Diabetic Eye Disease: Causes, Symptoms, Diagnosis and Treatment
Introduction
Diabetic Eye Diseases include problems with the eyes that develop as a result of diabetes like diabetic retinopathy, diabetic macular edema, cataracts and glaucoma. Diabetic retinopathy is one of the conditions that occur as a result of complications with diabetes where blood vessels in the retina get damaged because of high blood glucose.
At first it might be symptomless, but if not managed properly it could lead to vision loss. Patients with diabetes should be examined for their eyes even when there are no signs of visual impairment.
What is Diabetic Eye Disease?
Diabetic eye disease is a condition that comprises several eye conditions which could occur in patients with diabetes. It includes various disorders of different parts of the eye which could impair vision if not treated on time.
The retina is the light sensitive layer located at the back of the eye and is responsible for converting light signals into impulses to be sent to the brain. With high blood sugar level, the small blood vessels which supply the retina with nutrients can get damaged. It can result in leakage of fluids, swelling of blood vessels, blockage of blood vessels, or the formation of new abnormal blood vessels.
What Is the Cause of Diabetic Eye Disease?
Diabetic eye problems arise from the effect that diabetes has on the health of the eyes in terms of damaging the blood vessels of the retina. This is because high levels of sugar can damage these blood vessels leading to leakage, blockage or the formation of new abnormal blood vessels. This can lead to loss of vision over time.
There are several risks that increase one’s chance of developing diabetic eye problems:
- Poorly controlled blood sugar levels: High levels of sugar in the body can lead to damage of retinal blood vessels over time.
- The duration for which one has diabetes: This is the time period in which diabetes has been present in the body.
- High blood pressure: This puts extra strain on the blood vessels of the retina.
- High levels of cholesterol: This can also cause damage to the retina..
What Are the Symptoms of Diabetic Eye Disease?
A person may continue reading, driving and carrying out daily activities without noticing any changes, even while retinal damage is developing.
Later on, some of the possible symptoms might include:
- Blurred or fluctuating vision
- Difficulties reading and seeing details
- Dark spots or floaters in the visual field
- Sudden changes in vision
- Difficulties seeing at night
- Dark or empty spaces in the field of vision
- Vision impairment and distortion
- If you have diabetes, any new or unexplained vision changes should be assessed by an eye specialist.
In case you suffer from any of the above conditions, including sudden vision loss, an unusual increase in floaters, or flashes of light, you should see your eye doctor immediately.
What Are the Stages of Diabetic Retinopathy?
There are two primary stages in the development of diabetic retinopathy.
1. Non-Proliferative Diabetic Retinopathy (NPDR)
Non-proliferative diabetic retinopathy (NPDR) is the earlier stage of the condition.
In this stage, small blood vessels of the retina can swell up, leak fluid or have small areas of bleeding. Sometimes some of these blood vessels might even close up.
NPDR could either be mild, moderate or severe based on the level of changes in the retina.
Many people will not have any symptoms of visual impairment at this stage. However, fluid may accumulate in the macula area of the retina that gives clear sight. The condition is known as diabetic macular edema.
2. Proliferative Diabetic Retinopathy (PDR)
When the retina does not get enough blood, abnormal new blood vessels may form. These vessels are weak and bleed into the vitreous that fills up the eye.
In serious cases, there could be formation of scar tissue or retinal detachment which causes blindness.
How Is Diabetic Eye Disease Diagnosed?
Normal visual acuity tests may fail to reveal early signs of retinal damage; however, the examination done on the enlarged pupil gives the doctor an opportunity to check the retina and the blood vessels.
Dilated Fundus Examination
Eye drops are used in order to dilate the pupils in order for the doctor to be able to examine the retina, optic nerve, and blood vessels for signs of damage.
Retinal Photography
By taking photographs of the retina using specialised cameras, the retinal changes are documented and monitored.
Optical Coherence Tomography (OCT)
OCT imaging takes cross-sectional images of the retina without being invasive.
This method allows identifying fluid or swelling of the macula – part of the retina that affects the central vision.
Fluorescein Angiography
Sometimes, the fluorescent dye is administered into the bloodstream and the images are taken as the dye travels through the blood vessels in the retina.
This test helps detect any leakage, blockage of the blood vessels and their abnormal development.
What Are the Treatment Options for Diabetic Eye Disease?
The treatment should be determined by the stage of diabetic retinopathy, presence of retinal swelling and damage.
All patients do not require treatment immediately. Patients who have early changes may only need monitoring and proper diabetes control.
1. Anti-VEGF Injections
The anti-VEGF agents are often employed in the treatment of diabetic macular edema and some types of diabetic retinopathy.
They reduce the number of abnormal blood vessels and their leakage, thus helping to diminish the swelling of retina.
Such therapy is performed through injections in the eye done by a qualified ophthalmologist.
Some patients might require several injections, further monitoring, and treatment depending on the response.
2. Laser Treatment
The use of laser treatment might be advised at particular levels of diabetic retinopathy.
Based on the type of problem, laser treatment might help in sealing the leaking blood vessels or treating the part of the retina not getting sufficient oxygen.
A form of treatment called pan-retinal photocoagulation is used in proliferative diabetic retinopathy, where laser treatment helps in decreasing the likelihood of complications because of blood vessels growing in an abnormal way.
3. Vitrectomy Surgery
In more serious cases, there can be complications such as bleeding within the eye and retina scarring.
Vitrectomy surgery is performed in order to clean blood out of the vitreous fluid and treat some complications associated with the retina, such as traction or retinal detachment.
4. Blood Sugar and Health Management
Management of the blood sugar level, high blood pressure and cholesterol, taking medication and visiting the doctor is required in treating the condition.
The condition can be controlled, damage prevented, and sometimes vision improved through treatment. But this will depend on the degree of damage and time of diagnosis.
When Do You Need to See a Doctor for Diabetic Retinopathy?
Diabetic retinopathy specialist refers to an eye specialist who can diagnose and treat diabetic retinopathy. When a person develops symptoms of diabetic retinopathy, his or her eye doctor may refer him or her to a retina specialist.
In case you should see a doctor for your eyes, that means:
- You have diabetes, but you do not have any recent retinal exam.
- You suffer from diabetic retinopathy.
- Your vision is blurry or distorted.
- There are new floaters or spots appearing in your field of vision.
- Suddenly there are changes in your vision.
- Your diabetes has been hard to control.
- You are pregnant and have diabetes.
When the follow-up examinations will be carried out depends on your eyes’ condition and earlier results. Those who suffer from type 2 diabetes require a complete dilated eye exam when being diagnosed, and those who suffer from type 1 diabetes should get their first eye examination within five years of diagnosis.
Most people require annual examinations, but depending on their condition and diabetes control, the eye doctor may advise to conduct examinations either more often or less frequently.
Diabetic Retinopathy Treatment in Punjab
Diabetes-induced eye problems need early detection and proper treatment in order to preserve eyesight. Retinal examination helps detect any abnormalities even before they cause any problems.
The services offered by Dr. Rajan Eye Care Hospital in Phagwara for diabetic eye care are provided in their Diabetic Eye Clinic and Retina Clinic. The services available at the hospital include the assessment of the retina using Fundus Fluorescein Angiography (FFA), Laser Photocoagulation and the treatment of retinal problems.
According to the diagnosis results, the doctor shall prescribe a suitable diabetic eye treatment regimen that can involve monitoring, use of drugs, laser treatment or retinal surgery.
In case you suffer from diabetes, do not postpone eye examination even if there are no signs of visual impairment yet.
How Can You Reduce the Risk of Diabetic Eye Disease?
Diabetic retinopathy is not always preventable, but controlling one’s diabetes and visiting an ophthalmologist for checkups will go some way to avoid vision impairment.
- Keep your sugar levels under the recommended level as per your doctor’s suggestion.
- Check your blood pressure and cholesterol levels.
- Take your medicines as recommended by your doctor to control diabetes.
- Stay healthy and maintain balance in your diet and exercise.
- Avoid smoking.
- Visit your eye doctor on a regular basis for diabetic eye treatment.
Frequently Asked Questions
Can diabetic eye disease be treated?
Sometimes, yes. The eye disorder caused by diabetes is manageable through suitable treatment, depending on the kind of disease that the patient has. The treatment can involve the use of anti-VEGF injection, laser, and surgery. Right diagnosis prevents any issues in vision.
Does diabetic retinopathy cause blindness?
If diabetic retinopathy is not correctly managed, blindness may result. Eye examinations and treatment can drastically reduce the risk of going blind from diabetic retinopathy.
Does diabetic retinopathy treatment cause pain?
Pain during diabetic retinopathy is dependent on the treatment procedure. Anti-VEGF injections are usually performed after the numbing of the eye through application of eye drops.
How often should people with diabetes get eye examinations?
Diabetics should be under the recommendation to have a comprehensive eye examination done by the use of dilation at least once in a year. In case the patient is having diabetic retinopathy, then the ophthalmologist recommends that more eye tests should be carried out.
Can diabetic retinopathy improve with better blood sugar control?
Through better blood sugar management, one can slow down the progress of diabetic retinopathy. It, however, does not mean that one should not undergo treatment for the damaged retina.
Which physician should treat diabetic retinopathy?
Both ophthalmologists and retina specialists are able to carry out diabetic eye exams. The latter is specialized in cases dealing with retina disorders.
Protect Your Vision with Regular Eye Care
Even without any symptoms at all, a diabetic eye disease may occur; this is why eye examination is essential in dealing with diabetic individuals. Proper diagnosis may help in identifying and controlling any changes that might take place in the retina to prevent any vision complications.
As a diabetic individual, it is important not to wait for any changes in your vision to visit the eye doctor. Follow the guidelines of your eye doctor on how you should control your condition, along with your diabetes, blood pressure, and cholesterol.
Dr. Rajan Eye Care Hospital, Phagwara recommends that diabetic individuals should take retinal screening seriously.