Diabetic Eye Diseases
Patients with diabetes are at a higher risk for developing eye conditions because a high blood sugar level can damage blood vessels in the eye. Over 40 percent of patients diagnosed with diabetes develop some form of eye disease as a result. These conditions can cause blood or fluid to leak from the retina or new blood vessels to grow on the surface of the retina which can lead to significant damages to your vision and overall quality of life.
It is important for patients with diabetes to have dilated eye exams once a year to detect any signs of diabetic eye disease as soon as possible. You can also minimize your risk of developing diabetic eye disease by keeping your blood sugar and blood pressure under control, eating a healthy diet and exercising regularly.
Diabetic retinopathy is the most common diabetic eye disease and is a leading cause of blindness in adults. Diabetic retinopathy develops as a result of changes in blood sugar levels or simply the presence of long-term diabetes. Most patients don’t develop this condition until they have had diabetes for at least 10 years. If high blood sugar levels cause blood vessels in the retina to leak blood or fluid, the retina may become swollen and form deposits.
Patients who develop diabetic retinopathy may not notice any changes to their vision at first. In its earliest stages, this condition causes tiny areas of swelling in the small blood vessels of the retina. More and more blood vessels can become blocked, and the retina may send signals for new blood vessels to be grown.
Early stages of diabetic retinopathy do not usually require treatment, just that patients monitor their blood sugar level to prevent the disease from progressing. If the disease does progress, treatment may be necessary to preserve your vision.
Proliferative Diabetic Retinopathy
Proliferative diabetic retinopathy is the most advanced stage of diabetic retinopathy, and is classified by the growth of new blood vessels on the retina. These blood vessels are abnormal and fragile, and are susceptible to leaking blood and fluid onto the retina, which can cause severe vision loss and even blindness.
If blood leaks onto the retina, patients may begin to notice floaters in their vision, which are actually specks of blood that appear in front of your vision. While floaters can sometimes clear up on their own, it is important to see Dr. Brown as soon as you notice them, as they can recur and lead to severely blurred vision and vision loss.
Patients with proliferative diabetic retinopathy often require laser surgery to treat their condition. This treatment is known as scatter laser treatment and is used to shrink the newly developed abnormal blood vessels. This treatment is usually performed in two or more sessions due to the number of laser burns necessary. Scatter laser treatment is most effective before new blood vessels have started to leak, and may slightly reduce patients’ color and night vision, while preserving central vision. Severe bleeding may require a vitrectomy, or removal of the vitreous, to remove blood from the center of the eye.
Diabetic Macular Edema
Macular edema is a serious condition that can occur at any stage of diabetic retinopathy and involves a buildup of fluid in the macula, the light-sensitive part of the retina that allows us to see objects with great detail. Macular edema can cause difficulty reading or doing close work, and can often greatly affect a patient’s quality of life by interfering with regular activities.
Dr. Brown can diagnose macular edema during your regular eye exam before symptoms are present, but you should seek prompt medical attention at the earliest signs of this condition. Retinal swelling may indicate an early sign of macular edema.
Vascular endothelial growth factor (VEGF) is a chemical that is produced in the eye in patients with diabetic retinopathy and other eye diseases. VEGF can cause blood vessels to leak, causing swelling in the retina. This swelling is called macular edema. Medications that block VEGF can slow or stop the leakage. This often results in improved vision and a better prognosis for future vision. Avastin, Lucentis and Eylea are medications that can effectively block VEGF. In a 2015 study of 660 patients with diabetic macular edema, Lucentis, Eylea and Avastin were found to be equally effective, on average, in treating this complication of diabetes. Some patients with vision poorer than 20/50 may achieve greater visual acuity benefit with Eylea. Dr. Brown will discuss with you the proper treatment strategy for your condition.
Treatment for macular edema usually includes a laser procedure called focal laser treatment. During this procedure, small laser burns are placed in the areas of retinal leakage around the macula to prevent leakage from occurring and reduce the amount of fluid in the retina. This helps reduce the risk of vision loss and can improve vision in a small number of cases. Focal laser treatment is also performed at Dr. Brown’s office.