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Diabetes and the Eyes

If you don’t have diabetes, chances are there’s someone in your family, or a friend you know, suffering from the disease.  Diabetes is an epidemic both here in the United States and world wide.  The statistics on the number of people with diabetes are staggering-

  • There are an estimated 25.6 million Americans, 20 and older, with diabetes (with a third still undiagnosed)
  • There are 79 million people who are pre-diabetic- at high risk for developing diabetes.

Diabetes is characterized by the body’s inability to produce insulin (Type 1 Diabetic), or its inability to use the insulin it makes effectively (Type 2).  Type 1 generally effects young people, although it can occur at any age, and only accounts for about 5% of the diabetics in the U.S.  These patients are typically taking insulin to control their sugars simply for survival.  Type 2 more frequently develops in adults, but due to childhood obesity, is occurring more frequently in children and younger teens.  These patients may need to take insulin, but do not generally need it for survival, like Type 1 diabetics do.

Diabetic Retinopathy, what its called when diabetic side effects are found in the eyes, can be a vision debilitating event in its worst expression.  Right now, researchers believe 28.5% of the people with diabetes- about 4.2 million people in the U.S. over the age of 40- have some form of diabetic retinopathy.   The early stage of diabetic retinopathy causes damage to the small blood vessels in the back of the eye.

The early stage of diabetic retinopathy is referred to Non-Proliferative Diabetic Retinopathy (NPDR).  In this stage, the small blood vessels break leaking blood or fluid.  This can cause areas of the retina to swell or form deposits.  This stage of retinopathy usually does not affect vision but if the sugars are uncontrolled, the ocular defects also increase.  After 5 years, 25% of Type 1 diabetic patients are found to have some retinopathy.  After 10 years, the numbers jump to 60%.  In Type 2 diabetics, after 5 years, 40% of patients taking insulin and 24% not taking insulin are found to have retinopathy. Those numbers increase exponentially after 10 years for Type 2 diabetics.

A more advanced stage of diabetic retinopathy is called Proliferative Diabetic Retinopathy (PDR).  This is present when new blood vessels are found to be forming on the retina or optic nerve.  Unfortunately, these new blood vessels do not resupply the retina with normal blood flow.  This stage can cause more severe vision loss.

Another presentation of uncontrolled diabetes is called a vitreous hemorrhage.  This is when a blood vessel bleeds out into the vitreous of the eye.  It can often cause a partial or complete blockage of vision.  It may take days, months, or years to reabsorb the blood and sometimes a vitreous surgery may be recommended.  This is particularly scary for patients due to the rapid change in vision.

 

All patients with diabetes should have regular, yearly dilated eye examinations.  These examinations should include a photo of the retina and/or a OCT scan of the macula.  The photo documents what the retina looks like, if there are any diabetic signs.  The OCT of the macula helps us diagnose whether there is any edema, or swelling, of the macula.  Of first time diabetics, 20-39% of patients have retinopathy detected upon initial diagnosis of the disease.  The patients’ primary care provider will usually require the patient to get this examination, and we always send a letter to the doctor telling them of our findings.

The doctors here at Metrolina Eye are well educated on testing and interpreting signs and symptoms of Diabetic retinopathy, as well as working with your primary care provider to determine if the treatment of the disease is working best for you, the patient.

So whether you’re newly diagnosed, or had diabetes for years, come visit our providers to make sure your diabetes is not effecting your eyes. Contact Metrolina Eye at any of our 3 locations.

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