Diabetes mellitus can affect the eyes in multiple ways. Even early in the diagnosis, high blood sugar levels can cause changes in the natural lens of the eye that can alter one’s refractive error (glasses prescription). Diabetes can also lead to earlier cataract formation. On this episode of the Healthy Eyes 101 podcast, Dr. Lisa Borkowski, a specialist with Midwest Retina, talks about diabetic retinopathy, one of the leading causes of vision loss in the United States and worldwide.
Symptoms of diabetic retinopathy (DR) include blurred/distorted vision, an increase in floaters, or dark areas in the field of vision. However, many patients do not have any visual symptoms at all. This is why diabetics should have their eyes checked on a regular basis. Those with type I diabetes should get their first exam within 5 years of diagnosis. Those with type II diabetes should be examined soon after diagnosis because many of these patients may have had uncontrolled sugar levels for years.
The two main categories of diabetic retinopathy are non-proliferative (NPDR) and proliferative (PDR). When blood sugar levels remain elevated, NPDR can cause the retinal blood vessels to leak or even close off. If the leakage occurs near the center of the retina (macula), there can be vision loss. With PDR, the more advanced stage of DR, new blood vessels form (neovascularization) on the surface of the retina. These fragile vessels can bleed into the vitreous gel and block vision.
To properly diagnose DR, a dilated examination or extensive retinal photographs need to be performed by your eye care specialist. Many retina surgeons will also perform a fluorescein angiogram so that they can see areas of retinal swelling (macular edema) and new blood vessel growth. OCT (ocular coherence tomography) is useful for following changes in macular edema.
Treatments for DR include eye injections with ant-VEGF medications, laser surgery, and vitrectomy surgery in the operating room.
What can patients do to decrease their risk of losing vision from DR? Control the blood sugar levels and blood pressure and see your eye care specialist at the recommended intervals.
Here is another great resource on diabetic retinopathy.
To find out more about Dr. Lisa Borkowski and her practice, go to Midwest Retina’s practice website.
This is intended for informational and educational purposes only, and nothing in this podcast/blog is to be considered as recommending or rendering medical advice or treatment to a specific patient. Please consult your eye care specialist for proper diagnosis and treatment of any eye conditions that you may have.