Diabetic Retinopathy

Diabetic Eye Disease

Diabetic eye disease refers to a group of eye problems that people with diabetes may face. All can cause severe vision loss or even blindness, which is why your annual eye exam is so important. In addition to cataracts and glaucoma, diabetic eye disease may also include diabetic retinopathy, which is damage to the blood vessels in the retina, and is the most common diabetic eye disease and a leading cause of blindness in adults in the United States. It is caused by changes in the blood vessels of the retina.

In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina.

If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.

4 Stages of Diabetic retinopathy

  1. Mild nonproliferative retinopathy. At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina’s tiny blood vessels.
  2. Moderate nonproliferative retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked.
  3. Severe nonproliferative retinopathy. Many more blood vessels are blocked, depriving several areas of the retina of its blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
  4. Proliferative retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.

What can I do to protect my vision?

If you have diabetes, get periodic comprehensive dilated eye exams and remember:

  • Proliferative retinopathy can develop without symptoms. At this advanced stage, you are at high risk for vision loss.
  • Macular edema can develop without symptoms at any of the 4 stages of diabetic retinopathy.
  • You can develop both proliferative retinopathy and macular edema and still see fine. However, you are at high risk for vision loss.
  • Dr. Breno da Rocha Lima can tell if you have macular edema or any stage of diabetic retinopathy. Whether or not you have symptoms, early detection and timely treatment can prevent vision loss.

How are diabetic retinopathy and macular edema detected?

Diabetic retinopathy and macular edema are detected during a comprehensive eye exam that includes:

  • Visual acuity test. This eye chart test measures how well you see at various distances.
  • Dilated eye exam. Drops are placed in your eyes to widen (dilate) the pupils. This allows the eye care professional to see more of the inside of your eyes to check for signs of the disease. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
  • Optical coherence tomography. You have probably heard of ultrasound, which uses sound waves to capture images of living tissues. OCT is similar except that it uses light waves and can achieve very high-resolution images of any tissues that can be penetrated by light, such as the eyes.

Our physicians at Bowden Eye & Associates check your retina for early signs of the disease, including:

  • Leaking blood vessels
  • Retinal swelling (macular edema)
  • Pale, fatty deposits on the retina–signs of leaking blood vessels
  • Damaged nerve tissue
  • Any changes to the blood vessels

How is diabetic retinopathy treated?

During the first 3 stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their blood sugar, blood pressure, and blood cholesterol.

Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Dr. Lima places laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Two or more sessions may be required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision.

How is a macular edema treated?

Macular edema can be treated with laser surgery or injections. The laser procedure is called focal laser treatment. Your doctor places several small laser spots in the areas of retinal leakage surrounding the macula. These spots slow the leakage of fluid and reduce the amount of fluid in the retina. Further treatment may be needed.

Intravitreal injection of Avastin®, Lucentis®, or Eylea® is another option for treating macular edema. When injected into the eye, these medications reduce fluid leakage and interfere with the growth of new blood vessels in the retina. Dr. Lima will help you decide what is best for you. Several injections may be needed.

Find Out if You Have Diabetic Retinopathy in Jacksonville

Schedule an appointment online or call our office at (904) 296-0098.