Diabetes and the Eye
19671 Beach Blvd. Suite 400 Huntington Beach, California 92648
A very common disease in the United States, diabetes is the leading cause of blindness in adults under the age of 65.
Diabetic Retinopathy can affect patients with both Type I (juvenile onset) or Type II (adult onset) diabetes. Younger diabetics are usually free of retinopathy for at least the first 5 years after onset of the diabetic condition.
Diabetic Retinopathy is a disease of the blood vessels in the delicate tissue called the retina. (The retina acts like film in a camera and does the actual sensing of the light within the eye). With diabetic retinopathy, retinal vessels become incompetent and leak fluid and blood, thus failing to supply the nutrients necessary for good health in the retina.
Basically, retinopathy is divided into two forms (1) NON-PROLIFERATIVE (NPDR) or background retinopathy and (2) PROLIFERATIVE RETINOPATHY (PDR), NPDR consists of hemorrhages, leaky-spots and small dilation in the vessel walls. PDR is all of that plus NEW BLOOD VESSELS. These new vessels are always abnormal and will leak and bleed if left untreated. About 40% of all diabetics will develop PDR over a 15 year time span.
The most common cause of decreased vision with diabetes is NPDR, with swelling in the retina from leaky blood vessels. This is very difficult to treat, but with focal applications of LASER light to seal these leaks, vision may be preserved and occasionally improved. PDR poses a very serious threat to vision as well. Large hemorrhages may obscure vision for months at a time. When found, these new abnormal vessels should be treated with LASER therapy. Retinal detachments can also occur because of traction created by the new vessels.
Other factors contribute to the progression of diabetic retinopathy. This list includes HIGH BLOOD PRESSURE, LEVELS OF CHOLESTERL and TRIGLYCERIDES in the blood stream, and the other previously mentioned complications of diabetes. Each of these factors must be controlled as best as possible to assist in the treatment of retinopathy. Regular examinations are critical for early diagnosis and therapy. We now have more to offer diabetics than ever before. Most do well, and vision can be preserved in the majority of patients, but cooperation via regular eye exams is needed to control the disease.