If you’re one of the nearly 1 million Tennesseans who are living with diabetes, you need to be extra careful about your vision.
That’s because the leading cause of adult blindness is diabetic retinopathy. This disease is a growing problem that affects 7.7 million Americans today, but it is projected to impact 14.6 million by 2030.
“Diabetic retinopathy often has no symptoms in the early stages,” says Dr. Daniel Cusator, a medical director with BlueCross BlueShield of Tennessee. “At the same time, early diagnosis and treatment can improve vision and prevent further vision loss. So, it’s important for all individuals with diabetes to get regular screenings.”
What is diabetic retinopathy?
Dr. Cusator: Over time, diabetes — and high blood sugar levels — can damage the tiny blood vessels all over your body, including the tiny vessels in your eyes. Diabetic retinopathy develops when damage occurs to the blood vessels that connect to your retina, the light-sensitive back of your eye that sends signals to your brain. The damage makes it hard for blood to flow, causing blocked vessels that may leak fluid or bleed. Sometimes, abnormal blood vessels grow in the area as a response to inflammation, which can also harm your vision.
One key problem: many people don’t have symptoms in the early stages of diabetic retinopathy. They don’t know that something is threatening their vision, so they don’t seek treatment. But without treatment, the disease can cause complications such as diabetic macular edema, neovascular glaucoma and even retinal detachment. As a result, regular screenings are essential, even if you don’t have any symptoms.
What are the signs of diabetic retinopathy?
Dr. Cusator: Once the disease has progressed, you might start noticing symptoms. These can include:
- Floaters in your field of vision
- Blurry vision
- Blank areas in your field of vision
- Poor night vision
- Colors that look washed out
You’re likely to notice symptoms in both eyes. And if you do notice symptoms, schedule an appointment with your eye doctor.
If your eye doctor does detect signs of diabetic retinopathy, you will need to discuss the options for treatment. Those include medicines called anti-VEGF (vascular endothelial growth factor) drugs that are injected into the eye. They work by blocking a protein that causes blood vessels in the eye to leak, causing the retina to swell. Some people are also good candidates for laser surgery or a vitrectomy, which is a surgery to remove the vitreous fluid from the eye.
Maintaining good control of your blood sugar, blood pressure and cholesterol levels, all of which help reduce the damage that has occurred, is also important.
Why you need an annual dilated eye exam
Dr. Cusator: If you’ve put off your annual eye exam, you’re not alone. Only half of people with diabetes get this exam each year. However, your risk of developing diabetic retinopathy increases the longer you have diabetes.
Insulin resistance, which is the root cause of type 2 diabetes, causes inflammatory changes in the arteries and other organs, including your eyes, before any noticeable symptoms show up. That means the disease could progress and you wouldn’t even know about it. Since diabetic retinopathy can progress rapidly, people with diabetes should maintain a regular screening schedule. Be sure to schedule your dilated eye exam once a year so your eye doctor can look for signs of developing damage.
“People with diabetic retinopathy may need to get comprehensive dilated eye exams every few months,” Dr. Cusator says. “They may also need to see a doctor who specializes in retinal diseases, who can help determine the best treatment options.”
More from Dr. Cusator on WellTuned
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