Unfortunately, the number of Americans diagnosed with diabetes has rapidly increased over the past decade, and continues to grow. As the disease becomes more prevalent in the population, more people are experiencing the sight-threatening effects of this disease, such as diabetic retinopathy. Diabetic retinopathy is one of the leading causes of blindness among middle-aged Americans. The disease can manifest itself in several different ways, all of which have the potential to cause vision-loss. While diabetic retinopathy can be vision-threatening, it can also be prevented, treated, and managed appropriately by proper communication between your health-care professionals, including your eye doctor, primary care physician, or an endocrinologist. Read on to learn more about diabetic eye disease and its management.
What Causes Diabetic Retinopathy
Diabetes leads to chronic abnormalities in blood glucose (sugar) levels. When diabetes is uncontrolled or poorly managed, elevated levels of blood sugar result in damage to the blood vessels throughout the body. The disease tends to affect the tiny, fragile vessels first, leaving the blood vessels in the eye at high risk for damage from the disease.
There are two major risks that increase the likelihood of diabetic retinopathy: duration of the disease, and management or control of the disease. The longer you are diagnosed with diabetes, whether its Type 1 or Type 2, the more likely it is to have damage to your retinal blood vessels. Similarly, if diabetes is uncontrolled and blood glucose levels are high or drastically fluctuating, this will increase the risk of diabetic retinopathy.
When diabetes progresses enough to affect the retinal blood vessels, diabetic retinopathy can occur. The beginning of the disease may have very mild signs, such as small areas of swelling in the retinal vessels, known as microaneurysms. Diabetic retinopathy can progress to small hemorrhages in the back of the eye, proteins leaking out of vessels, or small areas of ischemia, where the retinal tissue is not receiving adequate blood flow. These manifestations of diabetic retinopathy can cause the retinal tissue to swell and result in a dangerous finding known as diabetic macular edema, in which the macula, responsible for providing clear central vision, is damaged.
In the most severe forms of the disease, the retina becomes very deprived of oxygen and blood flow, and attempts to grow new blood vessels. These new vessels are very weak, and can easily leak and cause further damage. Traction on these new blood vessels can cause retina to pull away from its underlying layers, resulting in a retinal detachment.
Prevention and Treatment of Diabetic Retinopathy
The early stages of diabetic retinopathy may cause symptoms such as fluctuating or blurry vision, but oftentimes the disease goes unnoticed until severe vision loss occurs. For that reason, it is important for diabetics to have annual comprehensive eye exams. This allows for an eye care professional to fully evaluate the health of the eye to ensure there are no changes occurring to the retinal blood vessels.
If changes are noted during the exam and early diabetic retinopathy is diagnosed, the doctor can take the appropriate steps to ensure the problems is resolved. For mild or moderate diabetic retinopathy, this may include communication with the primary care doctor and careful observation of the condition. In more severe cases of diabetic retinopathy, treatments such as surgery or injections may be required in attempt to preserve vision and prevent the leakage of blood vessels.
People with diabetes can protect their eyes by maintaining control over their blood sugar levels, regularly communicating with their doctors, and visiting their eye doctor when necessary, including follow-up appointments.