Don’t let diabetic retinopathy take away your vision
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By Sunir Garg, MD, as reported to Hallie Levine
Diabetic retinopathy, a form of diabetic eye disease, is a leading cause of blindness in the United States. Despite this, nearly 40% of people with diabetes do not get an annual eye exam. However, these screening tests are crucial because they can prevent vision loss by detecting diabetic retinopathy in the early, more treatable stages of the disease.
Diabetic retinopathy can lead to permanent vision loss.
Many people are surprised to learn that diabetic retinopathy is the leading cause of vision loss in diabetics. Here is a brief introduction.
Diabetes is a disease that affects the small blood vessels throughout the body, including the delicate blood vessels at the back of the eye. These blood vessels are like pipes: when they become damaged, they weaken and begin to leak. Over time, these tiny blood vessels drip blood and plasma onto your retina. This causes the retinal tissue to swell, resulting in cloudy or blurred vision. This also causes damage, resulting in less oxygen and other nutrients reaching your retina.
Sometimes your body tries to fix the problem by forming new blood vessels. But these blood vessels are fragile and can burst and bleed or form scar tissue that pulls your retina away from the wall of your eye. All of these scenarios can ultimately lead to blindness.
You can have diabetic retinopathy without even knowing it.
The disease is often asymptomatic in its early stages, which is why an annual eye exam is so important. If it gets worse, you may notice symptoms like:
Blurred visionVision that changes from blurry to clearBlank or dark areas in your visionSwimmers or dark spots in your visionPoor night visionColors appear pale
Unfortunately, patients often do not see an ophthalmologist until they notice symptoms such as floaters or blurred vision, and by then damage has occurred.
There is a lot you can do to treat diabetic retinopathy.
When we see signs of diabetic retinopathy during a patient’s routine eye exam, they are often very frightened. They fear that they will lose their sight. But most of the time her illness is mild. We explain that the best way to stop vision loss is to make sure both blood sugar and blood pressure are well controlled. They must be careful about their diet and take all their medications as prescribed. We often show patients a picture of their eyeball so they can see the damage their diabetes has done. That’s usually enough to understand why blood sugar and blood pressure control are so important to their overall well-being.
But if your illness is more advanced, don’t panic. The first step is a class of drugs known as anti-VEGFs. These drugs help reduce eye swelling, which can slow vision loss and even improve vision. It is given as a shot and injected into your eye in your eye doctor’s office. Laser surgery can also help seal leaky blood vessels, shrink abnormal blood vessels, and reduce retinal swelling. If you have a very advanced case, you may need a type of eye surgery known as a vitrectomy. An eye surgeon removes blood and plasma from your eye and removes scar tissue from your retina. This will also help you to see more clearly again.
Regular eye exams are key.
People with diabetes must have a full eye exam by an ophthalmologist, a doctor who specializes in eye diseases, at least once a year. This is true even if you otherwise have 20/20 vision. Your doctor will give you some eye drops to dilate or dilate your pupils so they can look into your eyes to check for diabetic retinopathy and other eye problems.
If you’ve just been diagnosed with diabetes, you need an eye exam right away to make sure your eyes are fine. After that, they should have an eye exam every year—more often if they have diabetes-related eye problems like diabetic retinopathy.
There are other times in your life when you may need a full eye exam. For example, pregnant women with diabetes need an eye exam every trimester because changes in blood pressure and fluid retention can make their diabetes worse.
Interestingly, once your diabetes is well controlled, you will also need to have your eyes checked. For some reason, this shift can lead to worsening diabetic eye disease in certain patients. We don’t know why, other than that your body has gotten used to things being a hot mess and your eyes don’t know how to deal with this sudden change.
The good news is that most people with diabetes who have regular eye exams and go on to develop diabetic retinopathy end up doing very well. If we monitor them appropriately and treat problems when they arise, we can keep the vast majority of patients seeing reasonably well for years, sometimes even for a lifetime. But for this, doctor and patient have to work together.
