Conditions and Treatments
Diabetic Eye Care
Patients with diabetes are at a higher risk of developing eye conditions as a complication of their disease. These conditions can lead to vision loss and blindness and include diabetic retinopathy, cataracts and glaucoma. Diabetic retinopathy is actually the leading cause of blindness in the United States.
Diabetic eye conditions often develop without any noticeable loss of vision or pain, so significant damage may have occurred by the time patients notice any symptoms. For this reason, it is important for diabetic patients to have their eyes examined at least once a year. Early detection of eye disease can help prevent permanent damage.
Diabetic-related eye problems develop from high blood sugar levels, which can cause damage to blood vessels in the eye. Over 40 percent of patients diagnosed with diabetes develop some form of eye disease as a result of their disease. The risk of developing eye problems can be reduced with regular eye exams and by controlling blood sugar levels with a healthy diet and regular exercise.
Causes of Diabetic Eye Conditions
Diabetic eye conditions develop in the retina as a result of microvascular abnormalities. The tiny blood vessels within the retina develop microaneurysms that, over time, leak blood. As new blood vessels develop to replace the blood vessels that are no longer viable, they also leak blood causing hemorrhages and permanent damage to the retina.
While diabetics struggle with a high sugar count in the blood along with insufficient insulin production, it is actually the lack of oxygen in the blood that leads to loss of vision.
Diagnosis of Diabetic Eye Conditions
Diabetic eye conditions can be detected through a comprehensive eye exam. A comprehensive eye exam involves a visual acuity test to measure vision at various distances, and a dilated eye exam to examine the structures of the eye for any signs of disease. During this test, Dr. Miranda can examine the retina and optic nerve with a special magnifying lens. Tonometry may also be performed during a comprehensive eye exam to measure the pressure inside the eye with a special instrument.
Eye exams should be performed at least once a year or as soon as any potential problems are detected in order to ensure early detection of any serious conditions. Early detection is the strongest protection against diabetic eye diseases.
Diabetic retinopathy is the most common type of diabetic eye disease and the leading cause of blindness in the United States. Diabetic retinopathy is caused by changes to the blood vessels within the retina that lead to swelling and leaking. Diabetic retinopathy can also cause the growth of abnormal new blood vessels on the surface of the retina. There are four stages of diabetic retinopathy that begin with the occurrence of microaneurysms and eventually lead to abnormal blood vessel growth on the surface of the retina that leak and result in severe vision loss and even blindness.
The leaking blood vessels can also leak into the center of the macula causing swelling and blurred vision, a condition known as macular edema. The risk of developing macular edema increases with the severity of the condition.
Treatment of Diabetic Eye Conditions
Other than controlling blood pressure, blood cholesterol and the levels of blood sugar, treatment is not needed during the first three stages of diabetic retinopathy. The fourth stage, proliferative retinopathy is treated with a laser surgery procedure known as scatter laser treatment. During the procedure the abnormal blood vessels are ablated causing them to shrink. This procedure works best once the blood vessels begin to bleed. Severe blood vessel bleeding may need to surgically corrected with a vitrectomy procedure to remove the blood from the eye.
Treatment for macular edema usually includes a laser procedure called focal laser treatment. During this procedure, several hundred small laser burns are placed in the areas of retinal leakage around the macula to prevent leakage from occurring and reduce the amount of fluid in the retina. This helps reduce the risk of vision loss and may improve lost vision in a small number of cases.