Diabetic Eye Care
Patients with diabetes are at an increased risk of developing eye diseases that can lead to vision loss such as diabetic retinopathy, cataracts and glaucoma. In fact, diabetes is actually the leading cause of blindness in the United States. To hear a video of Dr. Mark German explaining diabetic eye care, click on his image to the left.
Diabetic eye conditions often develop without any noticeable vision loss or pain, so significant damage may already be present by the time patients notices any symptoms. For this reason, it is important for diabetic patients to have a thorough eye examination with dilating drops at least once a year. Early detection of eye disease can help prevent permanent damage.
Diabetic-related eye problems develop from high blood sugar levels, which can cause damage to blood vessels in the eye. Over 40 percent of diabetic patients will develop some form of eye disease during their lifetime. The risk of developing eye problems can be reduced through regular eye exams and by keeping blood sugar levels under control with a healthy diet, regular exercise and medication.
Cause of Diabetic Eye Conditions
Diabetic eye conditions develop as a result of blood vessel abnormalities in the retina which is in back of the eye. In diabetics, existing or new tiny blood vessels within the retina may become leaky which causes swelling and bleeding in the back of the eye. If left untreated, vision loss and a type of glaucoma that is very difficult to treat may result.
While diabetics struggle with a high sugar count in the blood along with insufficient insulin production, it is actually the lack of oxygen in the blood that causes eye problems and leads to vision loss. Uncontrolled blood pressure can make these problems worse.
Diagnosing Diabetic Eye Conditions
Diabetic eye conditions can only be detected with a thorough and comprehensive eye examination. A comprehensive eye exam involves a visual acuity test to measure vision at various distances and a dilated eye exam to examine the structures of the eye for any signs of disease. During this appointment, we examine the retina and optic nerve with a special magnifying lens. Tonometry is also done during a comprehensive eye exam to measure the pressure inside the eye with a special instrument.
Thorough eye examinations should be performed at least once a year or as soon as any potential problems are detected in order to ensure early detection of any serious diabetic conditions. Early detection is the strongest protection against vision loss from diabetic eye disease.
Diabetic retinopathy is the most common type of diabetic eye disease and the leading cause of blindness in the US. This condition is initially caused by blood vessel changes within the retina that lead to swelling and fluid leakage. Diabetes can also cause the growth of abnormal new blood vessels on the surface of the retina. There are four stages of diabetic retinopathy that begin with the occurrence of microaneurysms (small ballooning of vessels) and eventually may lead to abnormal blood vessels on the surface of the retina. It is the leakage of fluid and hemorrhages in the back of the eye that potentially cause vision loss.
The fluid can also leak into the center of the macula and cause swelling and blurred vision, a condition known as macular edema. The risk of developing macular edema increases as diabetic retinopathy progresses.
Treatment of Diabetic Eye Conditions
Treatment for early stages of diabetic retinopathy usually focuses on maintaining appropriate blood sugar levels, blood pressure and blood cholesterol. This is the reason that we send a report to the primary care physician of all our diabetic patients at the time of each dilated eye examination so your care can be coordinated.
For more advanced stages of the condition such as macular edema or abnormal blood vessels, laser treatments are often effective. Macular edema can be treated through a focal laser treatment, which places hundreds of tiny laser burns in the central area of retinal leakage to reduce the amount of fluid in the retina. This treatment usually requires one session and is generally done after a test called a fluorescein angiogram or OCT is done to evaluate the retina. Macular edema can also be treated with steroid injections in the eye or with Avastin injections. Avastin has shown much promise in the treatment of macular degeneration and is often helpful in diabetic patients also.
Should abnormal blood vessels develop in the back of the eye, a more extensive laser treatment may be required which is called pan-retinal photocoagulation. This is usually done in one or more sessions and may involve a thousand laser spots in the peripheral retina. Both types of laser treatments can be performed in an office setting with the aid of anesthetic eye drops or injections to minimize pain during the procedure. Patients may experience blurry vision for the rest of the day, and should rest at home. It is important for patients to realize that these procedures cannot cure diabetic eye conditions, but rather help reduce vision loss for patients with advanced cases of the condition.
At Lakeshore Eye Care, we usually refer our patients to a retina specialist should they develop significant diabetic retinopathy or macular edema so they can take advantage of the latest treatments and have the best possible outcome. We generally refer our patients to Drs. Hershey, Raja and Tosi at Retina and Vitreous Consultants of Wisconsin. They have the lasers in their offices along with the most advanced diagnostic equipment. Our Ozaukee County patients also appreciate the fact that they have an office in Mequon at Columbia-St. Mary's Hospital.
To learn more about our Diabetic Eye Care services provided at our practice, please call us today to schedule an appointment.