Diabetes can have dramatic effects on the eye including glaucoma and cataracts but, the most significant cause of loss of vision can develop over many years as diabetes affects the retina. The effects imposed on the retina by diabetes is called diabetic retinopathy.
As time passes the vessels in the eye begin to leak causing small hemmorhages, swelling, new blood vessel formation (neovascularization) and noticeable loss of vision.
Later, as things progress, not only are there hemmorhages and swelling but, the retina becomes oxygen deprived (ischemic). In an attempt to compensate for lack of oxygen, the body grows new, fragile, blood vessels (this is call neovascularization). Because new blood vessels are weak and hemorhage easily, they often leak into the retina and vitreous, causing floaters, spots, and decreased vision. By now, the effects of diabetes on the eye is called proliferative diabetic retinopathy.
In the last stages of the disease, abnormal blood vessel growth continues and scar tissue may form causing serious problems such as retinal detachment.
Patients with diabetic retinopathy or at risk for the disease should perform an Amsler grid test at home each day.
Signs and Symptoms
- blurred vision associated with high blood sugar levels
- flashes and floaters
- sudden loss of vision
Diagnosis of diabetic retinopathy is best made by a thorough dilated fundus examination by a retina specialist. Many patients are referred by their internist or endocrinologist as well as by other eye doctors.
Diabetic retinopathy is treated in a variety of ways depending on the stage of disease, specific problems, and the patient. The doctor determines which treatments are appropriate based upon examinations and various tests including fluorescent angiography (FA), fundus photography, optical coherence tomography (OCT), and ultrasound.