House call
By Catherine O'Neill Grace
Focus on Eye Health
DIABETIC RETINOPATHY IS A LEADING CAUSE OF BLINDNESS. HERE’S WHAT YOU NEED TO KNOW TO PROTECT YOUR VISION.
People with diabetes are at risk for a range of vision problems, including an increased rate of cataracts, glaucoma and susceptibility to eye infection. In addition, a condition called diabetic retinopathy can lead to vision loss. We asked Dr. Thomas Albini, a retinopathy specialist at the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine, about the condition’s symptoms, treatment and, most important, prevention.
Q. What is diabetic retinopathy?
A. Diabetic retinopathy happens when tiny blood vessels in the retina — the sensitive area responsible for vision at the back of the eye — are damaged and begin to bleed or leak fluid into the retina, resulting in swelling and the formation of deposits that can lead to vision loss. People with diabetes are at risk for developing diabetic retinopathy, a leading cause of blindness. The longer a person has diabetes, the greater the chance of developing diabetic retinopathy. There are two types: non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). PDR occurs when blood vessels on the retina or optic nerve become blocked, starving the retina of necessary nutrients. PDR carries the greatest risk of vision loss.
Q. What are the symptoms of diabetic retinopathy?
A. People with PDR, the more serious form of diabetic retinopathy, experience a broad range of symptoms that may include dark “floaters” in their vision, the loss of central or peripheral vision, visual distortions or blurriness, and temporary or permanent blindness. Generally, people with mild NPDR can experience mild blurriness associated with swelling of the retina.
A dilated eye exam is the only way to detect changes inside the eye before a loss of vision occurs. This involves applying eye drops that dilate the pupil and looking inside the eye with an ophthalmoscope. People with diabetes should have an eye examination at least once a year. More frequent exams may be necessary after diabetic retinopathy is diagnosed.
Q. Are effective treatments available?
A. The most effective overall strategy is to prevent retinopathy as much as possible. Strict control of blood-sugar levels, blood pressure and cholesterol will significantly reduce the long-term loss of vision. Once retinopathy develops, treatment of the retina with a laser is essential to reducing the chances of progressive loss of vision. Treating swelling of the retina with steroids injected into the eye under anesthesia can be effective. Patients who develop retinal detachments and/or persistent hemorrhages in the eye often benefit from surgery. With improved diagnosis and treatment, only a small percentage of people with diabetic retinopathy develop serious vision problems.