Diabetic eye disease comprises a group of eye conditions that affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema (DME), cataracts and glaucoma. All forms of diabetic eye disease have the potential to cause severe permanent vision loss and blindness.
Diabetic retinopathy involves changes to retinal blood vessels that can cause them to bleed or leak fluid, distorting vision. It is the most common cause of vision loss among people with diabetes and a leading cause of blindness among working-age adults in the western world. Diabetic macular edema is a consequence of diabetic retinopathy that causes swelling in the area of the retina called the macula.
Because diabetic retinopathy often goes unnoticed until vision loss occurs, people with diabetes should get a comprehensive dilated eye exam at least once a year. Early detection, timely treatment, and appropriate follow-up care of diabetic eye disease can protect against vision loss. Most vision loss is a consequence of late detection and delayed treatment.
Diabetic retinopathy can be treated with several therapies, used alone or in combination.
NorthShore Eye Care has sophisticated imaging methods to detect diabetic eye disease in its earliest form and can provide treatments to preserve vision. Controlling diabetes—by taking medications as prescribed, staying physically active, and maintaining a healthy diet—can prevent or delay vision loss.
Detection and Treatment
Detection of diabetic retinopathy requires a complete eye examination which includes a dilated fundus examination. Drops are placed in the eye which dilate the pupil and the doctor can then look at the retina directly with specialized optical devices.
Testing may include a fluorescein angiogram which is a test done in the office and the results of which are immediately available. In this test, a small amount of fluorescein dye is injected into the arm of the patient. The dye circulates to the eye where the dye is captured with a special fundus camera. By studying the images, the doctor can determine features of the diabetic retinopathy such as loss of circulation and leakage (edema.)
Other studies may include an OCT (optical coherent tomograph) which can measure the thickness of the retina and provide other information not generated by the angiogram. If patients have a dense vitreous hemorrhage, an ultrasound (B-Scan) and be performed to “look through” the blood to examine the retina.
Diabetic retinopathy may progress through four stages (mild, moderate, severe and proliferative). Treatment of diabetic retinopathy is determined by the examination and testing. In mild retinopathy without edema, observation is the general recommendation. For patients with moderate diabetic retinopathy, depending on the extent and severity steroid eye drops, an injection of steroid near the eye, laser surgery or injection of medication into the eye may be warranted. For patients with neovascularization, intraocular injections and laser surgery are the two most common treatments. For more severe disease, for non-clearing vitreous hemorrhage and for scar tissue on the retina and retinal detachment, vitrectomy surgery in the operating room may be required.
In addition to regular dilated examinations, the patient should see their eye doctor if there are new floaters in the eye (dark objects sometimes described as “cobwebs” or “insects”.) Also, any blurring or other disturbance of vision should be reported to the eye doctor. Each eye should be check daily by covering one eye briefly and then the other.
Although diabetic retinopathy can be treated, it cannot necessarily be prevented. Severity of retinopathy depends on two primary factors – duration of the disease and level of blood glucose control. The patient obviously cannot control the former but should carefully with the medical doctors to control the latter.
NorthShore Eye Care hosts a monthly “ask the expert” health talk series. Come with your questions about eye health. Refreshments will be provided. Please check our website at www.northshoreeyes.com for details on our events.
For more information please visit www.northshoreeyes.com. For an appointment please call our Avon office at 440-653-8091, the Sandusky office at 419-626-8181 or the Avon Lake office at 440-455-3080. The offices are located at 36711 American Way in Avon, 1200 Prospect Street in Sandusky and 32730 Walker Road, Building J, in Avon Lake. Follow them on Facebook @northshoreeyecareohio.