Diabetes is a large and growing problem in the US. As primary eye care providers, we are at the forefront of diagnosing diabetic eye problems. Diabetes can have devastating effects on your eyes when it is uncontrolled. With advances in medicine, many people are able to keep these eye changes to a minimum through good blood sugar control. An annual dilated eye exam should be a priority when you have diabetes.
In most cases, diabetic eye changes start with mild retinopathy, which is visible as small dots of blood within your retina, as well as areas of the retina that are suffering from a lack of oxygen. No treatment is required for mild retinopathy, but if it worsens, you will have to be seen more frequently to monitor for progression to proliferative retinopathy. At the mild stage, the best recommendation is to pay more attention to good blood sugar control, which means aiming to keep your A1C under 7, as well as good diet and exercise.
Proliferative retinopathy is when the lack of oxygen to your retina has become so severe that new blood vessels begin to grow. Unfortunately, these new vessels are very unstable and leaky. Leaking blood in your eye can cause scarring, glaucoma, and in severe cases can lead to retinal detachments and loss of vision. This stage of diabetic retinopathy requires aggressive treatment.
Another complication of diabetes is swelling in your retinal called macular edema. Swelling within your retina is caused when diabetes damages your small blood vessels and they begin to leak. This swelling can cause blurred central vision. If this is detected, there are laser treatments that can be done to help stabilize the swelling. Special testing is done to locate the leaking, and then a laser is applied by a retinal specialist.