Diabetic eye disease refers to a group of eye problems that people may face as a complication of having diabetes. Tim Johnson, MD, ophthalmologist with University of Iowa Health Care, talks about diabetic eye care:
What types of eye diseases could develop in a person with diabetes?
Diabetes affects virtually every part of the body—the eyes included, and it affects all parts of the eye. It can:
- Affect the retina
- Cause cataracts—Cataracts develop at an earlier age in diabetics and these cataracts grow more rapidly in diabetics
- Affect the muscles of the eye and can cause double vision
- Cause a severe form of glaucoma, known as neovascular glaucoma
- Affect the surface of the eye, the epithelium of the cornea, such that if diabetics get a scratch on their eye, it would heal more slowly
Is one eye disease more common in a diabetic?
Yes. The retina is the most commonly affected tissue, or more specifically, the blood vessels of the retina are affected, and this condition is known as diabetic retinopathy.
Does diabetic retinopathy have any symptoms?
It depends on the stage of the disease. Early on, diabetic retinopathy can have no symptoms. In many cases the diagnosis is actually made at the time of a routine eye exam.
What are the stages of diabetic retinopathy?
There are two types of retinopathy:
- Nonproliferative, sometimes called background diabetic retinopathy, is the milder form
- Proliferative diabetic retinopathy is more severe.. Proliferative means that there are new blood vessels that grow and proliferate in the retina
Loss of vision from diabetes occurs in two ways:
- Nonproliferative—there is leakage of fluid into the retina, which is known as diabetic macular edema
- Proliferative retinopathy—there is bleeding into the retina from these new blood vessels.
How do you detect diabetic retinopathy?
Diabetic retinopathy is detected by a careful eye examination which includes dilation of the pupil to allow a thorough examination of the retina, and it's very important that diabetics have at least an annual eye exam since, as I said previously, the early stages may not have any symptoms.
How is diabetic retinopathy treated?
There are kind of two parts to this—controlling the diabetes itself and treating the eye complications.
It's critical when considering treatment of diabetic eye disease that you have good control of the diabetes itself because treatment of the eye complications is much harder if the blood sugars are running too high.
You also need to make sure the blood pressure is well controlled since poorly controlled diabetes and blood pressure makes eye complications worse.
The treatment of the retinopathy itself involves the use of lasers. The laser is used to reduce the fluid leakage from the macular edema that I had mentioned and also to reduce the proliferation of the blood vessels in more advanced stages of the disease.
More recently, there have been some medications that have been used that can be injected directly into the eye that can make the lasers more effective.
Are all diabetics at risk to develop diabetic retinopathy?
Pretty much anybody with diabetes has risk of developing retinopathy and the longer the duration of the disease, the higher the risk of having retinal complications. |
