with information about the latest medications being used. He can also supply refferral to an ophthalmologist that specializes in diabetic retinopathy. If you have diabetes make suer to keep your medical records up to date and inform your doctor immediately when there is any change in your vision.
| 
