November is Diabetes awareness month. During Diabetes awareness month the goal is to promote a better understanding of diabetes as a condition and to promote wellness strategies for better health for diabetics. One particular aspect of diabetes we will dive into is diabetic eye health.
Diabetic Eye Disease
It may seem trivial, but for the many living with diabetes, they are aware of the many eye complications that can become diabetic eye disease and permanently damage the eyes. Diabetic eye disease consists of a group of eye conditions affecting people with diabetes. The conditions include diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma.
Diabetic Retinopathy – Affects blood vessels in the retina. The most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults.
Diabetic Macular Edema – A consequence of diabetic retinopathy. Swelling in an area of the retina called the macula.
Cataract – A clouding of the eye’s lens. Adults with diabetes are 2 – 5 times more likely to develop cataracts. It develops in an early age in those with diabetes.
Glaucoma – A group of diseases that damage the eye’s optic nerve. Types of glaucoma are associated with elevated pressure inside the eye. Having diabetes nearly doubles the risk of glaucoma as an adult.
What Are the Symptoms?
Unfortunately, the early stages of diabetic retinopathy typically have no symptoms. This means the disease often progress unnoticed until it affects vision. This is even worse for diabetic retinopathy, which without treatment can cause blurred vision. This furthermore highlights the significance of having regular eye exams. An optometrist can properly diagnose diabetic retinopathy and DME.
When checking for diabetic retinopathy and DME a comprehensive dilated eye exam is performed. The details for each vary but are as follows:
Visual acuity testing – An eye chart test which measures a person’s ability to see at various distances.
Tonometry – A test which measures pressure inside the eye.
Pupil dilation – Drops are placed on the eye’s surface to dilate the pupil to allow further examination of the retina and optic nerve.
Optical coherence tomography (OCT) – A technique similar to ultrasound but uses light waves instead of sound waves to capture images of tissues inside the body. OCT provides detailed images of tissues easily penetrated by light, like the eye.
A comprehensive dilated eye exam allows the doctor to check the retina for changes to blood vessels, leaking blood vessels or warning signs of leaky blood vessels, swelling of the macula, changes in the lens, and damage to nerve tissue.
Prevention and Treatment
All forms of diabetic eye disease have the potential to cause severe vision loss and blindness which can be irreversible. However, early treatment can reduce the risk of blindness by 95%. Additional treatment for diabetic retinopathy can be delayed until DME occurs.
Once DME occurs a few treatment options may be performed:
Focal/grid macular laser surgery – A procedure where a few to hundreds of small laser burns are made to leaking blood vessels in areas of edema near the center of the macula. Laser burns for DME slow the leakage of fluid, thus reducing the swelling in the retina. This procedure is usually completed in one session; however, some people may need more than one treatment.
Corticosteroids – Typically injected or implanted into the eye, may be used alone or in combination with other drugs or laser surgery to treat DME. Corticosteroid use in the eye increases the risk of cataract and glaucoma. Two types of implants are used. The Ozurdex implant, which is for short term use and the Iluvien implant which is longer lasting.
In regards to prevention, diabetics should get a dilated eye exam at least once a year to check if they have diabetic eye disease. To go even further, the Diabetes Control and Complications Trial (DCCT) showed controlling diabetes slows the onset and worsening of diabetic retinopathy. Participants who kept their blood glucose level as close to normal as possible were significantly less likely to develop diabetic retinopathy as well as kidney and nerve diseases.
Visiting your local eye doctor is important for detection of diabetic eye disease. Here at First Eye Care North Arlington, we offer comprehensive eye exams using state-of-the-art technology and sophisticated tools to catch diabetic retinopathy or DMA before they cause permanent damage to vision.
Take care of your eye health. Contact First Eye Care North Arlington today and schedule your comprehensive eye exam with our experts.