Diabetes is a leading cause of vision loss in this country and around the world. This loss of vision is largely preventable with early screening and treatment. If you have diabetes, your body does not use and store sugar properly. High blood-sugar levels can damage blood vessels all over your body, including your eyes. Diabetes damages blood vessels in the retina, the layer which receives and transmits visual images to your brain. This damage is called diabetic retinopathy.
Types of Diabetic Retinopathy
Diabetic changes in the retina develop in stages, on a continuum. These stages are divided into early, nonproliferative, changes, referred to as background retinopathy, or BDR; and more advanced, proliferative, changes, or PDR.
In background retinopathy, or BDR, early damage to blood vessels leads to leaking of blood and fluid into the retina. If there is enough leakage the retina will swell, decreasing vision. As BDR progresses, vision may also be lost due to tissue damage from inadequate blood supply.
In more advanced or PDR, abnormal new vessels begin to grow in the retina. These vessels do not supply normal blood flow to retinal tissue. As the vessels grow they may cause severe bleeding, retinal detachment and glaucoma, all leading to significant loss of vision.
Diagnosis and Treatment
Regular exams by an ophthalmologist can detect early changes and help prevent vision loss. If significant disease is found, retinal photography and other tests may be necessary. Background retinopathy which threatens or affects vision with retinal swelling can be treated in the office with short laser treatments. This will greatly reduce the risk of visual loss. More advance disease is also treated with laser, often in multiple sessions. Bleeding or retinal detachment may require more involved surgery.
Vision Loss Is Largely Preventable
Early detection and treatment can reduce your risk of vision loss by a very large margin. With today's advanced diagnosis and treatment, only a small percentage of people who develop diabetic retinopathy have serious vision problems. Although strict sugar control reduces your risk of developing diabetic retinopathy, some patients with early or well controlled diabetes do develop retinopathy.
Early detection of diabetic retinopathy by an ophthalmologist is best protection against loss of vision.
When to Schedule an Exam
People with diabetes should see their ophthalmologist at least once a year. More frequent exams may be needed if retinopathy is detected.
Pregnant women with diabetes should schedule an appointment in the first trimester. Retinopathy can develop and progress quickly during pregnancy.
If you need new glasses, be sure your sugar is stable for at least several days before your appointment. Glasses that work well with an elevated sugar will not work well when sugar is stable.