Types Of Diabetic Retinopathy
- Non-proliferative retinopathy is an early form of the disease, where the retinal blood vessels leak fluid or bleed.
- Macular oedema is a swelling of the macula, caused by the leakage of fluid from retinal blood vessels. It can damage central vision.
- Proliferative retinopathy is an advanced form of the disease and occurs when blood vessels in the retina disappear and are replaced by new fragile vessels that bleed easily, and that can result in a sudden loss of vision.
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What Testing Is Done To Evaluate Eye Disease In Diabetics
A thorough exam is done by your doctor which involves checking your vision, eye pressure, eye motility, optic nerve function and peripheral vision. Exams are done by dilating the pupils to thoroughly assess any abnormalities in the back of the eye . Your doctor is looking for any signs of swelling in the retina, bleeding, abnormal growth of blood vessels, retinal detachment and glaucoma associated with diabetes. In addition, special testing is done on site which include:
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You should know that insulin can help you manage your diabetes and prevent further damage to your kidneys. If youre suffering from diabetes, its important to consult a doctor to make sure that youre a good candidate for the condition. If youre looking for more information, you can read about the various types of diabetes available, as well as how to get a free online health assessment. In many cases, its possible to avoid a doctors visit by doing simple exercises. If youre not familiar with the signs and symptoms of diabetes, you can read online articles about the condition and learn about its treatment.
Treatment Of Diabetic Retinopathy
Treatment depends on the ophthalmologists observations made while examining the patients eyes. It may include:
Controlling blood sugar levels. Sometimes, just by improving a patients metabolic control, their vision can improve.
Laser. This reduces the number of abnormal blood vessels and those which are producing oedema.
Intraocular injections. Different medicines are injected into the eye, or into the vitreous body , to reduce the amount of fluid in the macula.
Vitrectomy. Surgical intervention that eliminates any blood inside the eye. It is also the technique used to repair a retinal detachment.
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How Is Proliferative Retinopathy Treated
Laser and surgery can be used to treat advanced diabetic retinopathy that is threatening or affecting your sight.
Your diabetes healthcare team or ophthalmologist will discuss with you about the most appropriate treatment for you. You can find out more about these treatments by clicking on the links below:
- laser treatment
- eye injections
- eye surgery
Like any medical procedure, there are potential risks and these should be discussed with you before you consent to treatment. However, it is important to remember these treatments can help your sight.
Is There A Test For Diabetic Retinopathy
Yes. To check for diabetic retinopathy, you can get 1 of 2 main tests.
âDilated eye exam
After your online diabetes doctors refer you to an eye doctor they may do this dilated exam. During this exam, the eye doctor gives you eye drops to make your pupils dilate. By using drops, the eye doctor can see the different parts of the inside of your eye. After the drops have started working, the doctor looks at the back of your eye, called the retina. Thatâs typically the area of the eye that is damaged by diabetic retinopathy.
âDigital retinal imaging
For this test, a technician takes pictures of the eye with a special camera. Then they send the images to an ophthalmologist . Then, the ophthalmologist will look at those pictures. It is acceptable to use this test provided that your past eye tests have all been normal. Otherwise, you should have a regular dilated eye exam in an ophthalmologist office.
If either the digital retinal image or the dilated eye exam shows any signs of disease, the ophthalmologist may order some other testing as well.
When to start seeing an ophthalmologist ?
For people with type 2 diabetes, eye exams should start right after diagnosis.
How do doctors treat diabetic retinopathy/diabetic eye disease?
Treatments for diabetic retinopathy can include:
This is laser surgery to seal or destroy leaking or growing blood vessels in the retina. This treatment is not always the first option. Doctors typically try medicines first.
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What Is Diabetic Retinopathy
Diabetic retinopathy is the most common cause of vision loss among those with diabetes and the leading cause of vision impairment and blindness among working-age adults. Between 40-45% of those diagnosed with diabetes already have some degree of diabetic retinopathy.
Elevated blood glucose for prolonged periods of time causes damage to the retinal blood vessels . Such damage to the blood supply of the retina can result in abnormal bleeding, swelling of the retina, poor blood flow to the retina, and/or scarring of the retina.
Most sight-threatening diabetic problems can be prevented by laser treatment if it is given early enough. It is important to realize however that laser treatment aims to save the sight you have – not to make it better. The laser, a beam of high intensity light, can be focused with extreme precision. So, the blood vessels that are leaking fluid into the retina can be sealed.
Reduce Your Risk Of Diabetic Retinopathy
You can reduce your risk of developing diabetic retinopathy, or help prevent it getting worse, by:
- controlling your blood sugar, blood pressure and cholesterol levels
- taking your diabetes medicine as prescribed
- attending all your screening appointments
- getting medical advice quickly if you notice any changes to your vision
Read more about how to prevent diabetic retinopathy.
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Coping With Losing Your Sight
Diabetes is the leading cause of preventable sight loss in the UK. You can prevent it by going to regular eye screening, and because there are much better treatments available for both diabetes and retinopathy.
But sight loss does happen and this is extremely difficult for anyone to deal with. This is life-changing.
Many people do find a way to cope, and carry on to live happy, rewarding lives. Know that were here to help you and there is expert support out there to help you through it youre not alone.
You can talk to the RNIB . They are one of the UKs leading sight loss charities and the largest community of blind and partially sighted people. They provide a fantastic amount of practical and emotional support, including specifically set up to your needs.
Some people who develop sight loss may also experience sight hallucinations, where you see things that arent necessarily there. This is called Charles Bonnet Syndrome . It can occur in people with over 60% sight loss. Seeing things that arent there, can be very frightening. For more information on CBS visit Esme’s Umbrella.
And remember, you can give our trained counsellors a call, for more information and support, or just to chat. Were here for you.
Know Your Blood Sugar Blood Pressure And Cholesterol Levels
It can be easier to keep your blood sugar levels, blood pressure and cholesterol levels under control if you know what level they are and monitor them regularly.
The lower you can keep them, the lower your chances of developing retinopathy are. Your diabetes care team can let you know what your target levels should be.
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Diagnosis Of Diabetic Retinopathy
Optical coherence tomography Optical Coherence Tomography A variety of tests can be done to confirm an eye problem or to determine the extent or severity of an eye disorder. Each eye is tested separately. In general, angiography involves injecting… read more can help assess the severity of macular edema and assess how well the person is responding to treatment.
Diabetic Retinopathy Examination In Bermuda
Drops will be put in your eye to dilate your pupil. This allows your ophthalmologist to look through a special lens to see the inside of your eye.
Your doctor may do fluorescein angiography to see what is happening with your retina. Yellow dye is injected into a vein, usually in your arm. The dye travels through your blood vessels. A special camera takes photos of the retina as the dye travels throughout its blood vessels. This shows if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing.
Optical coherence tomography is another way to look closely at the retina. A machine scans the retina and provides detailed images of its thickness. This helps your doctor find and measure the swelling of your macula.
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Prevention Of Eye Disease For The Diabetic
- Blurry vision is a warning to get blood sugar levels under control under the direction of a primary care doctor or endocrinologist. This can be achieved through a combination of diet, exercise and medication.
- Keeping good track of your diabetes disease involves monitoring your blood sugar and knowing your glycosylated hemoglobin, or hemoglobin A1C test. The A1C test is a measure of your average blood sugar for the previous 3 month period. For most people, the goal is to keep the A1C level below 7.0 to prevent both eye and health complications from diabetes.
- Keep your blood pressure and cholesterol under control.
- Ask your doctor for help quitting tobacco products.
- Get your eyes checked regularly. Patients with a new diagnosis of diabetes mellitus type II should have a dilated exam soon after diagnosis, as eye damage could be starting without any symptoms of blurry vision. Younger patients with a new diagnosis of diabetes mellitus type I should have a dilated eye exam within 5 years of diagnosis, unless they have symptoms of blurry vision sooner.
Those diabetic patients who already have diabetic retinopathy should follow the prevention recommendations above to lower the chance of losing vision from diabetes. Diabetic retinopathy can sometimes progress despite improvement in health and should be followed closely by a retina specialist to ensure the best prognosis.
Causes And Risk Factors Of Diabetic Retinopathy
Anyone with any type of diabetes, including type 2, type 1, or gestational, can develop diabetic retinopathy.
The longer a person has diabetes and the worse their blood sugar control is, the greater their risk of getting diabetic retinopathy, Dr. Khan says.
The following factors may also raise your risk of developing retinopathy:
- Being African-American, Hispanic, or Native American
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Why You Need To See Your Eye Doctor If You Have Diabetes
Diabetes can do severe damage to all parts of your body. Your eyes are no exception to this, and in fact, can be even more susceptible to excess blood sugar.
If you dont manage your diabetes and take care of your body, theres a good chance diabetes could steal your vision. Your eye doctor can help you manage the visual symptoms caused by diabetes.
They can also tell you if the disease seems to be progressing based on what is happening in your eyes. Keep reading to learn why you need to see your eye doctor if you have diabetes.
Living With Diabetic Retinopathy
Learning to live with vision loss is difficult. The best way to prevent vision loss is to manage your diabetes. Keep your blood sugar at an appropriate level with the help of your doctor. Go in for a thorough eye exam every year or as recommended by your doctor. Doing these things can prevent vision loss even if you have been diagnosed with diabetic retinopathy.
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Treatment Options For Diabetic Retinopathy
The longer diabetic retinopathy goes untreated, the greater your risk of permanent vision loss.
If you have early or mild- to moderate NPDR, you may not need treatment immediately. Still, your eye doctor will probably want to monitor your condition closely with regular eye exams.
A diagnosis of severe NPDR or PDR will most likely require immediate surgery.
Because diabetes is a lifelong condition, additional retinal damage and vision loss are possible even after surgery. You should continue to get routine eye exams to monitor your condition.
Also, ask your endocrinologist about ways to improve your diabetes management plan. Effective blood sugar control can usually slow the progression of mild- to moderate diabetic retinopathy.
Laser Treatment For Diabetic Retinopathy
If you have diabetic retinopathy, your doctor may use a type of laser treatment called scatter laser surgery as part of your treatment plan. You may also need other treatments, like injections, in addition to laser treatments.
Scatter laser surgery can help treat advanced cases of diabetic retinopathy. Your doctor will use lasers to shrink blood vessels in your eye that are causing vision problems.
You can get this laser treatment at your eye doctors office. Your eye doctor will:
- Put numbing medicine in your eye
- Aim a laser into your eye using a special lens
During the treatment, you may see flashes of light and your eye may sting or feel uncomfortable. Your vision will be blurry for the rest of the day, so youll need someone to drive you home. You may need more than 1 session of scatter laser surgery.
Like any surgery, this treatment has risks. It can cause loss of peripheral vision, color vision, and night vision. But for many people, the benefits of this treatment outweigh the risks. Talk with your doctor to decide if scatter laser surgery is right for you.
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Complications Of Diabetic Retinopathy
Diabetic retinopathy can lead to other complications within the eye:
Retinal detachment Proliferative diabetic retinopathy is a later stage of the condition where fragile new blood vessels are formed in the eyes. These can bleed easily, and scar tissue that accompanies it can cause the retina to become detached.Diabetic Maculopathy The central area of the retina is known as the macula, and its responsible for the type of vision we use to read or drive. Diabetic maculopathy is when the macula is damaged an example of macular damage is diabetic macular oedema, which involves fluid leaking into the macula and causing loss of vision.Rubeosis Iridis This is when blood vessels grow in the coloured part of the eye called the iris. It may cause a reddish colour to develop in the iris, but it can also lead to neovascular glaucoma, a severe form of glaucoma that can be very painful.
Does Diabetes Cause Any Eye Diseases
If you have diabetes, diabetic retinopathy is one of the primary side effects you need to know. Diabetic retinopathy is a complication in your eyes caused by diabetes.
Excess blood sugar damages and weakens the blood vessels in your retinas. The longer you have diabetes, the more likely this damage becomes.
Eventually, it can cause the vessels to bulge and leak fluid into your eye. If this is happening in your eyes, you have diabetic retinopathy.
The bulging can cause visual distortions, but symptoms from expanding blood vessels are generally minor. However, once these blood vessels in your retina begin to leak, visual impairment is common.
The fluid leaks into your eye where it blocks light from reaching your retina, interrupting your eyesight. Also, as the blood vessels in your retina burst, your body grows new blood ones to replace them.
This phase of the disease is proliferative diabetic retinopathy, and it is more severe. The new blood vessels your body grows are weak from the start and apt to leak and burst as well. This feedback loop will continue until your eye doctor administers treatment.
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Pharmacotherapy In Diabetic Retinopathy And Diabetic Macular Edema
When the results of the ETDRS were published in 1985, focal laser for DME became established as the standard of care for the next 30 years.12 However, it was evident during this era that more effective therapy was needed.8 Pharmacological and surgical therapies were subsequently investigated.99101
Pharmacotherapy for both DR and DME can be subdivided by class of drugs and methods of delivery as shown in Table 1. The most important class of drugs is the anti-vascular endothelial growth factor agents, followed by the corticosteroids. Much less important are systemic angiotensin receptor blockers and fibrates. Topical nonsteroidal anti-inflammatory drugs have so far proven futile in long-term DME management.
Table 1 Pharmacotherapy of Diabetic Retinopathy and Macular Edema
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Its important to maintain a healthy body weight. You should also make sure that you drink plenty of water, and limit your intake of sugary drinks. In addition, make sure that you get regular exercise. You should also avoid alcoholic beverages. Lastly, you should avoid alcohol. These beverages contain high amounts of sugar. If you dont drink enough, youre not doing anything to prevent diabetes. Besides, drinking alcohol can be harmful to your health.
The most important thing to do is to follow the recommended diet. Eat more healthy foods that have low amounts of fat and high amounts of fiber. The best way to lose weight is to lose 7 percent of your body weight. If youre overweight, you should try to lose 14 pounds to reduce your risk of developing type 2 diabetes. However, you should not attempt to lose weight while pregnant. Talk to your doctor about what kind of weight is safe for you.
Besides high blood glucose, diabetes can also affect the nerves and skin. It may affect your sexual response and your nervous system. It can also affect your fertility. Women with diabetes are more likely to miscarry or have a baby with a birth defect. It can cause a person to have difficulty hearing and sleep. If the condition is left untreated, it can lead to type 1 diabetes and can even lead to amputation.
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