Diabetes can cause changes in your eyes. These changes, which are
known as diabetic retinopathy, occur in the small blood vessels in the
interior of the eye, in the area called the retina.
Retinopathy does not happen to all people with diabetes, and rarely
interferes with vision in the first 10 to 15 years of diabetes. But retinopathy
may sometimes lead to blindness.
Types of retinopathy
The early stage of the disorder is called background
retinopathy. This stage rarely causes changes in vision, but may cause
damage to the central vision that is necessary for reading.
The more advanced stage is known as proliferative retinopathy
. This occurs when new, abnormal blood vessels grow over the inner surface
of the eye. These new blood vessels tend to be very fragile, producing two
potential threats to your vision.
The first threat to vision in proliferative retinopathy is the risk
of bleeding into the vitreous substance (the clear substance in the
center of the eye). Blood that gets into the vitreous substance can produce "cobwebs"
in the vision, or block out light completely, causing blindness.
The second worry is that scar tissue developing on the retina can
reduce vision by blocking out light, or by may pull the retina out of its normal
position (which is called a retinal detachment).
Treatment
Fortunately, help is available for people with diabetic
retinopathy. If needed, laser beam light can be used in a procedure known as
photocoagulation. Vision is preserved because the treatment causes the
abnormal blood vessels to fade away, and halts the growth of new ones. In other
cases, the laser beam can be used to preserve the crucial central vision.
In cases where light can't reach the retina, it may be
possible to remove the vitreous substance surgically, in a procedure called a
vitrectomy. This procedure sometimes restores the ability to see.
Most importantly, scientific studies show that tight control of
the blood sugar level will delay the development of retinopathy. (It
must be pointed out that some patients who are started very rapidly onto
aggressive diabetes control programs may have temporary worsening of the retinal
changes, but the changes settle down after a year or two. Because of this risk,
every patient starting a tight control program should be under the care of a
diabetes specialist.)
What you can do
The standard advice is to have an eye specialist
(ophthalmologist or optometrist)
examine your eyes annually. This is an excellent idea,
since problems in the retina can be quickly diagnosed by an expert, and if
necessary, treatment can be started.
The information from the
Diabetes Control and Complications Trial
indicates that you should work with
your diabetes care team to control your blood sugar level as close to
normal as you can. Since this seems to prevent the development of retinopathy,
it's the best treatment of all!
Also see
 Complications: Eyes
at the
DiabetesMonitor
 DiabeticEyes.com
Eye Care and Retinopathy
American Diabetes Association
Diabetic Retinopathy
by David Mendosa
Diabetic Retinopathy: Your Questions Answered
Schepens Eye Research Institute
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