How a Visit to Your Eye Doctor Can Protect Your Vision by Zakiya Nicks, O.D.

In the United States alone, the Centers for Disease Control and Prevention (CDC) reports that as of 2015, 30.3 million people, or 9.4% of the country’s population, are living with diabetes. An additional 84.1 million have prediabetes, which if left untreated, can lead to type 2 diabetes. Nearly 1 in 4 adults with diabetes don’t even know they have it, and yet diabetes is the leading cause of blindness for adults ages 20-74 in the United States.

What is Diabetic Retinopathy?

Diabetic retinopathy is a disease of the retina found in patients of either type 1 or type 2 diabetes. High blood sugar levels cause damage to blood vessels in the macula. In diabetic retinopathy, swollen, closed off, or leaking vessels cause damage to the macula, or new blood vessels grow on the retina.

There are two stages of diabetic retinopathy:

• Non-proliferative diabetic retinopathy (NPDR): This is when blood vessels in the eye close off, called macular ischemia, or leak, also known as macula edema.
• Proliferative diabetic retinopathy (PDR): This is a more advanced stage of diabetic retinopathy, when the retina begins to grow new blood vessels. These new blood vessels are very fragile and can burst and bleed, causing more floaters than usual, totally blocking vision, or forming scar tissue. In addition to vision loss, scar tissue can lead to other problems with the macula or retinal detachment.

What are the Signs of Diabetic Retinopathy?

Often, people with diabetic retinopathy don’t notice symptoms in the early stages. Diabetic retinopathy typically starts with blurry vision, which many may not take as a serious sign. Because the retina is located at the back of the eye, there are no visible symptoms.

Here’s what to look for:

• Seeing more floaters than usual
• Blurry vision
• Vision that sometimes changes suddenly from blurry to clear
• Dark areas in your field of vision
• Poor night vision
• Vision with faded-looking or washed out colors

Vision loss from diabetic retinopathy is in many cases irreversible, so it’s better to catch it sooner than later.

See Dr. Nicks’s Full Bio Here

Prevention and Treatment

The first step in preventing vision loss from diabetic retinopathy is to maintain healthy blood sugar levels and blood pressure. In some cases, vision can even improve in patients with diabetic retinopathy who take steps to control their blood sugar.

However, in some cases, controlling your blood sugar is not enough and you may still be at risk for developing diabetic retinopathy. In these cases, it is important to have yearly eye examinations so that if diabetic retinopathy is present, it can be caught and treated before irreparable damage occurs.

Treatments recommended may include:

• Anti-VEGF medication, such as Avastin, Eylea, or Lucentis – Anti-VEGF medication reduces swelling of the macula, which can slow vision loss or potentially improve vision. Anti-VEGF medications are administered via injection to the eye.
• Steroid medication – Steroids can also be used to reduce macular swelling and are also administered by injection to the eye.
• Laser surgery – Laser surgery can be used to seal off leaking blood vessels, preventing floaters or total visual blockage and preventing macular swelling. Laser surgery can also shrink malformed blood vessels and prevent regrowth.
• Vitrectomy – A vitrectomy is a surgical procedure recommended for advanced stages of diabetic retinopathy in which vitreous gel and blood that is leaking from blood vessels in the eye is removed. Scar tissue may also be removed.

Protect Yourself from Diabetic Retinopathy

Although controlling your blood sugar is important, a study found that healthy glycemic control was not enough to prevent diabetic retinopathy in all cases. The only guarantee to preventing vision loss from diabetic retinopathy is to have yearly comprehensive eye exams. In a dilated eye exam, an eye doctor can see into the back of your eye and look for signs of damaged blood vessels or swelling in the retina, allowing you to take action early. The best way to maintain your healthy vision is through preventative care.

More About Ocular Disease Specialist Zakiya Nicks, O.D.

Dr. Nicks is a primary care optometrist at the Marietta Eye Clinic. She also specializes in ocular diseases and ocular surgery co-management. Dr. Nicks received her bachelor’s degree in chemistry from Alcorn State University and her doctor of optometry from the University of Alabama at Birmingham School of Optometry. She is a member of both the National Optometric Association and the American Optometric Association. Read more about Dr. Nicks in her full bio.

References and Additional Sources

The American Academy of Ophthalmology (AAO) is the world’s largest association of eye physicians and surgeons. It describes itself as a “global community of 32,000 medical doctors who protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public.” Its website is a great resource to learn more about how to care for your eyes.

The American Optometric Association (AOA) describes itself as the leading authority on quality care and an advocate for our nation’s health, representing more than 44,000 doctors of optometry, optometric professionals, and optometry students.

Diabetic Retinopathy

https://eyewiki.org/Diabetic_Retinopathy

Annual Eye Exams Can Save Sight for People with Diabetes

https://www.aao.org/eye-health/news/annual-exams-save-sight-diabetes

What is Diabetic Retinopathy?

https://www.aao.org/eye-health/diseases/what-is-diabetic-retinopathy

New CDC report: More than 100 million Americans have diabetes or prediabetes

https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html