Diabetic retinopathy
What eye problems are often associated with
diabetes?
Diabetic eye
disease refers to a group of eye problems that people with diabetes may face as
complications. All can cause severe vision loss or even blindness. Diabetic eye
disease can often be treated before vision loss occurs. All children with
diabetes should have a dilated eye exam at least once a year. Diabetic eye
diseases include:
is the most common eye disease in
persons with diabetes.
People with diabetes are also at risk for other diabetic eye diseases, such
as:
- cataract — a clouding or opaque area develops over the lens of the eye —
an area that is normally transparent. As this thickening occurs, it prevents
light rays from passing through the lens and focusing on the retina — the
light sensitive tissue lining located in the back of the eye. Persons with
diabetes are twice as likely as other adults to develop a cataract.
- glaucoma — increase in fluid pressure inside the eye that leads to optic
nerve damage and loss of vision. People with diabetes are also twice as likely
as other adults to develop glaucoma.
Diabetic retinopathy
Diabetic retinopathy is a leading cause of blindness in American adults. It
is caused by changes in the blood vessels of the retina. In some people with
diabetic retinopathy, retinal blood vessels may swell and leak fluid, while in
others, abnormal new blood vessels grow on the surface of the retina. These
changes may result in vision loss or blindness.
Diabetic retinopathy cannot be completely avoided, but the risk can be
greatly reduced. Better control of blood sugar level slows the onset and
progression of retinopathy and lessens the need for laser surgery for severe
retinopathy.
What are the symptoms of diabetic retinopathy?
There may be no symptoms or pain in the early stages of the diabetic
retinopathy, and vision may not change until the disease progresses.
A condition called macular edema may occur when the macula, a part of the
retina, swells from the leaking fluid and causes blurred vision. When new
vessels grow on the surface of the retina, they can bleed (hemorrhage) into the
eye, blocking vision.
Who is at risk for diabetic retinopathy?
Anyone
with diabetes is at risk for diabetic retinopathy. The longer a person has
diabetes, the more likely it becomes that he or she will develop diabetic
retinopathy.
Can diabetic retinopathy be prevented?
Although
diabetic retinopathy cannot be prevented, the risk of developing it can be
reduced by:
- having a dilated eye examination once a year
- strictly managing diabetes by:
- taking medications as directed
- using insulin as directed
- eating appropriate foods to manage blood sugar level
- exercising to lower and help the body use blood sugar
- testing blood-sugar levels regularly
- testing urine for ketone levels regularly
How is diabetic retinopathy diagnosed?
In addition
to a complete medical history and eye examination, your child's eye care
professional may perform the following tests to diagnose diabetic retinopathy:
- visual acuity test — the common eye chart test (see right), which measures
vision ability at various distances.
- pupil dilation — the pupil is widened with eyedrops to allow a close-up
examination of the eye's retina.
- tonometry — a standard test to determine the fluid pressure inside the
eye.
- ophthalmoscopy — a physician performs a detailed examination of the retina
using a special magnifying glass.
Treatment for diabetic retinopathy:
Specific
treatment will be determined by your child's physician(s) based on:
- your child's age, overall health, and medical history
- extent of the disease
- your child's tolerance for specific medications, procedures, or therapies
· expectations for the course of the disease
- your opinion or preference
According to the National Eye Institute, part of the National Institutes of
Health, even people with advance retinopathy have a 90 percent chance of keeping
their vision when they seek treatment before the retina becomes severely
damaged.
Treatment for diabetic retinopathy may include:
- laser surgery — often used to treat macular edema and proliferative
retinopathy; involves shrinking the abnormal blood vessels, or sealing the
leaking ones.
- vitrectomy — a type of procedure that involves removing the cloudy
vitreous (the clear, jelly-like substance that fills the center of the eye)
and replacing it with a salt solution. Vitrectomies are particularly effective
in persons with insulin-dependent diabetes, who may be at a greater risk of
blindness due to a hemorrhage in the eye.