Up to 80% of people who have had diabetes for 20 years or more will develop some form of diabetic eye disease. Because of its significance, being diligent and regularly monitoring eye health is important in preserving vision quality and maintaining good eyesight.
Annual eye exams are an important first-step in maintaining excellent eye health when living with diabetes. Left unchecked, diabetes can have a significant impact on your eye health.
Diabetes is linked with numerous eye diseases, including: diabetic retinopathy, diabetic macular edema (DME), cataracts, and glaucoma. Note that cataracts and glaucoma are not exclusively linked to diabetes, though diabetes is a major risk factor.
All diseases linked with diabetes have the potential for serious or complete vision loss.
High blood sugar from diabetes is associated with damaged to the blood vessels in the retina. It has four stages:
Diabetic retinopathy is generally diagnosed through a dilated eye exam. During a dilated eye exam the eyes are dilated using special eye drops. This dilation ensures that your pupil remains open, enabling us to better see the internal eye tissues.
Ocular coherence tomography (also called OCT imaging) is also used to diagnose diabetic retinopathy. This test creates detailed images of the eye and its internal structures, including areas where blood vessels are damaged or showing signs of retinopathy.
Detecting retinopathy in its early stages is the best way to ensure that as much vision quality as possible is preserved. Vision lost to retinopathy cannot be restored.
There is no cure for retinopathy, though treatments exist that, especially when retinopathy is caught early, can help preserve vision. These treatments include photocoagulation, vitrectomy, and anti-VEGF therapy.
DME is the accumulation of fluid on the retina. This is the result of abnormal blood vessels on the eye growing and swelling, eventually becoming damaged and dying. This process leaks fluid onto the eye.
A dilated eye exam is also used to diagnose diabetic macular edema, as is a fluorescein angiogram and OCT imaging. OCT imaging is used to create a visualization of your eye; DME is indicated in OCT images as areas of the retina that appear to be filled with fluid.
Like diabetic retinopathy, there is no known cure for DME. There are treatments available to preserve vision quality and prevent vision loss.
Anti-VEGF therapy blocks a protein called vascular endothelial growth factor (VEGF). The goal of anti-VEGF therapy is to prevent further abnormal blood vessel growth and to reduce the abnormal fluid in the retina. Anti-VEGF therapy is a multi-year treatment, where a decreasing frequency of treatments are applied until over the period of several years.
Laser surgery is also used to treat DME. Called the focal-grid macular laser surgery, the surgery makes hundreds/thousands of small burns where abnormal blood vessels are growing and leaking. These burns seal the blood vessels, reducing blood vessel growth and leakage.
Corticosteroids are injected into the eye to treat DME. While corticosteroids have been shown to suppress the development of DME, long-term use of corticosteroids has been linked with an increased probability of developing cataracts and glaucoma.
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