As the U.S. population continues to gain weight, an ominous side effect also grows — diabetic retinopathy. Diabetic retinopathy is now the leading cause of blindness among working-age Americans.
The Centers for Disease Control estimate that roughly 25,000 cases of blindness from diabetic retinopathy are now occurring in the U.S. every year. This correlates with the rate of diabetes, which has tripled since 1980.
But this doesn’t have to be the case. Early detection, coupled with management of the patient’s diabetes, can limit the damage of diabetic retinopathy and prevent blindness.
We diagnose and treat diabetic retinopathy at Wilkinson Eye Center in Clarkston and Pontiac, MI.
What is Diabetic Retinopathy?
Diabetic retinopathy develops when changes occur to the blood vessels of the retina. The retina is the light-sensitive tissue at the back of the eye. With diabetic retinopathy, the blood vessels may swell and leak fluid. Abnormal blood vessels may grow on the surface of the retina. This condition can develop in patients with either type 1 or type 2 diabetes. The longer a person has diabetes, the more likely he or she will develop diabetic retinopathy.
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Quick Links
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- Causes of Diabetic Retinopathy
- Symptoms of Diabetic Retinopathy
- Types of Diabetic Retinopathy
- Who is likely to get diabetic retinopathy?
- What can I expect from diabetic retinopathy treatment at Wilkinson Eye Center?
- Am I a Candidate for Diabetic Retinopathy Treatment?
- What to Expect During Recovery
- Can diabetic retinopathy go away on its own?
- Will my insurance cover diabetic retinopathy treatment?
- Schedule a diabetic retinopathy Consultation with Wilkinson Eye Center
Causes of Diabetic Retinopathy
When a person has diabetes, their blood sugar levels rise. This can impact various body functions, including the eyes. Too much sugar in the blood can lead to the blockage of the tiny blood vessels that nourish the retina. This cuts off blood supply. To compensate, the eye grows new blood vessels, but they don’t develop normally and can leak.
Symptoms of Diabetic Retinopathy
One problem with diabetic retinopathy is that it often doesn’t show early symptoms, but damage can be occurring in the eye. It usually affects both eyes. Symptoms may include:
- Floaters
- Blurred vision
- Fluctuating vision
- Impaired color vision
- Dark or empty areas in your vision
- Vision loss
This unknown damage makes it paramount for people who have diabetes to see the team at Wilkinson Eye Center for yearly eye exams. During dilation, we can spot early signs of diabetic retinopathy.
Types of Diabetic Retinopathy:
There are two types of diabetic retinopathy:
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Nonproliferative diabetic retinopathy
This is the more common form. New blood vessels aren’t growing. Instead, the walls of the blood vessels in the retina weaken. Smaller vessels may develop bulges that can leak blood and other fluid into the retina called diabetic macular edema. Larger vessels can become irregular in diameter. This early form of diabetic retinopathy can progress to the advanced form as more blood vessels become blocked.
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Proliferative diabetic retinopathy
In this more severe form of retinopathy, damaged blood vessels close off, instigating the growth of new, abnormal blood vessels in the retina. These can leak into the vitreous, the jelly-like filling of the center of the eye. Scar tissue will often form due to the new blood vessel growth, and this can cause the retina to detach from the back of the eye. The abnormal blood vessels may also interfere with the flow of fluid out of the eye, increasing pressure in the eyeball. This is glaucoma and the increased pressure can damage the optic nerve.
Who is likely to get diabetic retinopathy?
If you have diabetes, you can develop diabetic retinopathy. These factors increase your risk:
- Longer duration having diabetes
- Poor control of your blood sugar levels
- High cholesterol
- High blood pressure
- Pregnancy
- Tobacco use
- Being African American, Hispanic, or Native American
What can I expect from diabetic retinopathy treatment at Wilkinson Eye Center?
Your expectations can be linked to the stage of your diabetic retinopathy. For instance, if you have nonproliferative diabetic retinopathy you may not need treatment at this point, but Dr. Wilkinson and our other team members will keep tabs on your eyes to check for progression. We’ll also work with an endocrinologist to help manage your blood sugar levels, as this slows the progression of the disease.
Once your retinopathy progresses, here’s what you can expect after these treatments. These treatments can stop or slow the progression of diabetic retinopathy, but they are not cures. Future damage can still continue or even increase.
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Focal Laser Treatment
If you had blurred vision due to macular edema prior to your surgery, this laser treatment won’t return your vision to normal. But it is likely to reduce the chance the macular edema may worsen.
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Scatter Laser Treatment
Your vision will remain blurry for a day or two after this procedure. You may have some loss of peripheral or night vision. Scatter laser treatment can help maintain the health of cells in the macula, but there can still be some loss of peripheral vision.
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Vitrectomy
These procedures that remove the vitreous gel and replace it with saline or another alternative are usually successful with a 90 percent success rate for many conditions. Removing the vitreous has little effect on the health of the eye. Different surgical options keep being developed, even addressing issues such as macular holes, which formerly were thought to be incurable. This procedure can prevent more vision loss and even restore and enhance the vision in the patient.
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Intravitreal injection
By injecting these drugs into the eye, the goal is to stop growth of new blood vessels by blocking the effects of growth signals the body sends to generate new blood vessels.
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Am I a Candidate for Diabetic Retinopathy Treatment?
Diabetic retinopathy is the leading cause of blindness among working-age Americans. That means anyone with diabetes is a good candidate for eye exams with the team at Wilkinson Eye Center, along with treatment if any signs of diabetic retinopathy appear.
The U.S. has the highest rate of diabetes among 38 developed countries. Approximately 30 million Americans, roughly 11 percent of the adult population, have diabetes. About 90 percent of those diabetes patients have type 2 diabetes, where the body fails to produce enough insulin or the body becomes resistant to insulin. This causes glucose levels in the bloodstream to rise and this can lead to damage in the eyes, kidneys, nerves, or heart. The longer a person has had diabetes the higher the chances of developing retinopathy.
Because diabetic retinopathy doesn’t exhibit early signs, the best treatment is to have your eyes examined to catch this insidious disease early on. If you have diabetes, it’s imperative to give us a call at Wilkinson Eye Center so that we can check your eyes.
What to Expect During Recovery
With laser treatments, you may have some discomfort and your vision may be blurry for a day or two, but most patients can return to normal activities immediately after these treatments. Some patients experience flashes of light at night or when looking at anything with a white background. These issues will decrease and resolve.
With injections, your visual acuity will also be impacted, but will significantly improve within a week or two. Recovery varies between the different drugs injected.
Vitrectomy requires the most involved recovery, with full recovery taking between 4 to 6 weeks. Some patients may be required to lay face down for a period of time to help their eye heal properly. Typical activities such as driving, reading, and exercise will need to wait for at least a week, maybe more.
Can diabetic retinopathy go away on its own?
Diabetes is the inability of the body to regulate blood sugar. As diabetes progresses, a person’s blood sugar levels rise. Too much sugar in the blood can lead to the blockage of the tiny blood vessels that nourish the retina. This cuts off blood supply. In response, the eye grows new blood vessels, but they don’t develop normally and can leak. This progression leads to nonproliferative or proliferative diabetic retinopathy.
When a person has diabetes, diabetic retinopathy will not resolve on its own. In mild cases where vision has not been impacted, treatment may not be necessary. But this condition will not suddenly reverse itself.
Read what our patients are saying!
The office staff is super nice, overboard accommodating and they are keeping the waiting room sanitized- best I’ve seen yet!
Dr. Wilkinson is very thorough, really helped me get through my issues and actually listened to what I had to say (rate these days!!)
I highly recommend anyone needing an ophthalmologist to make an appointment with this office!!
Will my insurance cover diabetic retinopathy treatment?
Yes, these procedures are covered by insurance.
What Does My Cholesterol Have to Do with Diabetic Retinopathy?
If you have diabetes and are aware of the risks associated with that condition, including diabetic retinopathy and macular degeneration, your primary focus may be on your blood glucose levels. However, your cholesterol is also a factor in the overall risk to your long-term eye health. As a part of your diabetic healthcare team, it’s important that we involve ourselves not only in specific treatment conversations but also in your understanding of risk factors and how to manage them.
Cholesterol is a type of blood fats (lipids) that can form as a blanket over various cells in the body. Lipids are carried by lipoproteins in the bloodstream, which is how cholesterol is measured. You may recognize readings like LDL (low-density lipoprotein) and HDL (high-density lipoprotein). Low-density lipoprotein is usually observed as “bad” for your health. The reason why is that it can accumulate as plaque in various blood vessels and organs, impeding normal function. As bad of a reputation as LDL has, it’s necessary. Your primary care provider will discern the risk your cholesterol plays in your overall health as it relates to your diabetes by comparing your LDL with your HDL, your Triglycerides, and your total cholesterol.
What This Has to Do with Your Eyes
You may know that high cholesterol is a danger to your heart and cardiovascular health. It’s also a factor in your eye health. As fatty deposits accumulate in your arteries, they create a plaque that becomes rigid. This is why the condition known as atherosclerosis is often referred to as hardening of the arteries. Where blood flow is slowed down by arterial plaque, organs suffer. In the eyes, it’s the retina that may be affected by poor circulation that results from high cholesterol.
The eyes have incredibly small blood vessels. These veins feed the retina and its central portion, the macula. Circulation to these pieces of tissue carries vital oxygen and other nutrients. Without these, the tissue begins to change. The rate of change may be compounded by dysregulated blood sugar levels such as those associated with uncontrolled diabetes.
Can Vitrectomy Cure Diabetic Retinopathy?
The short answer is no. Vitrectomy is a procedure that is performed to postpone the worsening of vision and eye health. It may stabilize or even improve your vision, but it should not be perceived as a cure for diabetic retinopathy. Your retinas and eye health continue to be susceptible to your blood sugar, blood pressure, and cholesterol levels. Even if you have vitrectomy treatment to address vision problems caused by diabetic retinopathy, you need to implement lifestyle and clinical strategies to avoid blood sugar spikes and dips.
While your eye health requires attention to your overall health, particularly around your diabetes, a vitrectomy can achieve impressive results that either stabilize or improve your vision. Your eye doctor will discuss their expectations with you after a thorough eye exam. According to research, nearly 80 percent of patients classified as “low vision” gained significant improvements in visual acuity through the vitrectomy procedure.
It may be too much to expect perfect vision after vitrectomy treatment for diabetic retinopathy. This treatment cannot prevent further problems associated with chronic uncontrolled diabetes. However, some degree of improvement should occur, especially when treatment is conducted early after the onset of symptoms.
Schedule a diabetic retinopathy Consultation with Wilkinson Eye Center
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