Diabetic Eye Disease
August 10, 2009
Dr. Morgan Parker and Dr. Nathan Hall
Diabetic Retinopathy - Topic Overview
Retinopathy is a disease of the retina. The retina is the nerve layer that lines the back of your eye. It is the part of your eye that "takes pictures" and sends the images to your brain. Many people with diabetes get retinopathy. This kind of retinopathy is called diabetic retinopathy (retinal disease caused by diabetes).
Diabetic retinopathy can lead to poor vision and even blindness. Most of the time, it gets worse over many years. At first, the blood vessels in the eye get weak. This can lead to blood and other liquid leaking into the retina from the blood vessels. This is the most common kind of retinopathy.
If blood sugar levels stay high, diabetic retinopathy will keep getting worse. New blood vessels grow on the retina. This may sound good, but these new blood vessels are weak. They can break open very easily, even while you are sleeping. If they break open, blood can leak into the middle part of your eye in front of the retina and change your vision. This bleeding can also cause scar tissue to form, which can pull on the retina and cause the retina to move away from the wall of the eye (retinal detachment).
Retinopathy can also cause swelling of the macula of the eye. This is called macular edema. The macula is the middle of the retina, which lets you see details. When it swells, it can make your vision much worse. It can even cause legal blindness.
See a picture of the eye .
What causes diabetic retinopathy?
High blood sugar causes diabetic retinopathy. If you are not able to keep your blood sugar levels near normal, it can hurt your blood vessels. Diabetic retinopathy happens when high blood sugar damages the tiny blood vessels of the retina.
When you have diabetic retinopathy, high blood pressure can make it worse. High blood pressure can cause more damage to the weakened vessels in your eye, clouding more of your vision.
What are the symptoms?
Most of the time, there are no symptoms of diabetic retinopathy until it starts to change your vision. When this happens, diabetic retinopathy is already severe. Having your eyes checked every year can find diabetic retinopathy early enough to treat it and help prevent vision loss.
If you notice problems with your vision, call an eye doctor (ophthalmologist or optometrist) right away. Changes in vision can be a sign of severe damage to your eye. These changes can include floaters, pain in the eye, blurry vision, or new vision loss.
How is diabetic retinopathy diagnosed?
An eye exam by an eye specialist (ophthalmologist or optometrist) is the only way to diagnose diabetic retinopathy. Having an eye exam every year can help find retinopathy before it changes your vision. If you are at low risk for vision problems, your doctor may consider follow-up exams every 2 years. On your own, you may not notice symptoms until the disease becomes severe.
Can diabetic retinopathy be prevented?
You can lower your chance of damaging small blood vessels in the eye by keeping your blood sugar levels, blood pressure, and cholesterol levels near normal. If you smoke, quit. All of this decreases the risk of damage to the retina. It can also help slow down how quickly your retinopathy gets worse and can prevent future vision loss.
If you have an eye exam every one to two years, you and your doctor can find diabetic retinopathy before it has a chance to get worse. Finding retinopathy early gives you a better chance of avoiding vision loss and blindness.
How is it treated?
You may not need treatment for diabetic retinopathy unless it has affected the middle part of your eye. But you will need to see your eye doctor for regular follow-up exams.
Surgery, laser treatment, or medicine may help slow the vision loss caused by diabetic retinopathy. You may need to be treated more than once as the disease gets worse.
Detecting Eye Diseases and Conditions
As our population is aging, vision loss from eye diseases is increasing. 1
According to the National Eye Institute (NEI):
NEI has identified the most common eye diseases in people over age 40: