DIABETES AND THE EYE

  Diabetes is a very common disease in the United States and is the leading cause of blindness in adults under the age of 65. In general, there are five main potential complications with diabetes. They are
1. KIDNEY DISEASE because of degenerated blood vessels.
2. PERIPHERAL NEUROPATHYwith numb spots or shooting pains most often in the legs, but may be elsewhere as well.
3. INFECTION with an increased frequency and more difficulty getting rid of infections when they do occur.
4. Acceleratedrate of ARTERIOSCLEROSIS with increased risk of developing heart disease or stroke and DIABETIC RETINOPATHY.
  This brief overview will outline this disorder and explain its treatment.
   Diabetic retinopathy may affect patients with both Type 1 (juvenile onset)and Type 2 (adult onset) diabetes. The younger diabetics are usually free of retinopathy for at least the first 5 years after onset of the diabetic condition. Adults may acquire the retinopathy at any time after diagnosis is made.
  To make a very long story short, diabetic retinopathy is a disease of the blood vessels in the delicate tissue called the retina. It is the retina which acts like film in a camera and does the actual sensing of light inthe eye. These vessels become incompetent and leak fluid and blood andfail to supply the nutrients necessary for good health in the retina.
  Basically, retinopathy is divided into two forms (1) NON-PROLIFERATIVE(NPDR) or BACKGROUND RETINOPATHY and (2) PROLIFERATIVE RETINOPATHY (PDR).
   NPDR consists of hemorrhages, leaky spots and small dilatations in the vessel walls.
  PDR is all of that plus NEW BLOOD VESSELS. These new vessels are always abnormal and will leak and bleed if left untreated.About 40% of all diabetics will develop PDR over a 15 year span.
  The most common cause of decreased vision with diabetes is NPDR with swelling in the retina from leaky blood vessels. This is very difficult to treat, but with focal applications of LASER light to seal these leaks,vision may be preserved and occasionally improved. PDR poses a very serious threat to vision as well. Large hemorrhages may obscure visionfor months at a time. These new abnormal vessels should be treated with LASER therapy.
  Retinal detachments may also occur because of traction created by these new vessels.Other factors may contribute to the progression of diabetic retinopathy.This list includes HIGH BLOOD PRESSURE, ELEVATED LEVELS OF SUGAR,CHOLESTEROL and TRIGLYCERIDES in the blood stream. Each of these factors must be controlled as best possible to assist in the treatment of the retinopathy.
   Regular examinations are critical to early diagnosis and therapy. We now have more to offer diabetics than ever before. Most do well, and vision can be preserved in the majority. Help and cooperation with regular eye examinations are needed in controlling the basic disease.

 
© nholland 2002