Diabetes is a disease in which one’s blood sugar, or glucose, is too high. According to the National Institute of Health, diabetes affects over 29 million Americans. Over time, this disease can cause devastating damage to every system of the body, including the eyes.
With poor diabetic control, high blood sugar levels may damage the blood vessels within the eye. The back layer of the eye, called the retina, is responsible for sensing light and sending an image to the brain so that one may see, and it is the blood vessels within the retina that are susceptible to damage from diabetes. When such damage occurs, it is referred to as diabetic retinopathy.
There are two primary forms of diabetic retinopathy. The first is known as Non-Proliferative Diabetic Retinopathy (NPDR), and it occurs when damaged blood vessels leak blood and fluid into the retina. This can result in swelling of the retina and vision loss.
The second and more severe form is called Proliferative Diabetic Retinopathy (PDR). This occurs when poorly functioning retinal blood vessels fail to adequately supply the surrounding retinal tissue with nutrients. In response, the retina grows new blood vessels but, unfortunately, these new blood vessels don’t work well. In addition to leaking blood and fluid, the new vessels can also cause retinal scarring, bleeding into the central cavity of the eye, retinal swelling, glaucoma, and retinal detachments, any one of which can result in significant vision loss.
Once present, diabetic retinopathy can be treated in a number of ways, and is reversible as long as it is not too advanced. Treatments depend on severity and may include eye drops to decrease swelling of the retina, lasers or injections into the eye to stop bleeding, or a more involved surgery to treat a large bleed or a retinal detachment.
Prevention of diabetic retinopathy begins with tightly and regularly monitoring one’s blood sugar level and working with one’s primary care provider or endocrinologist to maintain a healthy hemoglobin A1C level, a more long-term marker of diabetic control. Blood sugar control is tailored to the individual, and includes a healthy diet, regular exercise, and may require oral medication or insulin. Early damage from diabetes is typically without symptoms, and this is another reason why all diabetic patients should regularly see their ophthalmologist to be checked for any signs of diabetic retinopathy.