As a practitioner, when I ask patients what comes to mind when they hear the word diabetes, oftentimes they share some of the worst-case scenarios, such as losing a limb or going blind. Certainly, the eyes are one of the many parts of the body affected by diabetes and in turn why ophthalmologists are among the Eight Specialists that Impact Diabetes Care.  Vision, a vital sense that connecting us to the world around, can be threatened by uncontrolled diabetes. Diabetic retinopathy is a leading cause of blindness in adults and it is estimated that two in five Americans with diabetes have some form of diabetic retinopathy. Fortunately there are preventative measures to ensure you keep your eyes in their best condition. Let’s take a closer “look” to understand the retina, the complication of diabetic retinopathy and what you can do to prevent or treat it to keep vision as healthy as possible.


The Retina: A Key Part to Our Vision

The retina is a thin tissue layer that makes up the inner lining at the back of each eye. It serves a few important functions such as:

  • Detecting light
  • Allowing the eye to focus
  • Sending signals to the brain to illustrate vision as you know it


Diabetic Retinopathy

Uncontrolled diabetes and other health factors can compromise the blood vessels that supply the retina with oxygen and nutrients vital for healthy vision, which is called retinopathy.

There are two types of diabetic retinopathy:

  • Non-proliferative: early-stage retinopathy where the blood vessels in the retina begin weakening and nerve fibers may begin to swell
  • Proliferative: abnormal new blood vessels grow on the retina blood vessels begin to leak into the fluid of the eye, eventually allowing scar tissue to form, causing the retina to detach from the eye and vision problems occur


Symptoms and Risk Factors

There are signs and symptoms that can be red flags for retinopathy, though in early stages, many people experience no symptoms Later-stage, more advanced retinopathy is characterized by blurry vision, seeing spots  The biggest risk factors for developing retinopathy include:

  • Poorly managed diabetes
  • Elevated blood pressure
  • High Cholesterol
  • Smoking
  • Age
  • Race/Ethnicity
  • If of child bearing age with diabetes, pregnancy can increase the risk of retinopathy because pregnancy increases pressure and strain on the eyes


Prevention and Treatment 

The National Eye Institute estimates that 95 percent of vision loss cases are preventable with early detection methods and treatments.  Some important prevention measures you can take include:

  • Get a comprehensive eye exam at least once per year and be sure to notify your ophthalmologist of your diagnosis of diabetes
  • Keep up on your diabetes management plan:
    • Frequent visits (every 3-6 months) with the doctor that manages your diabetes
    • Daily monitoring of your blood sugar
    • Monitoring Hemoglobin A1c levels every 3-6 months
    • Take medications as directed
    • Healthy nutrition and regular exercise
    • Follow your treatment plan for blood pressure and cholesterol management
    • Ask for help with tobacco cessation

If you are, in fact, diagnosed with diabetic retinopathy, there are options to help retain vision and work to stop or slow progression such as:

  • Anti-VEGF therapy injections in the eye
  • Surgery to reduce scar tissue and stop bleeding vessels
  • Laser therapy to reduce enlarged blood vessel size

While discussing diabetes complications, namely problems with your eyes, is not typically the most fun or comforting topic, it is essential for overall health and diabetes management. Knowledge is power and the more you know, the better you can take care of yourself. When in doubt, always discuss your concerns with your care team, and be sure to speak up early if you think you are experiencing any changes in your vision.