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Diabetes

Along with its many other complications, diabetes can cause diseases of the eye. One of the most prevalent diseases is diabetic retinopathy (DR), which is one of the leading causes of blindness in the US. Fortunately, it is also one of the most preventable. Most symptoms do not arise until over a decade after being diagnosed with diabetes. Because of this, regular eye appointments will most likely be able to prevent the disease presenting itself.

Diabetes is characterized by unusually high blood sugar levels. The oversaturated blood flows irregularly as sugars accumulate in your blood stream. Sugar buildups in the retina begin to affect the eyes ability to see.

Initially you may develop non-proliferative diabetic retinopathy (NPDR). NPDR develops much earlier than DR would. During this stage one can observe mini-aneurysms happening in the retina. For the most part these are harmless but if left untreated NPDR will become DR.

The symptoms of DR are much worse. Initially, your vision may fluctuate in clarity; you may become farsighted, and begin to see more floaters. As the disease progress, vision loss may become worse. Straight lines may appear to be curved. Your vision may become blurred and blind spots may begin to appear. You may also experience double vision. Your eye may have trouble healing itself and you might begin to feel pressure on your eye or an acute pain. Cataracts may also develop. Additionally, aneurysms will continue from NPDR.

Developing proliferative diabetic retinopathy (PDR) has the highest risk for blindness. Along with the other symptoms of DR, PDR is characterized by abnormal blood vessel growth, slowed blood flow, and hemorrhaging.

With all cases of DR, it is possible to loss motor control of your eyes, which may result in spasms.

Those with hypertension develop varying degrees of DR in a similar fashion. Minorities are also at more of a risk. African and Hispanic Americans are twice as likely to develop DR and Native Americans have almost five times the risk when compared to the US average.  This is most likely attributed to these groups’ lack of access to healthcare when compared to the rest of the country.

Diabetic macular edema (DME) is the swelling of the macula that causes blurred vision and decreased sharp central vision. Focal DME is when aneurysms (sometimes caused by DR) interfere with the macula’s ability to capture light. Diffuse DME is when swollen blood vessels and puts pressure on the macula.

DME and DR are treated in a similar manner. Laser surgery is used to destroy excess blood vessels and weld leaking blood vessels closed. Fluorescent dye is inserted intravenously to detect overgrowth. Steroid injections are also used that regulate the pressure placed on the macula. In some cases, a vitrectomy is performed where excess fluid is removed from the eyeball.