What Treatments Are Available for Diabetic Eye Disease?
The first step in any treatment for diabetic eye disease is to maintain blood glucose, blood pressure, and blood cholesterol levels as close to normal as possible. Treatment of diabetic macular edema (swelling or the accumulation of blood and fluids in the macula, the part of the retina that provides sharp central vision), has evolved a great deal in the last five to ten years, and is based on the severity of the edema. At present, there are three options:
● Laser treatment
● Avastin, Lucentis, or Eylea injection
● intravitreal steroids: Kenalog, Ozurdex, and Iluvien
What Is Diabetic Eye Disease?
Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of this disease. All can cause severe vision loss or even blindness. Diabetic eye disease may include:
Diabetic retinopathy -- damage to the blood vessels in the retina.
Cataract -- clouding of the eye's lens.
Glaucoma -- increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision.
Cataract and glaucoma also affect many people who do not have diabetes.
Most Common Diabetic Eye Disease?
Diabetic retinopathy is most common diabetic eye disease. The retina senses light coming into your eye, and it sends messages to your brain about the things you see. Damage to blood vessels inside the retina from blood sugar buildup is called diabetic retinopathy. You might not notice changes at first, but over time the walls of your blood vessels may leak fluid. When you’ve had diabetes for a while, blood vessels can form scar tissue and pull the retina away from the back of your eye. This can lead to severe vision loss and even blindness.
Laser Diabetic Eye Disease Treatment
This technique is used by retinal surgeons to treat a number of eye conditions, one of which is diabetic eye disease. A beam of high-intensity light is directed into the eye to seal off leaking blood vessels and prevent additional blood and fluid from leaking into the vitreous, which is the jelly-like substance that fills the inside of the back part of the eye. The doctor administers eye drops to dilate (open up) the pupil and numb the eye before treatment begins. Because lasers cannot restore lost vision, it is critical to maintain regular comprehensive eye examinations so that treatment can be initiated as soon as diabetic eye changes are detected. There are two types of laser treatments for diabetic eye disease:
● Focal laser treatment, also called photocoagulation: The retina is treated to stop or slow the leakage of blood and fluid from abnormal blood vessels within the eye. Focal laser, however, can also destroy surrounding healthy retinal tissue as it seals the leakage from abnormal blood vessel growth; therefore, it is not used on blood vessels directly under the macula, the center of the retina.
● Scatter laser treatment, also called panretinal photocoagulation: The areas of the retina away from the macula are treated to shrink abnormal blood vessels.
What are the signs and symptoms of diabetic eye disease?
● If the person has fairly large, rapid shifts in their blood sugar levels, they may notice that their vision becomes blurry. This may occur prior to the diagnosis of diabetes mellitus, or it may develop after the initiation of treatment or a change in treatment of diabetes mellitus. This difficulty with vision or focusing will disappear once blood sugar levels have been stable for approximately one week.
● Even if the person has background diabetic retinopathy or early proliferative diabetic retinopathy, it is possible that they may not have any symptoms, or they may experience mild-to-severe blurring or vision loss. Many people with severe diabetic eye disease may not realize that they have a vision problem until it is too late and permanent damage has already occurred.
●If the person has a cataract, vision may become blurry or hazy. At night, the person may experience glare from oncoming lights.
●If the person has glaucoma, they may not experience any symptoms until a significant loss of vision has already occurred.
● In diabetic eye disease due to diabetic retinopathy, symptoms of pain or discomfort in the eyes are usually not present.
What causes diabetic eye disease?
Over many years, high blood sugar (hyperglycemia) and other abnormalities in metabolism found in people with diabetes may damage the blood vessels in the body. This damage to the blood vessels leads to poor circulation of the blood to various parts of the body. Since the function of the blood is to carry oxygen and other nutrients, this poor circulation causes decreased oxygen delivery to tissues in different parts of the body and subsequent damage to those tissues. Some of the most sensitive tissues to decreased blood flow and oxygen delivery include the brain, heart, kidneys, and the eyes. Lack of adequate oxygen delivery to these areas causes strokes, heart attacks, kidney failure, and vision loss.
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