Diabetic retinopathy is the most common cause of legal blindness in middle-aged Americans. The Centers for Disease Control and Prevention (CDC) estimates that 29.1 million people (9.3% of the U.S. population) have diabetes. It is further estimated that 28% of those people are currently undiagnosed.
Diabetic retinopathy is a very common cause of vision loss in the greater River Region area. Signs of eye damage usually start to occur approximately 5 to 10 years after having diabetes. Many people have already had diabetes for one or more years when they are diagnosed. Therefore, every diabetic patient should have an eye exam at the time of his or her initial diagnosis. If diabetic damage is detected during an eye exam, closer follow up may be warranted.
There are two main ways that diabetes damages the normal retina (Figure 1). First, the high sugars and high blood pressure associated with diabetes can cause the blood vessels in the macula (center of the retina) to leak fluid and cholesterol (Figure 2). This condition is known as Clinically Significant Macular Edema (CSME). This can cause severe and permanent vision loss. This leakage can be treated either by conventional laser treatments or by injecting special medicines into the eye that help to eliminate the fluid. Vision may be partially restored or stabilized. However, persistent leakage can occur with loss of further vision even with treatments. These “eye injections” are not usually painful but do have risks. Speak to your retina specialist about the different modes of treatment for this leaking condition.
Second, new abnormal blood vessels can grow into the retina as a response to the existing blood vessel damage caused by diabetes. These new vessels are bad and may cause bleeding. Over time, scar tissue can grow and damage the retina (Figure 3). Vitrectomy procedures may be performed to remove blood and/or scarring in an attempt to stabilize the retina. In some situations vision can be significantly improved with surgery. In other situations the objective of surgery is to attempt to stabilize the process or slow down the progression of further vision loss.
If diabetic eye disease is found in time, there are many treatments available that help to improve and maintain good vision. These treatments include laser surgery, medicine injections, topical drops and eye surgery. Blood pressure, blood sugar, and cholesterol control are also essential in ensuring your best vision with this disease.