Diabetes affects your entire body, including your eyes. According to The American Academy of Ophthalmology, diabetics are 25 times more likely to lose vision than those without this disease. The most common complication of diabetes is diabetic retinopathy, and the longer you have diabetes, the more likely it is that you’ll develop diabetic retinopathy.
High blood sugar levels, as associated with diabetes, often affect blood vessels in the retina of the eye, causing diabetic retinopathy. There are 2 stages of classifications of diabetic retinopathy: non-proliferative or proliferative.
Non‐proliferative retinopathy, sometimes known as background diabetic retinopathy, is the most common form of the disease. This condition is first diagnosed when small retinal blood vessels start to swell. As the disease progresses, these blood vessels break and leak blood.
Proliferative retinopathy is the more advanced stage of diabetic retinopathy. As the condition progresses, more and more blood vessels are blocked. Sensing the need for new blood vessels to supply nourishment, new blood vessels grow, but they are frail and abnormal, often hemorrhaging and scarring. Patients with this type of diabetic retinopathy can experience severe vision loss, and even blindness.
At both the early and advanced stage of diabetic retinopathy, fluid can leak into the macula, the center of the retina that allows you to see fine detail. Known as diabetic macular edema, it is another common cause of vision loss in diabetics.
It is worth noting that smoking does accelerate the damaging effect that diabetes has on the retina. Several other influencing factors include your genes, your blood pressure levels, how long you have had diabetes and of course, your blood sugar level.
In the early and most treatable stages of diabetic retinopathy, there are usually no visual symptoms or pain. In fact, many times the disease can even progress to an advanced stage without any noticeable change in your vision.
The most important tool for treating diabetic retinopathy is good management of the underlying diabetic condition. Nevertheless, once diabetic retinopathy has presented itself, there are several methods of treatment including laser treatment, intravitreal injections/implants, and surgery. At The Eye Associates, we have the latest cutting edge technology and medication treatments available in the United States for diabetic retinopathy. Our retinal specialist, Dr. Joshua Mali, is a leader in his field and on the forefront of new medications and medical/surgical treatments developed for diabetic eye disease. He was one of the first retinal specialists in the United States to inject Iluvien, a new steroid implant used to treat patients with diabetic macular edema.
The optimal time for treatment is before the patient experiences visual symptoms, so early detection and treatment is the best protection against significant vision loss. Diabetic retinopathy can progress into its advanced stages with no pain, no recognizable vision loss, or other symptoms. That’s the reason it is so important for all diabetics to get a yearly comprehensive medical eye examination.
We strongly recommend that all diabetics have yearly comprehensive medical eye exams. Your eye doctor will dilate your eyes and check your retina, blood vessels and optic nerves for changes. They may also order a fluorescein angiogram to track and photograph dye as it flows through the retina and its blood vessels to look for leaking blood vessels.
We also commonly perform an Optical Coherence Tomography (OCT) to assess fluid accumulation (macular edema) in the retina of diabetics. The OCT can show areas of retinal thickening and is often a useful tool in assessing a patient’s response to a treatment.