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Diabetic Retinopathy

What is diabetic eye disease?

Diabetic eye disease refers to a group of eye complications that occur as a result of Type 1 and Type 2 Diabetes Mellitus, potentially resulting in severe vision loss or even blindness. All diabetes patients are at risk for diabetic eye disease and should have a comprehensive eye exam with dilation annually. The risk of complications increases significantly with poorly controlled blood sugar levels and the longer one has diabetes.

Diabetic Retinopathy is the most common manifestation of diabetic eye disease and is the result of increased blood sugar in the circulation. This causes the blood vessels of the retina to swell and leak fluid and exudates. Nearly half of all people with diabetes will develop some degree of diabetic retinopathy during their lifetime.

Another significant complication of diabetes is macular edema (swelling), which causes central vision loss, however the more serious complication is neovascularization (new blood vessel growth). Diabetic RetinopathyWith high blood sugar levels, oxygen and retinal nutrients are limited and as a result new retinal blood vessels begin to grow in an attempt to supply what the retina requires for normal function. This sounds like a reasonable adaptation, however these new vessels are not like normal blood vessels in that they are thin-walled and can easily leak. They can also grow into the vitreous space, which can lead to vitreo-retinal traction and ultimately retinal detachments.

Neovascularization can also lead to blood vessel growth on the iris and in the tissue where fluid exits the eye, causing a sight threatening and severe form of glaucoma called Neovascular Glaucoma.

It is VERY important that all Diabetes Patients schedule a yearly eye exam with Dr. Stokol or his associate.

What are the symptoms of diabetic retinopathy?

As with glaucoma, diabetes is not symptomatic in its early stages. By the time symptoms develop there is usually clinically significant swelling of the macula and blurred vision becomes a problem. Vision often fluctuates and symptoms vary greatly from one patient to the next and even if there are no symptoms initially it does not mean that the disease will spare one’s sight. Eventually, if uncontrolled, progressive diabetic eye disease will cause severe vision loss. Once again, yearly monitoring and early intervention is the key.

How is diabetic retinopathy detected?

As part of the eye exam, drops that dilate the pupils will be administered which provide Drs. Stokol and Associates a more extensive view of the inside of the eye. A thorough evaluation of the retina will be done in order to check for signs of diabetic retinopathy. Without dilation it is not possible to completely evaluate the health of the retina and the retinal blood vessels.

Can diabetic retinopathy be treated?

Yes. Drs. Stokol and his Associates may suggest consultation with and laser treatment by a retina specialist. Treatments can control the blood vessel leakage and swelling of the macula. Once again, finding diabetic retinopathy early is the best way to prevent vision loss.

Can diabetic retinopathy be prevented?

The majority of patients with diabetes will develop some degree of diabetic retinopathy, but the risk can be greatly reduced by controlling blood sugar levels, however adequate control significantly slows the onset and progression of retinopathy. Studies show that people who control their blood sugar levels with diet and/or medication have less eye and systemic complications. Maintaining regular Internist or Endocrinologist visits to determine the right sugar level for each patient is critical.

How common are the other diabetic eye diseases?

Cataracts: Studies show that diabetes patients are twice as likely to get cataracts compared to people who do not suffer from the condition. Also, cataracts develop earlier and more rapidly in those with diabetes.

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