Diabetes and Diabetic Retinopathy
If you have diabetes or high sugars, regular examinations are critical to preventing and treating complications of this potentially blinding disease.
What types of diabetes are there?
There are two types of diabetes, Type I and Type II. Depending on which kind you have, you should be tested for diabetic eye disease at different times.
Type I diabetics need to be tested 5 years after diagnosis unless they are having blurring of vision, with at least yearly examinations afterwards
Type II diabetics should be tested when diagnosed, with at least yearly examinations afterwards
What can diabetes do to my eyes?
Diabetes is a disease that causes breakdown of blood vessels in the body, and can cause problems with the kidneys, heart, brain, and eye. In the eye, diabetes can lead to blurry vision from cataracts and from leaking blood vessels in the retina. Diabetes in the eye can even cause irreversible blindness from bleeding in the eye or from diabetes-related glaucoma causing high eye pressures. This is a very serious disease, and it is very important to catch the disease as early as possible so that we can slow down or even reverse the disease before permanent damage occurs.
What can I do as the patient?
We must work together to ensure your vision remains as good as possible and to prevent vision loss and blindness. Most importantly, make sure you follow with your medical doctor or endocrinologist to ensure your sugars, blood pressure, and cholesterol are under control. You should find out your Hemoglobin A1c (A- one- C) as this number lets us know how high your sugars are on average over 3 months. Controlling these 3 factors is like turning down the source of a fire (the gas), and helps not only your eyes but your kidneys, heart, brain, and all other organs.
Our job as eye doctors is to look for and treat the eye effects of your diabetes, with the tools below. This may help you to avoid vision loss, surgery, and may even improve vision.
Laser Treatment - Focal Laser
Laser treatment to the macula can help reduce macular edema (swelling from diseased, leaking blood vessels) and the frequency of intraviteal injections in the eye. This may help improve the efficacy of injections and potentially improve vision.
Procedure:
We will plan the laser using your ocular blood flow study, also called a fluorescein angiogram
We will numb the eye with an eyedrop and use a gel to coat the surface of the eye for comfort
A lens will be placed on the eye to ensure proper positioning and magnification of the lasrr
You will be able to do your usual activities the same day, including exercise, washing, and other activities of daily living. This is non-surgical and there is no cutting into the eye.
Injections
Injections have been proven to help improve vision in cases of swelling of the retina, and even to help reverse damage that diabetes has caused in the eye. If your diabetes is advanced enough to require injections, we will work together to ensure you have the proper treatment.
Benefits of Injections:
Visual Gains — when macular edema is treated patients may regain vision
Regression of Disease — Many studies have shown the regression (rolling back) of diabetic disease in the eye as a result of regular injections
Combination Therapy — Injections can be used in conjunction with laser treatments in order to enhance control of diabetic eye disease
Laser - Pan-Retinal Photocoagulation (PRP)
Laser treatment is an effective, proven way to treat diabetic eye disease and prevent the need for surgery and vision loss in certain people with diabetes. We can assess whether you fit into this category and use this treatment to help prevent vision loss and blindness.
Risks and Benefits of PRP:
Long-term control of eye disease, decreased risk of bleeding and vision loss
Peripheral vision, night vision, and accommodation may be affected by the laser