Diabetes is a disease that occurs when the
pancreas does not secrete enough insulin or
the body is unable to process it properly.
Insulin is the hormone that regulates the
level of sugar (glucose) in the blood.
Diabetes can affect children and adults.
How does diabetes affect the retina?
Patients with diabetes are more likely to
develop eye problems such ascataracts and
glaucoma, but the effect of the disease on
the retina is the main threat to vision.
Most patients develop diabetic changes in
the retina after approximately 20 years.The
effect of diabetes on the eye is called
Over time, diabetes affects the circulatory
system of the retina. 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.
The next stage is known as proliferative
diabetic retinopathy. In this stage,
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
SIGN & SYMPTOMS
The affect of diabetic retinopathy on vision
varies widely, depending on the stage of the
disease. Some common symptoms of diabetic
retinopathy are listed below, however,
diabetes may cause other eye symptoms.
Blurred vision (this is often linked to
blood sugar levels)
Floaters and flashes
Sudden loss of vision
Diabetic patients require routine eye
examinations so related eye problems can be
detected and treated as early as possible.
Most diabetic patients are frequently
examined by an internist or endocrinologist
who in turn work closely with the
The diagnosis of diabetic retinopathy is
made following a detailed examination of the
retina with an ophthalmoscope. Most patients
with diabetic retinopathy are referred to
vitreo-retinal surgeons who specialize in
treating this disease.
retinopathy is treated in many ways
depending on the stage of the disease and
the specific problem that requires
attention. The retinal surgeon relies on
several tests to monitor the progression of
the disease and to make decisions for the
appropriate treatment. These include: fluorescein
angiography, retinal photography, and
ultrasound imaging of the eye.
The abnormal growth of tiny blood vessels
and the associated complication of bleeding
is one of the most common problems treated
by vitreo-retinal surgeons. Laser surgery
called pan retinal photocoagulation (PRP)
is usually the treatment of choice for this
With PRP, the surgeon uses laser to destroy
oxygen-deprived retinal tissue outside the
central vision of the patient. While this
creates blind spots in the peripheral
vision, PRP prevents the continued growth of
the fragile vessels and seals the leaking
ones. The goal of the treatment is to arrest
the progression of the disease.
Vitrectomy is another surgery
commonly needed for diabetic patients who
suffer a vitreous hemorrhage (bleeding in
the gel-like substance that fills the center
of the eye). During a vitrectomy, the retina
surgeon carefully removes blood and vitreous
from the eye, and replaces it with clear
salt solution (saline). At the same time,
the surgeon may also gently cut strands of
vitreous attached to the retina that create
traction and could lead to retinal
detachment or tears.
Patients with diabetes are at greater risk
of developing retinal tears and detachment.
Tears are often sealed with laser surgery.
Retinal detachment requires surgical
treatment to reattach the retina to the back
of the eye. The prognosis for visual
recovery is dependent on the severity of the
Researchers have found that diabetic
patients who are able to maintain
appropriate blood sugar levels have fewer
eye problems than those with poor control.
Diet and exercise play important roles in
the overall health of those with diabetes.
Diabetics can also greatly reduce the
possibilities of eye complications by
scheduling routine examinations with an
ophthalmologist. Many problems can be
treated with much greater success when