Diabetic Eye Care

Diabetic Eye Care

What is diabetic eye disease?

Diabetic eye disease is a group of eye problems that can happen in people with diabetes. All of these problems can cause severe vision loss or even blindness.

The most common diabetic eye disease is diabetic retinopathy. But diabetic eye disease can include other eye problems such as:

• Cataract – This is a clouded area in the eye's lens. While many people get cataracts as they age, they happen at an earlier age in people with diabetes.
• Glaucoma – This is damage of the optic nerve and loss of vision. It is usually associated with an increase in fluid pressure inside the eye. A person with diabetes is nearly twice as likely to get glaucoma.

What is diabetic retinopathy?

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in adults in the U.S. It is caused by changes in the blood vessels of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.

In some people with diabetic retinopathy, blood vessels might swell and leak fluid. In other people, abnormal blood vessels grow on the surface of the retina. Diabetic retinopathy usually affects both eyes.

If you have diabetic retinopathy, you might not notice changes to your vision at first. But over time, diabetic retinopathy can worsen and cause vision loss.

How is diabetic retinopathy treated?

People in the first three stages of diabetic retinopathy, do not need treatment unless they have macular edema. To prevent diabetic retinopathy from getting worse, people with diabetes should control their blood sugar levels, blood pressure, and blood cholesterol.

People in later stages of the disease, or who have macular edema, will need treatment. Treatment options depend on the type of diabetic retinopathy. They include:

• Scatter laser treatment – This is a kind of laser surgery for people with proliferative retinopathy. Scatter laser treatment helps to shrink the abnormal blood vessels. For this treatment, the doctor places 1000 to 2000 laser burns in the areas of the retina away from the macula. This causes the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, a person who gets this treatment usually needs two or more sessions. Scatter laser treatment can cause some loss of peripheral (side) vision, but it can preserve and save the rest of the person's vision, especially critical central vision. It might also slightly reduce color vision and night vision.
  Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Once some bleeding has started, it is important to have scatter laser treatment as soon as possible. This is because floating blood can prevent your eye doctor from being able to see your retina well.
• Vitrectomy – This is a surgical procedure for people with severe bleeding. During a vitrectomy, the doctor removes blood from the center of the eye. If you have this treatment, you will probably also have scatter laser treatment at the same time.
• Focal laser treatment – This is a kind of laser surgery for people with macular edema. For this treatment, the doctor places small laser burns directly in the areas of retinal leakage surrounding the macula. These burns slow the leakage of fluid and reduce the amount of fluid in the retina.
  The surgery is usually completed in one session, but a person might need focal laser surgery more than once to control leaking fluid. If surgery is needed for macular edema is in both eyes, generally only one eye will be treated at a time, usually several weeks apart.
  Focal laser treatment not only preserves vision, but it reduces the risk of vision loss by 50 percent. In a few cases, lost vision can even be improved.
• Medications – If you have macula edema, your eye doctor might give you injections of medications such as ranibizumab, bevacizumab and steroids. You will have these injections in your eye doctor's office, once he or she has cleaned and numbed your eye. These medications can help by decreasing fluid and swelling in the macula without the risk of scarring from laser burns. Treatment with injections usually requires multiple treatments.