Management of Ocular Disease
Diabetic Retinopathy
Symptoms of diabetic retinopathy:
Once symptoms of diabetic retinopathy do develop, they can include: dark or black spots in your visual field, or blurry vision, and it increases over time. This is a result of bleeding at the back of the eye, which prevents a clear image from being transmitted from the retina to the brain as well as:
- There are usually no symptoms in the early stages of diabetic retinopathy
- Floaters
- Difficulty reading or doing close work
- Double vision
- If left untreated, severe vision loss can occur
Causes of diabetic retinopathy:
Whether you have type 1, type 2, or even just gestational diabetes, you are at risk for developing diabetic retinopathy. The longer you have had the disease, the greater the risk. It is essential to keep your blood sugar levels under control to prevent vision loss, and this may require a trip back to your primary care physician.
- Diabetes: Everyone who has diabetes is at risk for developing diabetic retinopathy, but not everyone develops it. Changes in blood sugar levels increase the risk. Generally, diabetics don’t develop diabetic retinopathy until they’ve had diabetes for at least 10 years.
You can reduce your risk of developing diabetic retinopathy by:
- Keeping your blood sugar under control.
- Monitoring your blood pressure.
- Maintaining a healthy diet.
- Exercising regularly.
- Getting an eye exam at least once a year.
Diagnosing diabetic retinopathy:
There are usually no symptoms in the early stages of diabetic retinopathy. Vision may not change until the disease becomes severe. An exam is often the only way to diagnose changes in the vessels of your eyes. This is why regular examinations for people with diabetes are extremely important. Your eye doctor may perform a test called fluorescein angiography. During the test, a harmless orange-red dye called Fluorescein will be injected into a vein in your arm. The dye will travel through your body to the blood vessels in your retina. Your doctor will use a special camera with a green filter to flash a blue light into your eye and take multiple photographs. The pictures will be analyzed to identify any damage to the lining of the retina or atypical new blood vessels.
Treatment for diabetic retinopathy:
Diabetic retinopathy does not usually impair sight until the development of long-term complications, including proliferative retinopathy (when abnormal new blood vessels bleed into the eye). When this advanced stage of retinopathy occurs, pan-retinal photocoagulation is performed. During this procedure, a laser is used to destroy all of the dead areas of retina where blood vessels have been closed. When these areas are treated with the laser, the retina stops manufacturing new blood vessels, and those that are already present tend to decrease or disappear. If diabetic retinopathy has caused your body to form cataracts, they can be corrected with cataract surgery.
Treating diabetic retinopathy can include vitrectomy, replacing the inner gel-like substance that supports the eyeball structure, and laser surgery.