Diabetes and your Eyes

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Diabetes and your Eyes

Diabetes can cause changes in your eyes. These changes, which are known

as diabetic retinopathy, occur in the small blood vessels in the

interior of the eye, in the area called the retina. Retinopathy does not

happen to all people with diabetes, and rarely interferes with vision in

the first 10 to 15 years of diabetes. But retinopathy may sometimes lead

to blindness.

Types of retinopathy

The early stage of the disorder is called background retinopathy. This

stage rarely causes changes in vision, but may cause damage to the

central vision that is necessary for reading.

The more advanced stage is known as proliferative retinopathy . This

occurs when new, abnormal blood vessels grow over the inner surface of

the eye. These new blood vessels tend to be very fragile, producing two

potential threats to your vision.

The first threat to vision in proliferative retinopathy is the risk of

bleeding into the vitreous substance (the clear substance in the center

of the eye). Blood that gets into the vitreous substance can produce

" cobwebs " in the vision, or block out light completely, causing

blindness.

The second worry is that scar tissue developing on the retina can reduce

vision by blocking out light, or by may pull the retina out of its

normal position (which is called a retinal detachment).

Treatment

Fortunately, help is available for people with diabetic retinopathy. If

needed, laser beam light can be used in a procedure known as

photocoagulation. Vision is preserved because the treatment causes the

abnormal blood vessels to fade away, and halts the growth of new ones.

In other cases, the laser beam can be used to preserve the crucial

central vision.

In cases where light can't reach the retina, it may be possible to

remove the vitreous substance surgically, in a procedure called a

vitrectomy. This procedure sometimes restores the ability to see.

Most importantly, scientific studies show that tight control of the

blood sugar level will delay the development of retinopathy. (It must be

pointed out that some patients who are started very rapidly onto

aggressive diabetes control programs may have temporary worsening of the

retinal changes, but the changes settle down after a year or two.

Because of this risk, every patient starting a tight control program

should be under the care of a diabetes specialist.)

What you can do

The standard advice is to have an eye specialist (ophthalmologist or

optometrist) examine your eyes annually. This is an excellent idea,

since problems in the retina can be quickly diagnosed by an expert, and

if necessary, treatment can be started.