Diabetic Eye Exams in Winnipeg

Diabetes is linked to numerous eye diseases, including:

• Diabetic retinopathy
• Diabetic macular edema (DME)
• Cataracts
• Glaucoma

Cataracts and Glaucoma are not exclusively linked to diabetes, but diabetes can be a major risk factor for both diseases. All of the above diseases carry the potential for severe or total vision loss.

High blood sugar from diabetes is associated with damage to the blood vessels in the retina. It has four stages:

• Mild nonproliferative retinopathy: microaneurysms take place on the blood vessels within the retina, often leaking fluid.
• Moderate nonproliferative retinopathy: retinal blood starvation begins to set in as the blood vessels in the retina are inhibited from properly transporting blood. There are notable changes to the appearance of the retina.
• Severe nonproliferative retinopathy: blood-starved areas of the retina produce hormones that stimulate the growth of new blood vessels.
• Proliferative diabetic retinopathy (PDR): fluid leaks from the new blood vessels. Since the new blood vessels are weak, they often die and leave behind scar tissue. This scar tissue can peel back the retina, leading to retinal detachment—which causes complete blindness.

We generally diagnose diabetic retinopathy with a dilated eye exam. During a dilated eye exam we use special eye drops to dilate your eyes. This dilation ensures that your pupil remains open, enabling us to better see the internal eye tissues.

We also use ocular coherence tomography (or OCT imaging) 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 preserve as much vision quality as possible. Vision lost to retinopathy cannot be restored.

While there is no cure for retinopathy, treatments exist that can help preserve vision—especially when the disease is caught early. These treatments include photocoagulation, vitrectomy, and anti-VEGF therapy.

DME is the accumulation of fluid on the retina. This happens when abnormal blood vessels on the eye grow and swell, eventually becoming damaged and dying. This process leaks fluid onto the eye.

We also use dilated eye exams to diagnose diabetic macular edema, along with OCT imaging. OCT imaging is used to create a visualization of your eye since DME shows up 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. However, there are treatments available to preserve vision quality and prevent vision loss. In the case that these treatments are needed, Henderson Vision Centre will refer you to an ophthalmologist.

Anti-VEGF therapy blocks a protein called vascular endothelial growth factor (VEGF). The goals of anti-VEGF therapy are to prevent further abnormal blood vessel growth and to reduce the abnormal fluid in the retina. Anti-VEGF therapy is a multi-year process, during which the frequency of treatments gradually decreases.

Laser surgery is also used to treat DME. Focal-grid macular laser surgery creates many small burns where abnormal blood vessels are growing and leaking. These burns seal the blood vessels, reducing blood vessel growth and leakage.

Corticosteroids may be injected into the eye to treat DME. While corticosteroids have been shown to suppress the development of DME, their long-term use has been linked to an increased probability of developing cataracts and glaucoma.