Diabetes is a common diagnosis related to difficulty in metabolizing blood sugar. Although we diagnose and treat diabetes by assessing the patient’s blood sugar, the main effect of diabetes is seen on small blood vessels. In the eye, the retina contains a complex organization of small blood vessels that can become damaged by diabetes. This process is called diabetic retinopathy.
Diabetic retinopathy is a serious problem that is the leading cause of blindness among adults under the age of 65. Patients with diabetic retinopathy can develop leaky blood vessels in the retina causing the retina to swell. This is called non-proliferative diabetic retinopathy and it can lead to decreased vision and damage to the delicate retinal tissue. A second form of diabetic retinopathy involves the growth of abnormal and immature blood vessels. This is termed proliferative diabetic retinopathy. These blood vessels can bleed and cause scarring which leads to decreased vision and retinal detachment.
Patients who have well controlled diabetes are less likely to develop diabetic retinopathy. Control of other vascular risk factors such as high blood pressure, high cholesterol, and avoiding cigarette smoking are also important in reducing the risk of diabetic retinopathy. Early detection of diabetic retinopathy is critical in preserving vision. Patients diagnosed with diabetes should have their eyes examined with dilation at least once a year by an ophthalmologist. Besides detecting diabetic retinopathy, an ophthalmologist can also communicate with your diabetes doctor giving better insight into your overall care.
Treatment of Diabetic Retinopathy
The treatment of diabetic retinopathy starts with proper monitoring and diagnosis through yearly dilated ophthalmic exams. If diabetic retinopathy is diagnosed in the mild or early stages, then more frequent exams with tighter blood sugar control is advised.
Progressive non-proliferative diabetic retinopathy may qualify for “focal laser treatment”. This laser treatment is performed in the office setting and is comfortable for patients. Focal lasers are designed to prevent further vision loss from diabetic retinopathy, but are not designed to improve vision. This limitation of treatment is essential to understand and underscores the importance of early detection through regular dilated ophthalmic exams.