Diabetes and the Eyes

Background

As we’ve mentioned in previous blogs, our founder, Bryan Reedy, is a Type 1 diabetic, so issues pertaining to vision and diabetes are particularly interesting to us. Not only that but given that tens of millions of Americans are also affected by diabetes, there’s a chance this blog post may be relevant to you or a loved one as well. An article by University of Michigan Health and written by Allison Mi will help us dive more into its title, “Diabetes and your eyes: 4 things to know.” Julie Rosenthal, M.D., M.S., an ophthalmologist who specializes in diseases of the retina and vitreous will be our guide through the 4 things to know.

Damage May Not Be Noticeable

In terms of signs early on (or lack thereof), Rosenthal states, “Early changes can include bleeding within the retina, which may not affect your vision at first. At any stage, you can develop swelling in the macula, which often leads to blurred central vision, known as macular edema.” Rosenthal also mentions, “The macula is where you have your ‘sweet spot’ of vision. It's what helps you recognize faces, read and see objects up close.”

At later stages, according to the article, blood flow to the retina tapers off and this recruits new blood vessels. This is called neovascularization according to Mi, and it’s one of the clearest signs of diabetic retinopathy. Rosenthal states that while this sounds like a good solution, the blood vessels aren’t good, and this can lead to vision loss if left untreated.

Untreated Diabetic Retinopathy

Looking at both states of Diabetic Retinopathy, we will cite directly from Mi:

“Non-proliferative diabetic retinopathy, or NPDR: The retina can have spots of bleeding, areas where blood flow is disrupted called cotton wool spots, and fatty tissues that leak from the blood vessels into the retina. This can result in serious vision loss if left untreated.

Proliferative diabetic retinopathy (PDR): The more advanced form of the disease develops when new blood vessels form on the retina by way of neovascularization. The blood vessels, which break easily and are extremely fragile, can lead to bleeding within the eye, causing cloudy vision. Left untreated, the disease can result in retinal tears or detachments, both which can severely damage your vision.”

It is also noted that macular edema can occur at either stage.

Treatment and Maintenance

In terms of treatment, Rosenthal calls laser treatment “the gold standard” and states that this puts a laser in the areas that are sending a signal to bring new blood vessels to stop it. Medicine injections are another treatment option that tries to address the new blood vessels that are in the process of being formed. However, Rosenthal mentions that this is a temporary treatment that potentially needs to be repeated monthly. Mi notes that this is “a great treatment for macular edema, however, and can help improve your vision if you have this.”

The article mentions that these issues stem from diabetes itself, so combating the problem at its root is important by managing blood sugar, blood pressure, and cholesterol with a primary care provider. Regarding advice going forward, Rosenthal recommends visiting an eye doctor yearly. Rosenthal goes on to state, “You might not notice any problems during the earlier stages, so it’s important to get your eyes examined regularly.” She also said, “If we can detect the issue early, we have a much better chance of preventing irreversible vision loss and the later stages of the disease.” Finally, regarding advancing diabetic disease, new floaters, decreased vision ,and spots in your vision are signs to look out for.

Sources:

https://healthblog.uofmhealth.org/eye-health/diabetes-and-your-eyes-4-things-to-know

Photo by Victor Freitas on Unsplash