Diabetic retinopathy is the leading cause of blindness in adults in America. Approximately ¼ to ½ of current diabetics have some form of the disease. It is estimated that over 90% of diabetics may experience some form of eye changes over the course of their life. The risk of developing diabetic retinopathy is related to both age and to how long one has had the disease. Having diabetes does not mean that you will develop eye problems.
Diabetic retinopathy occurs in people with diabetes mellitus when the tiny blood vessels that nourish the retina, located in the back of the eye, begin to develop abnormalities. These vessels weaken, leak fluid and blood, and fail to provide the retina with the nutrients necessary for good health. This is called non-proliferative diabetic retinopathy. If the blood vessels leak fluid into the center of the retina, vision can become blurred. This condition is called macular edema. As diabetic retinopathy progresses, new fragile blood vessels grow on the surface of the retina. This is called proliferative diabetic retinopathy. During this stage of diabetic retinopathy, both retinal detachments and glaucoma may occur. Left untreated, diabetic retinopathy can result in severe vision loss, and even blindness.
As you know, diabetics have high levels of glucose (sugar) in their blood. These high levels of glucose damage the blood vessel walls and ultimately lead to blood vessel dysfunction.
Though vision may gradually become blurred, significant loss does not usually occur with background (early) diabetic retinopathy. Because the patient does not experience symptoms such as pain or redness, changes in the retina can go unnoticed unless detected during an eye examination. Symptoms may include: blurred or distorted vision, floaters or flashes of light, partial or total loss of vision or a veil across your vision, and pain in the eye. If any of these symptoms occur, you should see an eye doctor immediately.
A complete eye examination is the best protection against and tool for detecting diabetic retinopathy. Once again, prevention is the best medicine!
Early detection and treatment of diabetic retinopathy is important to slow or arrest the development of the sight-threatening complications of diabetic retinopathy. Even when no symptoms are noticed, all diabetic patients should have frequent eye examinations as recommended by their doctor. At a minimum, diabetics should have a dilated examination yearly for the rest of their life. Non-diabetics should also have their eyes examined periodically to help detect the presence of diabetes and other diseases.
There are four typical treatments for this condition. The first level of treatment undertaken is in coordination with your primary care doctor: blood glucose (sugar) control is improved, blood pressure is well controlled, a healthy diet is followed, and regular exercise is undertaken. The second treatment is laser therapy. This can both decrease the leakage from the damaged blood vessels, and can help to prevent the growth of new weak blood vessels. Injections of medicines can also be given to decrease the amount of fluid leaking from the blood vessels. The last treatment undertaken is a surgery called a vitrectomy. During this procedure, the gel that fills the back part of the eye is removed along with any blood that has leaked into this gel.
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