|Approximately 24 million people in the United States, or 8% of the population, who have diabetes. Diabetes can affect your eyes. Five million may lose their vision because they didn’t know they had the disease. Each year, 12,000 to 24,000 people lose their sight because of diabetes. Shoreline Vision is reminding the public that an annual dilated eye exam can help prevent vision loss in people with diabetes.
Diabetic eye disease, eye problems that affect those with diabetes, include diabetic retinopathy, cataracts and glaucoma. The most common of these is diabetic retinopathy, the leading cause of new cases of blindness among working age people in the United State. People with diabetes are more likely to get cataracts at a younger age and are twice as likely to develop glaucoma.
WHAT IS DIABETIC RETINOPATHY?
Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina.
In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.
If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.
WHAT ARE THE SIGNS AND SYMPTOMS?
Likely to have blurred vision, making it hard to do things like read and drive. In some cases, the vision will get better or worse during the day.
As new blood vessels form at the back of the eye as a part of proliferative diabetic retinopathy (PDR), they can bleed (hemorrhage) and blur vision. The first time this happens, it may not be very severe. In most cases, it will leave just a few specks of blood, or spots, floating in a person's visual field, though the spots often go away after a few hours. These spots are often followed within a few days or weeks by a much greater leakage of blood, which blurs vision. In extreme cases, a person will only be able to tell light from dark in that eye. It may take the blood anywhere from a few days to months or even years to clear from the inside of the eye, and in some cases the blood will not clear. These types of large hemorrhages tend to happen more than once, often during sleep.
WHAT ARE THE TREATMENTS DIABETIC RETINOPATHY?
A type of laser surgery called panretinal photocoagulation is used to treat severe macular edema and proliferative retinopathy. The goal is to create 1 000 - 2 000 burns in the retina with the hope of reducing the retina's oxygen demand, and hence the possibility of ischemia. In treating advanced diabetic retinopathy, the burns are used to destroy the abnormal blood vessels that form at the back of the eye.
Scatter laser treatment or panretinal photocoagulation makes hundreds of small laser burns away from the center of the retina. The treatment shrinks the abnormal blood vessels. Patients may lose some of their peripheral vision after this surgery, but the procedure saves the rest of the patient's sight. Laser surgery may also slightly reduce colour and night vision.
Vitrectomy is done instead of laser surgery. A vitrectomy is performed when there is a lot of blood in the vitreous. It involves removing the cloudy vitreous and replacing it with a saline solution made up of salt and water. Because the vitreous is mostly water, there should be no change between the saline solution and the normal vitreous.
IS HAVING LASIK POSSIBLE FOR SOMEONE WITH DIABETES?
If you have diabetes and are interested in having LASIK surgery, you may not be a candidate. Diabetes is listed by the FDA as a contraindication to LASIK surgery. Reasons include: unstable glasses needs, altered immune function, poor healing and potential for developing retinal blood vessel problems. Similar concerns are present with other eye surgeries that reduce glasses or contact lens needs. There are many factors to consider if thinking about vision correction and you have diabetes. The best thing to do if you’re considering LASIK surgery is consult with one of the LASIK surgeons at Shoreline Vision to help you better understand your individual risk.