Diabetes is the most frequent cause of new blindness in 20-74 year-olds. There are approximately 21 million diabetics in the U.S. with 8 million having some form of diabetic retinopathy. Of those 8 million, 700,000 have serious retinal disease. There will be 65,000 new cases of proliferative diabetic retinopathy each year with 24,000 new cases of blindness.
The longer someone has diabetes, the increased risk of developing serious eye disease. After 15 years of diabetes, approximately 65% of patients not taking insulin and 85% of patients taking insulin will develop some form of diabetic eye disease.
The small blood vessels in the retina become damaged from the high blood sugars in the circulation. The retina becomes ischemic (a decrease in blood flow to the retina). The ischemic retina sends out signals for the eye to produce new blood vessels to increase circulation. These new blood vessels are weak and can leak fluids and cause bleeding.
If abnormal blood vessels grow around the pupil, this can block fluid in the eye increasing pressure, causing glaucoma. Leaking blood can cloud the jelly-like vitreous inside the eye and block light entering the eye. New blood vessels can cause scar tissue that can pull the retina away from the back of the eye, causing a retinal detachment. Severe vision loss, or blindness can result.
Diabetes can affect vision by causing an increased risk of cataracts and glaucoma. Also, high blood pressure and high cholesterol can aggravate diabetic retinopathy and retinopathy can progress very quickly during pregnancy. Common symptoms can be blurry or distorted vision, difficulty reading, sudden vision loss in one eye, halos around lights, dark spots or floaters in vision, or flashes of light.
Many people with vision-threatening diabetic retinopathy have no symptoms. This is why regular eye exams are so crucial.
At Ohio Eye Alliance, we offer patients the most advanced technology available today for detecting and treating diabetic eye conditions to tailor treatment therapy to each individual. This includes the use of Optical Coherence Tomography (OCT), a non-invasive means of obtaining cross-sectional, layered images of the retina. We also offer a complete retinal angiography department, which takes retinal photographs of the eye to detect signs of new blood vessel growth.
The best treatment is prevention. However, once new blood vessels or fluid in the macula develops, they must be treated to preserve vision. Laser therapy by the use of a light beam is used to burn very small spots in the retina, causing the abnormal blood vessels to regress. Laser can also be used to treat fluid in the macula by sealing the blood vessels that caused the leaking. The eye then absorbs the fluid.
Intraocular steroid injections are used to treat diabetic macular edema. These injections can reduce swelling and inflammation inside the eye. Often injections are used as a complement to the use of lasers.
Treatment is essentially used to prevent the worsening of vision and can sometimes improve it. If laser treatment is no longer effective, or the condition worsens, retinal surgical intervention may be needed.
Because of the vision loss which can occur with diabetes, diabetics are encouraged to have a thorough eye examination at least once a year. With regular examinations, management, and treatment, diabetic eye disease may be controlled and vision preserved.