Diabetic retinopathy is the leading cause of blindness in younger individuals. This disorder affects the blood vessels in the retina, the membrane that lines the back of the eye (see section on "How the eye works"). There are two distinct types of diabetic retinopathy, background and proliferative.
Normal Retina
Background diabetic retinopathy, is characterized by the leakage of blood, fluid and fatty material (lipids) from the blood vessels into the retina. When fluid collects in the center of the retina we call it macular edema. This condition can lead to permanent visual impairment.
Proliferative
Diabetic Retinopathy
A more advanced stage of diabetic eye disease is called proliferative diabetic retinopathy. In this form of retinopathy there is the growth of new, abnormal blood vessels on the retina. These new blood vessels (called neovascularization) are fragile. They tend to bleed into the vitreous cavity which is located in the back of the eye. This sort of bleeding can lead to a more profound loss of vision due to scarring and detachment of the retina.
What are the symptoms of diabetic retinopathy?
In the early stages of diabetic retinopathy there are no symptoms. There is no headache, pain or blurring of the vision. It is during this stage, before there are any symptoms, that treatment is most successful. Background diabetic retinopathy causes blurring of the center portion of the vision. In the advanced stages of proliferative retinopathy patients may see spots or threads floating in front of their eyes. These "floaters" are caused by hemorrhaging inside the eye. The vision becomes more clouded as the amount of bleeding increases.
How do we treat Diabetic Retinopathy?
Old
& New Laser Treatment Spots
The first line of defense against the loss of vision from diabetic retinopathy is to have frequent eye examinations. Treatment for diabetic retinopathy is much more successful if it is instituted before the patient has noticed any symptoms.
We treat diabetic retinopathy using a laser. This procedure is done in the office with the use of a local anesthetic or anesthetic eye drops. In Background retinopathy the laser beam is used to "weld" the defects in blood vessels thereby stopping the leakage. In proliferative retinopathy more extensive treatment with the laser stimulates the regression and eventual disappearance of the abnormal blood vessels.
What are the results of laser treatment?
The goal of laser treatment is to prevent loss of vision. In those patients who have already suffered some loss of vision the laser is very useful in preventing further deterioration of the vision. The laser is not as effective at restoring vision that has already been loss. It is for this reason that we recommend that all diabetics have frequent eye examinations. Early diagnosis and early treatment are imperative to prevent loss of vision from diabetic retinopathy.
Frequently Asked Questions
Recent studies have show that patients who maintain better control of their blood sugar levels tend to have less visual loss from diabetic retinopathy. High blood pressure is an important contributing factor to the loss of vision from diabetes. It is particularly important to keep hypertension under control.
Unfortunately, even those patient who maintain strict control of the blood sugar and blood pressure can develop diabetic retinopathy. The best defense is prevention and the best prevention is to undergo frequent eye examinations. Early diagnosis and early treatment produce the best results.
We recommend that diabetic patients with no retinopathy be examined at least every year. Patients who already have diabetic retinopathy may need to be seen more frequently depending on the severity of their disease.