Preventing Vision Loss From Diabetic Eye Disease

With the epidemic of obesity in the United States, the number of people diagnosed with diabetes is expected to rise dramatically in the next decade.  Unfortunately, with that diagnosis comes the potential for many complications, including vision loss and even blindness.

Diabetic eye disease is a major problem in the U.S. and a leading cause of blindness among working-age adults.  Most patients understand that diabetes can increase the risk for heart attack and stroke, but many aren’t aware of the devastating impact it can have on eyesight.

When diabetes is poorly managed, it can damage the blood vessels and block the supply of oxygen and nutrients to the tissues.  Every vital organ in the body can be affected, including the eyes.

Understanding Diabetic Retinopathy

Diabetic retinopathy is a progressive, sight-threatening disorder in which the blood vessels in the retina are damaged.  It is the most common type of diabetic eye disease. The National Eye Institute estimates that between 40 and 45 percent of adults with diabetes have some stage of diabetic retinopathy.

Like the film in a camera, the retina contains light-sensitive cells that convert light rays into impulses. These impulses travel through the optic nerve to the brain, which then converts them into images. 

Diabetes damages the retina in several ways.  Blood vessels that deliver nutrients to the tissue may become blocked.  The vessel walls can weaken, leading to tiny bulges or micro-aneurysms that leak fluid into the retina, causing vision to become blurry and cloudy.

A network of tiny abnormal blood vessels can begin to grow on the surface of the retina.  The vessels, which are fragile, can easily bleed into the eye.  Scar tissue can also develop, increasing the risk of retinal detachment.  In addition, pressure can increase within the eye, which leads to glaucoma and possible damage to the optic nerve.

What’s The Answer?

Early detection is the key to preserving sight and avoiding vision loss.  Annual eye exams that include dilation are vital to identifying problems early, especially since in its earlier stage, diabetic retinopathy may have few or no symptoms.  Patients with diabetes should also be vigilant about controlling their blood sugar levels.

Treatment options for diabetic retinopathy include injections, laser therapy and surgery.   Injections of medication are a short-term, temporary measure that can repair leaky blood vessels and stop fluid from pooling in the center of the retina.  Injections usually need to be repeated on a monthly basis. 

Laser therapy targets the development of new blood vessels.  The treatment not only seals and contracts the vessels, it also allows more oxygen to reach the retinal tissues. 

Surgery is usually considered as a last resort when injections and laser are no longer effective.  The goal of surgery is to preserve vision to the extent that is possible.

(This post was written by Abumere Akinwale, M.D.  Dr. Akinwale is a retina, vitreous and diabetic eye disease specialist at Southern Eye Center in Hattiesburg, Mississippi.  She completed fellowship training through the Joslin Diabetes Center at Harvard Medical School with an emphasis on diabetic eye disease.)