Diabetic Retinopathy

Diabetic retinopathy: Diabetes is a problem where the body loses the ability to control the amount of glucose, or sugar, in the blood. Glucose is the fuel that your brain and nervous system use to keep running, but when glucose levels are too high, small blood vessels and capillaries in all the body’s tissues become damaged. In the eye, the tissue most susceptible to damage is the retina. The retina acts like the film in a camera; it is the thin inner lining of the back wall of the eye that is responsible for capturing the visual information that ultimately gets sent back to the brain. The retina is very delicate and has more blood vessels in it per unit weight than any other tissue in the body. Therefore, it is very sensitive to damage from high glucose levels, and damage to the retina, or diabetic retinopathy, eventually leads to vision loss. A significant amount of damage may occur to the retina before vision is affected, and sometimes this damage is permanent. It is essential to prevent retinopathy or minimize retinopathy through strict control of blood sugar with diet, exercise, oral medications, and, if necessary, insulin. Periodic dilated eye exams are also essential to enable the ophthalmologist to diagnose retinopathy at an early stage when it can be effectively treated. Waiting until the vision loss has occurred makes treatment more difficult and less effective.

Diabetic Retinopathy Columbus

Treatment for diabetic retinopathy often involves the use of lasers. Laser treatments may be directed at the macula, the central portion of the retina, in order to treat areas of swelling caused by leaking blood vessels. If untreated, the swelling can lead to progressive vision loss. When retinal damage reaches a more severe level, new abnormal blood vessels will start to grow within the eye, which can lead to bleeding, scar tissue formation, retinal detachment and permanent total loss of vision. If new blood vessels or bleeding are found, a laser may be used to treat the peripheral portion of the retina in a procedure called panretinal photocoagulation. This treatment is a little more intense and is often broken up into two or more sessions. The goal of this treatment is to cause the abnormal vessels to shrink and stop bleeding. Any blood that is already present, which the patient may note as floating spots in the vision, may slowly absorb on its own. However, if the bleeding is severe, surgical removal of the blood may be required.

As an alternative to laser treatment, or sometimes in conjunction with laser, certain medications may be injected directly into the eye in a procedure called intravitreal injection. The injected medications are often effective in shrinking new blood vessel growth and in improving macular swelling, but they may need to be repeated periodically.

If diabetic retinopathy becomes advanced, either because it is diagnosed at a late stage, or because it does not respond well to treatment, surgery in an operating room is sometimes necessary. This usually involves removing the gel from within the eye in a procedure called vitrectomy. Blood and scar tissue may also be removed. Vitrectomy can be very effective in restoring vision, but at times, when retinopathy is very advanced, even surgery fails to restore vision, and blindness can occur.

Diabetic retinopathy is an example of a disease for which prevention, early diagnosis, and timely treatment make all the difference. It is vital for patients to maintain strict control over their blood sugar, blood pressure, and cholesterol by following an appropriate diet and exercise regimen and by using medications when needed. Patients who have regular visits with their ophthalmologists and undergo appropriate treatment when indicated, ideally when vision is still excellent, are much more likely to maintain good vision throughout their lives.