Diabetic Retinopathy

Diabetes can cause all sorts of health problems, including diabetic retinopathy. Diabetic retinopathy is a disease in which the retina (on which light is focused in the eye so we can see) is starved of oxygen and ultimately damaged. The condition develops when a patient's blood sugar levels surge, causing severe injury to the blood vessels that supply oxygen to the retina. The vessels often begin to function poorly and can even leak fluid into the center of the retina, called the macula. This fluid accumulation, called proliferative diabetic retinopathy, can cause mild to severe vision loss. Other complications include macular swelling, called macular edema, which can also lead to impaired vision. When treated properly, diabetic retinopathy and its effects are reversible; when ignored, it can lead to permanent vision loss and other health problems.

Who is most at risk for diabetic retinopathy?

Anyone with Type I (juvenile onset) or Type II (adult onset) diabetes is at risk. Additionally, diabetic pregnant women may particularly susceptible to diabetic retinopathy. We recommend that all diabetic pregnant women have dilated eye examinations each trimester to protect their vision.

What are the symptoms?

Diabetic retinopathy often has no early warning signs. At some point, though, you may develop macular edema, which blurs vision, making it hard to do things like read and drive. In some cases, your vision will get better or worse during the day. As new blood vessels form at the back of the eye, they can bleed (hemorrhage) and blur vision. The first time this happens it may not be very severe. In most cases, it will leave just a few specks of blood, or spots, floating in your vision. They often go away after a few hours. These spots are often followed within a few days or weeks by a much greater leakage of blood. The blood, too, will blur your vision. In an extreme case, one will only be able to tell light from dark in that eye. It may take the blood anywhere from a few days to months or even years to clear from the inside of the eye. In some cases, the blood will not clear. Also, you should be aware that large hemorrhages tend to happen more than once, often during sleep.

How is it detected?

Diabetic retinopathy is detected during an eye examination that includes:

• Visual acuity test: This eye chart test measures how well you see at various distances.
• Pupil dilation: The eye care professional places drops into the eye to widen the pupil. This allows him or her to see more of the retina and look for signs of diabetic retinopathy. After the examination, close-up vision may remain blurred for several hours.
• Ophthalmoscopy: This is an examination of the retina in which Dr. Waring examines the eye either by looking through a device with a special magnifying lens or, wearing a headset, uses a bright light to look through a special magnifying glass to get a good look at the retina.
• Tonometry: A standard test that determines the fluid pressure inside the eye. Elevated pressure is a possible sign of glaucoma, another common eye problem in people with diabetes.

We will use these tests to screen for early signs of the disease, such as

• leaking blood vessels
• retinal swelling, such as macular edema
• pale, fatty deposits on the retina – signs of leaking blood vessels
• damaged nerve tissue
• any changes in the blood vessels

If we suspect that you need treatment for macular edema, we may ask you to have a test called fluorescein angiography, during which a special dye is injected into the arm and photographed as it passes through the blood vessels in the retina. This test allows us to find the leaking blood vessels and to target them during laser surgery.

How is Diabetic Retinopathy Treated?

There are several treatments for diabetic retinopathy: laser surgery, intraocular injections of medications to reduce retinal swelling or to suppress blood vessel growth, and vitrectomy. Combinations of these treatments are very effective in reducing vision loss from this disease. In fact, even people with advanced retinopathy have a 90 percent chance of keeping their vision when they are treated early. However, it is important to note that although these treatments are very successful, they do not cure diabetic retinopathy, and they also do not cure your underlying diabetes.

How do I schedule an appointment?

Please call our center at (770) 623-3931 or complete our online contact form.