Diabetic Eye Disease

Many people with diabetes may be having their sight stolen by a silent thief -- themselves. Millions of Americans with diabetes are robbing themselves of their sight as a result of not maintaining control over their blood sugar levels and not undergoing yearly eye examinations.

Diabetic retinopathy, a potentially blinding complication of diabetes, is a serious threat to the 16 million Americans with diabetes. Studies show that half of these individuals (8 million Americans) will be afflicted with diabetic retinopathy. Individuals with Type I or Type 2 diabetes are at risk for blindness from the disease.

Diabetic retinopathy often has no early warning signs. If undetected and untreated, diabetic retinopathy causes the small blood vessels in thc back of the eye to leak or burst. Blood leaking into the eye causes clouding and blurry vision in early stages. If treatment is not sought and more leakage occurs, permanent blindness is imminent.

TIGHT BLOOD SUGAR CONTROL CAN SPARE SIGHT

The 10-vear Diabetes Control and Complications Trial (DCCT) showed that good blood sugar control slows the onset and progression of retinopathy and lessens the need for laser surgery for severe retinopathy. It is important to see your doctor regularly and establish good blood sugar control in order to prevent diabetic retinopathy and other complications.

EARLY DETECTION IS KEY

If detected early, the outlook for individuals with diabetic retinopathy is promising. All individuals with diabetes should receive a thorough yearly eye examination including:

• Visual Acuity Test: Measures vision at various distances.
• Pupil Dilation: Widens the pupil allowing an eye care professional to see more of the retina and look for signs of retinopathy.
• Opthalmoscopy: Examination of retina through a device that provides a narrow view of the retina or a device that shines light into the eye and pro-vides a wide view of the retina.
• Tonometry: Determines fluid pressure in eye, ele-vated pressure may be a sign of glaucoma-another risk for people with diabetes.

TREATMENT OPTIONS

Once diabetic retinopathy has been detected, there are currently two treatments options which are very effective in reducing vision loss from the disease. The first option, laser surgery, is performed to seal leaking blood vessels, preventing bleeding into the eye. The second option, vitrectomy, is necessary for diabetic patients who have a significant amount of blood in the fluid portion of the eye (vitreous). In the vitrectomy procedure, the vitreous is removed and replaced with a salt solution. Because the vitreous is mostly water, there is no noticeable difference between the salt solution and the normal vitreous. Both laser surgery and vitrectomy are successful treatments in the hands of specialists, hut they do not cure diabetic retinopathy additional treatment may be necessary.

Individuals with diabetes face many challenges in attempting to avoid complications of the disease. Diabetic retinopathy is one of these challenges and another reminder of the importance of good diabetes self-management and undergoing yearly eye examinations.

Eric Luy, MD
Medical College of Wisconsin Internist
Lincoln Avenue Clinic

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.