Diabetes attacks the small blood vessels in your body first. Given that, opthamologist Dr. Babek Marefat keeps his eye on a particular area.
Dr. Marefat says he focuses on the retina. He says it's the area of the eye that acts like the film in the camera - taking the pictures and sending them to the brain. He says it's fed by small blood vessels. When those vessels are damaged, lasers can shore them up.
Dr. Marefat says diabetics can develop one of two eye problems. In the first, vessels leak. He says that can case swelling in the retina, like the film soaking up water, becoming wrinkled and no longer seeing a clear picture. He says, in that case, the laser is used as a spot treatment to reduce the leakage and allow the eye to clean up after itself and reduce the swelling.
The other problem is damaged vessels not being able to get blood to the retina, causing abnormal vessels to grow. Dr. Marefat says these blood vessels don't work as well as the ones we're born with, plus the new ones are brittle and they can break off and bleed. That bleeding can cause lack of vision. Lasers are used to treat the periphery of the retina, preventing the vessels from growing while saving central vision.
Dr. Marefat says these problems can be seen at any age. He says the longer a person's been a diabetic or the more uncontrolled their condition is, the higher the risk they'll have diabetic eye disease. He says an annual eye exam can help doctors focus on the problem before it's too late.
WIBW Expanded Coverage:
Seeing Clearly with Diabetes: Preventing Diabetic Eye Disease
by Candace J. Steele
Diabetes is the leading cause of new cases of blindness in adults in the United States. Between 12,000 and 24,000 new cases of blindness per year are caused by diabetes.1 The most common eye disease in diabetics is called retinopathy (REH-tih-NOP-uh-thee). People with diabetes also get cataracts and glaucoma more often and at a younger age than people who don’t have diabetes.
The retina in the eye has very tiny blood vessels that are easily damaged. Slow injury is caused to the retina when these blood vessels swell and become weak. They can also become clogged, and some may actually break and cause bleeding or fluid leakage in the retina. Sometimes there is abnormal growth of new blood vessels on the surface of the retina, which can also lead to vision loss or blindness.
The primary cause for injury to the retina in diabetes is high blood sugar levels and high blood pressure over a period of time. It is very possible, with proper care of your diabetes, that you can prevent diabetic retinopathy from causing significant damage to your eyes.
What can I do to prevent diabetic eye disease?
If you have diabetes, you should have your eyes examined at least once per year by an eye specialist - a doctor specializing in ophthalmology. You can find an eye doctor through the American Academy of Ophthalmology. The doctor will dilate your pupils with eye drops in order to see the inside of your eyes and examine them for signs of blood vessel damage or fluid leakage.
Keeping your blood sugar within the recommend levels is one of the keys to slowing the onset of or preventing diabetic eye disease. It is important to monitor your blood sugars regularly and write them in a logbook so that your doctor and/or diabetes educator can evaluate your blood sugar control. Changes may be necessary in your diet, your medication, or your exercise level to maintain good control. A blood test called a "Hemoglobin A1c" can determine if your blood sugar has been within normal limits for the three months prior to the test.
Have your blood pressure checked regularly. Because of the damage that diabetes can do to your blood vessels, you may need medication to keep your blood pressure within a safe range; the goal for your blood pressure is 130/85.2 Keeping your weight under control and participating in regular exercise will also help maintain good blood pressure control.
What are the symptoms of diabetic eye disease?
It is possible that damage is present without any symptoms, or your symptoms may be so subtle that you just don’t notice them. You should seek an immediate eye exam if:
You have blurry or double vision
You see flashing lights, blank areas, or rings around objects
You have problems with your peripheral vision
You see dark spots or "floaters"
You have pain or a pressure feeling in one or both eyes
How is diabetic eye disease treated?
Advances in treating the complications of diabetic eye disease have improved eyesight for many diabetics, but the procedures available will not cure it. Even if retinopathy is advanced, diabetics have a 90 percent chance of keeping their vision if they seek treatment before the retina is severely damaged. Unfortunately, once vision is lost, surgery most often cannot restore it.
Laser treatment is done in a doctor’s office or an eye clinic. A strong beam of light is aimed in the retina to shrink abnormal vessels and seal bleeding vessels. You may also lose some of your peripheral (or side) vision in order to save your sight. Your color vision and night vision may also be affected. You may need to have multiple laser treatments done to one or both eyes if the eye disease progresses.
Another procedure, called a vitrectomy, can remove blood and fluid from the vitreous portion of the eye. The vitreous fluid in the eye, which has clouded from bleeding, is replaced with a clear fluid. You will need to wear a patch over your eye for at least a few days, and often your doctor will prescribe eye drops to prevent infection.
Keep your diabetes under control!
Most complications from diabetes, including retinopathy, can be avoided (or at least delayed) by keeping your blood sugars within the goal range your doctor or diabetes educator has given you. Medication, diet, and exercise remain the foundation to good blood sugar control, and will limit the complications you may get.
References and further information:
National Institute of Diabetic and Digestive and Kidney Diseases
Joint National Commission on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure
American Diabetes Association
The National Diabetes Information Clearinghouse
National Eye Institute