Diabetes and Eye Care

Can my eyes be affected by diabetes?

Patients with diabetes are more likely to develop eye problems such as cataracts and glaucoma, but the disease’s effect on the retina –specifically the blood vessels in the retina – is the main threat to vision. Diabetic retinal disease is the leading cause of blindness for people under the age of 65 in the developed world. Most patients develop diabetic changes in the retina within 7 years of being diagnosed with Type I diabetes. Most Type II diabetics have retinal damage when they are first diagnosed with diabetes.

Diabetes affects patients in three phases

The earliest phase of the disease is known as background diabetic retinopathy. In this phase, the arteries in the retina become weakened and leak, forming small, dot-like hemorrhages. These leaking vessels often lead to swelling or edema in the retina and decreased vision, referred to as ‘macular edema’.
The next phase is known as proliferative diabetic retinopathy. In this phase, circulation problems cause areas of the retina to become oxygen-deprived or ischemic. New, fragile vessels develop as the circulatory system attempts to maintain adequate oxygen levels within the retina. This is called neovascularization. Unfortunately, these delicate vessels hemorrhage easily. Blood may leak into the retina and vitreous, causing spots or floaters, along with decreased vision.
In the later phases of the disease, continued abnormal vessel growth and scar tissue may cause serious problems such as retinal detachment and glaucoma.

Diagnostic Methods

Intravenous Fluorescein Angiography (IVFA)

Fluorescein angiography is a diagnostic procedure which uses a special camera to take a series of photographs of the retina, the light sensitive tissue in the back of the eye. A special water-soluble dye (fluorescein) is injected into a vein in the hand. The dye then travels through the veins and into the arteries, which circulate throughout the body. As the dye passes through the blood vessels of the choroid and retina, the photographer takes a series of photographs in rapid succession. This allows the doctor to see signs of circulation problems, swelling, leakage, or abnormal blood vessel formation.

Heidelberg Spectral Domain Optical Coherence Tomography (Spectralis™ OCT)

The Spectralis™OCT is a laser imaging system which allows the doctor to see a 3-D image of the internal structure of the retina. This non-invasive test takes only a few minutes to preform, offering our patients the best, state of the art retina diagnostics in the world today.

Treatment Options

Multiwave Length Argon Laser

1. Focal Laser

The purpose of focal laser treatment is to cauterize the abnormally growing blood vessels or injured blood vessels to reduce the amount of leakage, thereby reducing swelling of the retina. Focal laser is designed to prevent further worsening of vision.

2. Pan Retinal Photocoagulation

The purpose of the laser is to destroy the oxygen-starved retina so as to reduce the growth of the abnormal blood vessels or cause their shrinkage.