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.
What are the symptoms of diabetic retinopathy?
- 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.
What causes 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.
There are two types of diabetic retinopathy:
- 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.
- 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
- Tobacco use
- Being African American, Hispanic, or Native American
How is diabetic retinopathy treated?
As mentioned above, diabetic retinopathy can develop and damage the eyes before it really shows any signs. But it can be spotted early before this happens. That makes early diagnosis the best treatment.
At Wilkinson Eye Center, our treatment approaches depend on if you have nonproliferative (early stage) or proliferative (advanced) diabetic retinopathy. In the early stages, simply managing your blood sugar and blood pressure effectively can slow the progression of diabetic retinopathy.
If you have diabetic macular edema or proliferative diabetic retinopathy, you may need treatment. We may use these procedures, depending on your situation:
- Focal laser treatment — In this procedure, a laser is used to either stop of slow the leakage of blood and fluid in the eye. Also called photocoagulation, the laser energy closes the leaking vessels.
- Scatter laser treatment — Also known as panretinal photocoagulation, here the areas of the retina away from the macula are treated with scattered laser burns. These burns cause the new abnormal blood vessels to shrink and scar.
- Intravitreal injection – In this procedure, a medication is delivered directly into the eye to treat leaky and abnormal blood vessels.
- Vitrectomy — This surgical procedure creates a tiny incision in your eye to remove blood from the vitreous, as well as the scar tissue that is pulling on the retina creating detachment.
These procedures are very successful in preventing blindness in most people with diabetic retinopathy.