and Your Eyes
Your Eyes Require Special Attention
one knows exactly how diabetes causes damage to
the eyes, but there's no doubt about this fact:
people with diabetes are at an increased risk
of visual impairment, and even blindness. The
longer a person has had diabetes, the greater
we are living in a time when major medical progress
makes it possible to prevent, reduce or repair
damage to the eyes caused by diabetes. This brochure
will tell you about the latest developments in
detecting and treating diabetic eye problems.
You will also see that, as with all of the complications
of diabetes, self-care and regular medical checkups
are the cornerstone of prevention, but not a guarantee.
at Diabetic Retinopathy
retinopathy is the most common eye condition related
to diabetes--and the most serious.
occurs when the retina, a thin, light-sensitive
tissue that lines the back of the eye and transmits
visual images to the brain via the optic nerve,
is damaged by the deterioration of small blood
vessels that supply the retina with vital oxygen
and nutrients. The extent and nature of diabetic
retinopathy varies from person to person.
Retinopathy (Non-Proliferative Retinopathy)
retinopathy is the earliest stage of the disease,
and the mildest form. At this stage, retinal capillaries
become clogged and swollen, forming balloon-like
sacs that leak fluids into the retina and cause
swelling. For the vast majority of people with
diabetes (80 percent), retinopathy never progresses
beyond the background stage--many won't notice
any change at all in their vision.
Edema (Diabetic Maculopathy)
some cases, however, the leaking fluid from the
capillaries will pool in the most sensitive part
of the retina--the macula. The macula is in the
center of the retina and is responsible both for
the fine vision used in reading, and for color
vision. People with macular edema may experience
any or all of the following:
is the most advanced form of diabetic retinopathy
which can and does cause blindness. In proliferative
retinopathy, new blood vessels begin to sprout on
the retina or the optic nerve. This is called neovascularization.
The new blood vessels are fragile, and hemorrhage
easily. The blood which spills from the weakened
vessels may prevent light from hitting the retina,
abruptly blocking vision. Scar tissue that forms
near the retina may tug on the retina, detaching
it from its normal position at the back of the eye.
When the retina becomes detached, a person experiences
severe loss of vision, or even blindness.
to Detect Diabetic Retinopathy
Examinations are a Must
the early stages of retinopathy, there may be no
symptoms to indicate its presence. For
any person with diabetes, annual eye examinations
by an ophthalmologist are absolutely
essential. If retinopathy is detected, more frequent
checkups may be necessary.
Any Changes in Vision to Your Doctor
the following symptoms do not necessarily indicate
diabetic retinopathy, they should nevertheless be
reported promptly to your doctor:
field of vision
pressure or pain in the eyes
no single symptom confirms the presence of retinopathy,
your doctor is the best one to evaluate its significance.
for Diabetic Retinopathy
the early 1970's, tremendous strides have been made
in the treatment of diabetic retinopathy. The most
important breakthrough was the discovery that lasers
can reduce the risk of visual loss caused by retinopathy.
form of treatment has been proven to reduce the
change of severe visual loss by 60 percent in people
it Works--Laser photocoagulation is a form
of microsurgery in which a powerful laser beam is
aimed at many spots in the retina. It seals hemorrhages
in the eye that are caused by neovascularization
(new blood vessels), and prevents further development
of new blood vessels.
It Is Used--Although laser treatment is usually
used to treat proliferative retinopathy, many ophthalmologists
now believe that lasers can be used in prevention
as well. Treatment is given in the preproliferative
retinopathy usually include three sessions per eye.
is involved--Usually laser treatment is performed
in the doctor's office and normally does not require
hospitalization. The patient sits in a chair and
is given a drop of anesthetic in the eye to be treated.
Once the surgeon has identified the exact spots
where treatment is needed, he uses a foot pedal
to direct the laser beam at the retina. The patient
sees a brief flash of light. This process is repeated
many times. Treatment usually lasts less than half
an hour, and initial treatments for proliferative
retionpathy usually include three sessions per eye.
the success of laser photocoagulation, some people
with diabetic retinopathy suffer vitreous hemorrhages,
massive bleeding into the vitreous--the normally
clear gel that fills the center of the eye. When
the vitreous is clouded by blood and scar tissue,
blindness may result. Today, new surgical techniques
have made it possible to remove blood and scar tissue
from that part of the eye through a process called
vitrectomy. This surgery clears up the vitreous
and makes the area transparent again so that light
can get through to the retina. Vitrectomy is a complex
microsurgical procedure requiring general anesthesia
and a two hour operation. Following vitrectomy,
many patients have improved vision--some even see
well enough to read or drive again.
to Protect Your Eyesight
is a real and serious potential complication to
every person who has diabetes. To ensure everything
possible is being done to prevent eye damage, follow
Blood Sugar Levels
who have difficulty controlling blood glucose levels
are at an increased risk of experiencing eye problems.
So test blood sugar frequently, and make sure your
diabetes management plan is designed for maximum
Reason Not to Smoke
is particularly damaging to small blood vessels.
Smoking, which constricts blood vessels, increases
circulatory problems which may make diabetic eye
disease more severe.
of High Blood Pressure
blood pressure also contributes to diabetic eye
damage by increasing stress on already fragile blood
vessels in the eyes. Be sure to have your blood
pressure checked frequently.
and Eye Care
is known to be a factor in the development of diabetic
eye complications. Pregnant women with diabetes
should therefore pay particular attention to monitoring
their vision--and schedule more frequent visits
to the ophthalmologist.
Your Eyes Checked Each Year
sure your doctor or ophthalmologist thoroughly examines
your eyes at least once a year. Remember, changes
can happen in your eyes without any noticeable symptoms.
Early detection makes a big difference in preventing
common problem for older people is cataracts. Cataracts,
the clouding of the lens of the eye, interferes
with vision by blocking the passage of light rays
to the back of the eye. This occures more often--and
at an earlier age--in people with diabetes. In addition,
diabetics experience complications from cataract
surgery more often than non-diabetic patients.