Retinopathy

Diabetic retinopathy is one of the most frequent causes of blindness in this country. Tragically, this form of blindness is completely preventable with proper control of the diabetes, and with yearly eye examination through dilated pupils.

Diabetes causes a problem with the blood vessels in the body. The blood vessels begin to leak fluid, blood, and protein. In the eye, this leakage is seen in the retina as retinal bleeding and swelling. This blood and swelling interferes with the normal function of the eye, resulting in decreased vision. If this condition is not corrected, visual loss can be permanent. This type of retinopathy is called background, or non-proliferative diabetic retinopathy (See Photo).

Eventually, the abnormal blood vessels in the eye begin to grow. These abnormally growing blood vessels are very fragile, and especially prone to bleeding. These abnormal blood vessels may cause a large sudden hemorrhage, called a vitreous hemorrhage, can result in rapid complete loss of vision. Usually, this visual loss is not permanent, but vision may not return to normal after this hemorrhage. This type of retinopathy is called proliferative diabetic retinopathy (See Photo).

The best treatment for diabetic retinopathy is PREVENTION. All diabetics should check their own blood sugar daily, and record the result in a journal. This should be shown to the primary medical doctor at each follow-up visit so that tight control of blood sugar can be achieved.

This means that all fasting blood sugar measurements should fall within a very narrow range. If your blood sugar tends to fluctuate a lot, your doctor must adjust your medications and your diet to optimize control of your diabetes. This is the best way to prevent blindness from diabetes.

If prevention of diabetic retinopathy has failed, your ophthalmologist can use a laser to cauterize the abnormal blood vessels to stop the leakage of fluid and blood. However, these problems will continue to recur as long as the diabetes is not medically controlled.