Diabetes

Diabetes is a complex disease which can affect nearly every tissue of the body, including the tiny blood vessels in the eyes. About 40 percent of people with diabetes have some signs of disease-related eye problems. About 3 percent suffer severe visual loss because of diabetes.

What eye problems can diabetes cause?

No one knows exactly how diabetes damages the eyes, but diabetics are more likely than other people to develop a number of visual disorders. This is especially true for people who have had diabetes five years or longer. One of the milder, often temporary effects of diabetes is a change in the focusing power of the eye. Eyeglasses or contact lenses might suddenly seem to be too strong or too weak. Diabetes may also lead to cataracts and glaucoma.

The most important and most common cause of visual impairment in diabetics is Diabetic Retinopathy. This is a condition which affects the retina, the seeing part of the eye.

What is Diabetic Retinopathy?

Diabetic Retinopathy is the breakdown of small blood vessels that nourish the retina. When these blood vessels become damaged by diabetes, they can no longer supply all the oxygen and nutrients the retina needs to remain healthy. The blood vessels may begin to bulge out, leak fluid, bleed, grow abnormally or close up completely. The longer a person has diabetes, the greater the risk of retinopathy. It may interfere with vision during the first 5-10 years of diabetes. About 60 percent of people who have diabetes for more than 15 years have some degree of damage to the blood vessels of the eye.

How serious is the disease?

A person who has had diabetes for several years may begin to develop tiny bulges in the walls of the retina's blood vessels. Fluid may leak from the vessels and deposits of fat may form. This is called background retinopathy, and usually has no symptoms unless the leakage occurs in the center of vision called the macula. In this case, vision may be slightly decreased and later progress to more severe impairment.

Another problem that affects the retina is proliferative retinopathy. New blood vessels begin to form in and around the retina. Scar tissue may form and block out light. The new vessels may bleed into the eye. The person may experience cloudy vision or see cobwebs in the eye. If the retina itself becomes detached, the results may be serious loss of vision or blindness.

What can be done?

The treatment most commonly used for Diabetic Retinopathy is laser photocoagulation. An intense beam of laser light energy is used to seal off leaking blood vessels and to control or prevent the growth of new, abnormal blood vessels. This painless treatment is done with a laser in the ophthalmologist/Eye M.D.'s office.

If abnormal blood vessel growth is severe or bleeding continues to be a problem, a procedure called vitrectomy may be recommended.

The ophthalmologist/Eye M.D. uses special surgical instruments to remove the blood and scar tissue from the clear fluid in the center of the eye called the vitreous. About 50 percent of patients who have a vitrectomy operation have improved vision.

What should you do?

If you have diabetes, you should have your eyes examined by an eye professional at least once a year. You should consult an ophthalmologist/Eye M.D. immediately if you suddenly lose vision, or if you experience any unusual visual sensations. It is also very important to work with your physician to keep your diabetes under control.