If you have diabetes mellitus, whether Type 1 or Type 2, your body does not use and store sugar properly. High blood sugar levels can damage blood vessels in the retina, the nerve layer at the back of the eye that senses light and helps to send images to the brain. The damage to retinal vessels is referred to as diabetic retinopathy.
Diabetes is the leading cause of new blindness in the U.S. among adults. Diabetics are 25 times more likely to become blind than non-diabetics. Also, diabetics have increased risk of cataracts and glaucoma. However, there are steps you can take to avoid eye problems.
First and more important, keep your blood sugar levels under tight control. This can significantly reduce the risk of developing diabetic retinopathy. Also, rapid changes in blood sugar levels can cause fluctuating vision n both eyes even if retinopathy is not present.
Second Bring high blood pressure under control. High blood pressure can make eys problems worse.
Third, if you smoke, quit now.
Fourth, see your eye care professional at least once a year for a dilated eye exam. The eye care professional dilates the pupil and looks inside the eye to detect the presence of retinopathy. Additional testing may be performed to further determine the extent of any noted retinopathy.
Once diagnosed with diabetes, those age 29 years or younger should schedule an initial diabetic eye exam within 5 years of being diagnosed and yearly thereafter. Those 30 years and older should have an initial diabetic eye exam within a few months of their diagnosis and then once a year.
Pregnant women with diabetes should schedule an appointment in the first trimester because retinopathy can progress quickly during pregnancy.
There are 2 types of diabetic retinopathy.
The nonproliferative type is an early stage of diabetic retinopathy in which the tiny blood vessels within the retina leak blood or fluid. Often, this type does not affect your vision, and when it does, usually your peripheral vision continues to function.
In the proliferative type, there is widespread closure of retinal blood vessels causing inadequate blood flow. The eye responds by growing new blood vessels. Unfortunately, the new blood vessels do not recreate normal retinal blood flow. This type of retinopathy causes more severe vision loss and can affect both central and peripheral vision.
The best treatment is to prevent the development of retinopathy as much as possible. Strict control of blood sugar will significantly reduce the long-term risk of vision loss from diabetic retinopathy. If you have high blood pressure and/or kidney problems, these should also be treated.
Once diagnosed with diabetic retinopathy, treatment will vary depending on which type you have and how severe it is. Laser surgery may be recommended for the proliferative type of retinopathy. Multiple laser treatments over time are sometimes necessary.
You may be referred to a retinal specialist for injection of medicine into your eye, called intravitreal injections. They are designed to shrink any swelling of the macula. Your eye specialist may recommend a surgical procedure called vitrectomy if you have advanced proliferative diabetic retinopathy.