Diabetic Retinopathy

Understanding diabetic eye disease?

diabetic retinopathyAre you a diabetic patient at Kentucky Eye Institute? Has your family doctor told you about the importance of regular eye examinations? If you are diabetic, having regular eye health exams is highly suggested by the eye physicians at Kentucky Eye Institute.

According to the National Eye Institute, it is estimated that nearly 5.4 million Americans, ages 18 and over currently have diabetic retinopathy. This eye disease causes over 8000 cases of new blindness annually, and is the primary cause of blindness for people ages 25 to 74 (Valero and Drouilhet, 2001).

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What is diabetic eye disease?

Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of diabetes. All can cause severe vision loss or even blindness. Some of the eye diseases associated with diabetes are cataracts, glaucoma and diabetic retinopathy. For the purposes of this website page we will focus on diabetic retinopathy.

Understanding Diabetic Retinopathy

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. In the majority of diabetic retinopathy cases, blindness is completely preventable. Patients will need to work closely with their Kentucky Eye Institute diabetic retina eye doctors to monitor and treat this disease. The use of medications and daily blood sugar monitoring can make a major impact on containing the worsening of diabetic retinopathy.

The retina is in the back of the eye and is like the light sensing film in a photographic camera that captures the images. In the diabetes disease, sugar (glucose) builds up within blood vessels in the retina and tissues of the body causing it to attach to the proteins in the wall. This alters the vessel’s normal structure and functioning. The vessels eventually get blocked and leak fluid. When they cannot deliver an adequate amount of blood supply to the eye, the eye can generate abnormal new blood vessels. Early diabetic retinopathy usually has no symptoms. However, worsening diabetic retinopathy can lead to visual loss and blindness.

The stages of diabetic retinopathy are divided into two categories, nonproliferative retinopathy and proliferative retinopathy.

Quick NOTE: If you have diabetic retinopathy, at first you may not notice changes to your vision. Over a long period of time, diabetic retinopathy can get worse and cause vision loss.

Nonproliferative Retinopathy

This is the first and earliest stage of diabetic retinopathy. NPDR occurs when the small blood vessels of the retina start to leak fluid or bleed. This activity will lead to the formation of deposits called exudates. Once these blood vessels start to leak swelling within the central part of the retina occurs. When the leakage of these blood vessels causes swelling, macular edema sets in and the blood vessels can become blocked. This stage of diabetic retinopathy is common when a person develops diabetes. Most diabetics have some grade of NPDR. It is imperative to maintain regular eye examinations with the retina specialists at the Kentucky Eye Institute to monitor and treat NPDR.

Proliferative Retinopathy

When new vessels start to grow as a result of the existing vessels becoming blocked, this marks the beginning of the next stage of diabetic retinopathy, proliferative diabetic retinopathy. This level of diabetic retinopathy is the most severe and dangerous for the diabetic patient. These new abnormal blood vessels can grow on the retina, optic nerve, iris or into the vitreous gel inside the eye, and tend to grow poorly and are very fragile. The damage that these blood vessels bring to the retina can be catastrophic and include hemorrhages on the retina, scar tissue build up, and possible retina detachment.

Diabetic Eye Retinopathy - Causes and Risk Factors

Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways:

  • Weak and abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision.
  • Fluid can leak into the center of the macula, the fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses.

Learning to live with diabetes and diabetic retinopathy
Essential nutrition tips for Kentucky Eye Institute diabetic retinopathy patients

If you are diabetic patient you have most likely had some kind of discussion with your primary care doctor regarding diet. The nutrition of the food you eat becomes critical for maintaining proper blood sugar levels. Please refer to this list below for diabetic nutrition tips:

  • Drink water (8 glasses per day)
  • Reduce artificial fats
  • Juice and vegetables
  • Increase fiber intake
  • Reduce caffeine and refined sugar

Diabetic Retinopathy Treatment Options
Diabetic retinopathy treatments: Kentucky Eye Institute

  • Laser treatments - These laser treatments are also known as photocoagulation. The laser is uses controlled bursts to seal leaking blood vessels, destroy abnormal blood vessels, seal retinal tears and remove abnormal tissue that has formed on the back of the eye.
  • Intraocular corticosteroids – Many studies have been conducted recently with these types of injections. They may reduce retinal swelling and improve visual acuity in patients with diabetic macular edema.
  • Vitrectomy - A vitrectomy may be performed to clear blood and debris from the eye, to remove scar tissue, or to alleviate traction on the retina. The Vitrectomy actually removes vitreous gel from the eye through a small incision using a laser. Vitrectomy allows the retina to flatten. Depending on the severity of the diabetic retinopathy, gas or air might be placed in the eye to replace the vitreous fluid that was removed. This gas or air helps smooth out the retina and prevent retinal detachment.

Living with Diabetes

If you are a diabetic eye care patient we suggest regular eye examinations to monitor any activity related to your retina and blood vessels in the back of the eye. Our retina eye doctors help many people with diabetes on a yearly basis and we hope to help you too! Please feel free to contact any of our Kentucky diabetic eye doctors.

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