According to the American Diabetes Association, approximately 1.25 million Americans have Type 1 diabetes. As if that figure isn’t daunting enough, 1.5 million new cases are diagnosed every year. One of the more debilitating effects of diabetes is vision loss. In fact, it’s the leading cause of blindness among working age adults. To understand how to prevent retina issues from diabetes, start with understanding the disease itself.
What is Diabetes?
Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high.
How Does Diabetes Cause Vision Loss?
Diabetic eye disease stems from the effect of the disease on the retina, macula, lens and optic nerve. It can cause many eye issues including diabetic macular edema, cataracts, and glaucoma, and the most common, diabetic retinopathy.
The retina acts like film in a camera with the exception that a camera creates one image at a time, while the retina is continually recording images and sending them to the brain through the optic nerve. How? By converting light into signals that form the image in the brain. When blood sugar levels are chronically high, the blood vessels in the retina can become damaged, causing them to leak fluid or even bleed. The disease can progress through four stages as noted below.
Mild non-proliferative retinopathy – Tiny microaneurysms occur in the blood vessels of the retina, typically leaking fluid into the retina.
Moderate non-proliferative retinopathy – Blood vessels swell and become distorted and may lose their ability to transport blood as the disease progresses. This can contribute to diabetic macular edema.
Severe non-proliferative retinopathy – Many blood vessels are blocked at this stage of the disease, limiting the blood supply to areas of the retina. Those areas of the retina can secrete growth factors that result in the growth of abnormal blood vessels.
Proliferative diabetic retinopathy – The most severe stage of the disease, growth factors secreted by the retina spark the growth of even more abnormal blood vessels along the inside surface of the retina and into the fluid that fills the eye. These new blood vessels are delicate, making them more likely to leak and bleed. Scar tissue can form on the retina. This may cause the retina to pull away or detach and result in permanent vision loss.
Symptoms and Detection
Unfortunately, there are often no symptoms of diabetic retinopathy in the beginning. The disease can progress undetected until vision issues occur. As it advances, symptoms can include floating spots in your vision, blurred or color impaired vision and fluctuating areas of darkness. If your doctor suspects diabetic retinopathy is causing vision impairment, they will typically perform a dilated eye exam. This consists of placing drops on the eye’s surface to widen the pupil so the doctor can look for damage to the retina and optic nerve. The doctor will also perform a tonometry test to measure the pressure inside the eye and may use an optical coherence tomography test to gather detailed images of the eye tissues. For the most severe cases, a fluorescein angiogram may be required. This procedure involves injecting a fluorescent dye into the bloodstream to identify any blood vessels that may be leaking or damaged.
Prevention and Treatment
Like any disease, early detection is essential for preventing long-term severe vision loss due to diabetic retinopathy. In fact, it can greatly reduce the risk of blindness. Obviously, controlling the disease itself by effectively managing high blood sugar is crucial. Depending on the severity of the condition, your doctor may prescribe a variety of different treatment plans. Laser surgery, or scatter laser surgery, is often performed on the retina to shrink abnormal blood vessels. However, Anti-VEGF drugs that block abnormal blood vessel growth are being used more often to slow the progress of the disease, particularly in the early stages of development.
Two of the most precious gifts you will ever open are your eyes. The world is a beautiful place. Keep on seeing it clearly by protecting your eyes with regular eye exams. Don’t let issues with your vision go unchecked. If you’re experiencing vision loss and suspect it may be related to diabetes, contact the professionals at Tyson Eye Centers. With six locations to choose from and a dedicated team of vision experts, we’re here to help you see the world. To schedule a consultation with an eye specialist, call us at (239) 542-2020 or request an appointment online today.