When should you visit an eye doctor?
Early diagnosis of diabetic retinopathy is the best prevention against vision loss. Risks can be reduced by controlling blood sugar levels and regularly consulting an eye doctor. Several important considerations must be taken into account:
- Conduct an eye exam for diabetic patients with dilated pupils at least once a year.
- Increase the frequency of periodic check-ups if diabetic retinopathy is present.
- Perform an eye exam for pregnant women during the first trimester, as the risk of retinopathy increases.
- Ensure blood sugar levels are stable before conducting an eye exam for prescription glasses.
It is essential to examine the eyes in urgent cases, such as when one eye has an issue or when a vision problem arises without changes in blood sugar levels.
Diabetic retinal disease
Diabetic retinopathy
Diabetic retinopathy is a complication of diabetes that affects the eyes. It occurs due to damage to the blood vessels in the light-sensitive tissue at the back of the eye (the retina).
It can be early (non-proliferative), advanced (proliferative), or cause macular edema.
Vitreous Hemorrhage
This refers to bleeding from fragile and weak new blood vessels. If the bleeding is minor, the patient sees floating dark spots in their vision. If severe, it can completely obscure vision. Absorbing the leaked blood over time can improve vision, or else a vitrectomy surgery may be required.
Macular Edema
The macula is a small area in the center of the retina that enables detailed vision. Fluid leaking from retinal blood vessels causes swelling in the macula. Macular edema leads to significant vision loss while preserving peripheral vision. When retinal capillaries are blocked, it is termed macular ischemia, resulting in blurred vision.
Retinal Detachment
Retinal detachment occurs due to scar tissue formation alongside new blood vessels, pulling the retina away from its natural position. If the macula is affected, vision becomes blurry. The condition worsens as more of the retina detaches.
Proliferative Diabetic Retinopathy
In this condition, many of the retina’s primary blood vessels become blocked. The body compensates by growing new blood vessels, but these are fragile and lead to scar tissue and retinal detachment. This form is more severe than the non-proliferative type, as it affects both central and peripheral vision.
How is diabetic retinopathy treated?
It is crucial to control blood sugar levels as much as possible to prevent retinal damage.
Option 1:
Laser Therapy
It is the essential treatment for most of these cases, such as:
- Macular edema.
- Proliferative diabetic retinopathy.
- Glaucoma associated with the growth of new blood vessels.
In the case of macular edema:
The laser focuses on the damaged areas of the retina near the macula to stop fluid leakage from the blood vessels that cause the edema.
In the case of proliferative diabetic retinopathy:
The laser is applied to all parts of the retina except the macula. This treatment causes abnormal blood vessels to shrink and prevents them from forming again, as well as stopping vitreous hemorrhage. However, laser surgery does not always prevent the possibility of future vision loss.
Option 2:
Intravitreal Drug Injections
There is no oral medication available to treat retinal edema or hemorrhages. The medication is injected directly into the eye’s vitreous cavity to deliver it to the retinal tissuesز This is done under local anesthesia using eye drops.
Option 3:
Vitrectomy
It is a microsurgical procedure performed by a specialist in retinal and vitreous diseases. The procedure involves removing the vitreous, a gel-like transparent substance that fills the eye’s cavity, to access and treat the retinal tissues. It is used in advanced cases of diabetic retinopathy, vitreous hemorrhage, tractional retinal detachment, and other conditions such as macular holes and fibrosis affecting the macula.