Diabetes mellitus is the most common cause of blindness in people younger than 65 years of age and one of the leading causes of permanent decreased vision.
An estimated 41 million people in the United States alone, 40% of which are adults ranging in age of 40 – 74 years, have “pre-diabetes,” a condition that significantly increases their risk of developing diabetes.
This new definition underscores the importance for you to take steps to help prevent your development of this disease. You can try to avoid the problems associated with diabetes mellitus including those that affect the eyes by managing your diabetes well.
Causes of Diabetic Retinopathy
High blood sugars and abnormalities in metabolism in diabetes mellitus may damage the
blood vessels in the retina. Some of the most sensitive tissues to decreased blood flow and oxygen delivery include the brain, the heart, the kidneys and the eyes.The retina can be thought of as film in a camera. If the film in a camera is faulty, the resulting picture would be distorted or blurry.
- Small blood vessels leak in the retina causing swelling or edema, and permanent damage if not treated. Not all cases are treatable.
Background Diabetic Retinopathy is considered to be mild and Proliferative Diabetic Retinopathy is considered to be more severe.
In cases of severe Proliferative Diabetic Retinopathy, new blood vessels may grow on the surface of the iris, causing neovascular glaucoma, a particularly severe form of glaucoma.
- Many people with diabetes mellitus may notice that their vision becomes blurry when their blood sugar fluctuates. Over time, the swelling that causes the blurred vision is thought to damage the lens and cause it to become cloudy, resulting in a cataract.
- The high blood sugar levels may also eventually damage the cells lining the trabecular meshwork toward the front of the eye, where the fluid (called aqueous humor) flows out from within the eye causing glaucoma.
If you have fairly large, rapid shifts in your blood sugar levels, you may notice that your vision becomes blurry. This may occur prior to the diagnosis of diabetes mellitus, or it may develop after the initiation of treatment or a change in treatment of diabetes mellitus.
- Frequent changes in eye glass prescriptions
- Blurred vision from fluctuating blood sugars
- More rapid cataract development
ALL DIABETICS MUST BE UNDER THE CARE OF AN OPHTHALMOLOGIST (EYE M.D.) AND BE SEEN AT LEAST ONCE A YEAR.
Surgery for Diabetic Retinopathy
Surgical treatment of a diabetic eye disease most commonly involves treatment of the retina with an argon laser.
- For Background Diabetic Retinopathy, Focal/Macular photocoagulation or grid macular photocoagulation is performed.
- For Proliferative Diabetic Retinopathy, Panretinal photocoagulation (PRP) is performed. During this treatment, the entire retina, except for the macula, (the center of the retina) –is treated with a laser to decrease the leaking of blood vessels and growth of unwanted new blood vessels.
- If extensive growth of new blood vessels, extensive scar tissue formation, tractional retinal detachment, or severe bleeding inside the eye has occurred, a vitrectomy is performed. In some instances, a vitrectomy combined with laser treatment and/or retinal detachment surgery is required.
If you have diabetes mellitus and mild diabetic retinopathy, you may only need follow-up examinations with your ophthalmologist every six months to one year.
If you have more serious diabetic retinopathy, more frequent follow-up appointments with your ophthalmologist are recommended based on the severity of your disease.
Prevention
If you have diabetes mellitus, “an ounce of prevention is worth a pound of cure.” If you watch your diet, exercise daily, monitor your blood sugars and take your diabetic medications, the chances of developing serious eye problems from diabetes will decrease dramatically.
