Diabetes can cause complications that affect your eyes. While diabetes can increase the odds of a person developing glaucoma or cataracts, those diseases also develop in people without diabetes. The main concern for diabetes patients is diabetic retinopathy, which involves damage to the blood vessels in the retina of the eye. Diabetic retinopathy is one of the leading causes of blindness in the U.S.
We treat diabetic retinopathy and the other eye diseases caused by diabetes at Richens Eye Center.
What is diabetic retinopathy?
The retina is the light-sensitive tissue at the back of the eye. Diabetic retinopathy is caused by changes in the blood vessels in the retina. These vessels may swell and leak fluid. Abnormal blood vessels may grow on the surface of the retina. Diabetic retinopathy can develop in anyone who has type 1 or type 2 diabetes. The longer a person has diabetes, the more likely diabetic retinopathy will develop.
What are the symptoms of diabetic retinopathy?
One problem with diabetic retinopathy is that it often doesn’t show early symptoms, but damage can be occurring in the eye. It usually affects both eyes. Symptoms may include:
- Blurred vision
- Fluctuating vision
- Impaired color vision
- Dark or empty areas in your vision
- Vision loss
If you have diabetes, it’s imperative to see the team at Richens Eye Center for yearly eye exams. During dilation, we can spot early signs of diabetic retinopathy.
The Causes of Diabetic Retinopathy
As diabetes progresses, a person’s blood sugar levels rise. Too much sugar in the blood can lead to the blockage of the tiny blood vessels that nourish the retina. This cuts off blood supply. In response, the eye grows new blood vessels, but they don’t develop normally and can leak.
There are two types of diabetic retinopathy:
- Nonproliferative diabetic retinopathy — This is the more common form. New blood vessels aren’t growing. Instead the walls of the blood vessels in the retina weaken. Smaller vessels may develop bulges that can leak blood and other fluid into the retina. Larger vessels can become irregular in diameter. This early form of diabetic retinopathy can progress to the advanced form as more blood vessels become damaged.
- Proliferative diabetic retinopathy — In this more severe form of retinopathy, damaged blood vessels close off, instigating the growth of new, abnormal blood vessels in the retina. These can leak into the vitreous, the jelly-like filling of the center of the eye. Scar tissue will often form due to the new blood vessel growth, and this can cause the retina to detach from the back of the eye. The abnormal blood vessels may also interfere with the flow of fluid out of the eye, increasing pressure in the eyeball. This is glaucoma and the increased pressure can damage the optic nerve.
Who is likely to get diabetic retinopathy?
If you have diabetes, you can develop diabetic retinopathy. These factors increase your risk of:
- Longer duration having diabetes
- Poor control of your blood sugar levels
- High cholesterol
- High blood pressure
- Kidney disease
- Tobacco use
- Being African American, Hispanic, or Native American
How we diagnose diabetic retinopathy
At Richens Eye Center, we can diagnose diabetic retinopathy during a dilated eye exam, where we use drops to dilate your pupils. We look for these signs:
- Swelling, blood, or fatty deposits in the retina
- Abnormal blood vessels
- Growth of new blood vessels and scar tissue
- Bleeding in the vitreous
- Retinal detachment
- Abnormalities with the optic nerve
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How is diabetic retinopathy treated?
The best treatment is early diagnosis. Otherwise, vision damage may already have occurred. Treatment depends on if you have nonproliferative (early stage) or proliferative (advanced) diabetic retinopathy. In early stages, simply managing your blood sugar effectively can slow the progression of diabetic retinopathy. Medications are showing promise in preventing abnormal blood vessels from forming in the eye, but they are under study at this point.
If you have proliferative diabetic retinopathy, you’ll need surgical treatment. We may use these surgeries, depending on your situation:
- Focal laser treatment — In this procedure, laser energy is used to either stop or slow the leakage of blood and fluid in the eye. Also called photocoagulation, laser burns close the leaking vessels.
- Scatter laser treatment — Also known as panretinal photocoagulation, here the areas of the retina away from the center are treated with scattered laser burns. These burns cause the new abnormal blood vessels to shrink and scar.
- Vitrectomy — This surgical procedure creates a tiny incision in your eye to remove blood from the vitreous, as well as the scar tissue that is pulling on the retina creating detachment.
These surgeries are very successful in preventing blindness in most people with diabetic retinopathy.
Recovery from Diabetic Retinopathy
Laser surgery for diabetic retinopathy cannot restore vision that has already been lost, but it slows the progression of the disease. Your vision will be blurry for a day or so after laser surgery, but this should clear. Your eyes may ache for days after treatment. In the weeks after laser surgery, some people notice spots in their side vision when looking at anything with a white background. This fades. Flashes of light at night are also not unusual. If more laser treatment is needed, this can eventually cause excessive glare and difficulty seeing in sunlight.
Does insurance cover diabetic retinopathy treatment?
Insurance covers these treatment options.
The Potential Risks of These Procedures
These surgeries present risks, such as damaged peripheral vision, increased glare during daylight vision, and follow-up pain from the laser burning of the retina. Each treatment can require potentially thousands of laser burns to shrink or stem the leaking vessels.
Your team at Richens Eye Center will walk you through everything to expect during and after these treatments. There will be no surprises.
What if I don’t treat my diabetic retinopathy?
In most cases, early nonproliferative retinopathy will progress to proliferative retinopathy if not treated. This will continue to worsen until the patient can become blind.
What are other diabetic eye diseases?
In addition to diabetic retinopathy, diabetes also increases the risk of developing glaucoma and cataracts. People with diabetes are 40 percent more likely to suffer from glaucoma than people without diabetes. People with diabetes are 60 percent more likely to develop cataracts.