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Diabetes

Why are Eye Exams Important in Diabetes?

Diabetes is a common disease in the United States. Diabetic eye disease, referred to as diabetic retinopathy, is the most common cause of blindness in the US in ages 25 to 65. Regular eye examinations are important in diabetes because diabetic eye disease and the vision loss caused by it are often preventable. In diabetes, high sugar levels in the blood damage the blood vessels throughout the entire body. Damage to the blood vessels in the kidneys can cause kidney failure requiring dialysis. Damage to the blood vessels in the nerves can cause painful neuropathy. High blood glucose levels cause damage to the blood vessels in the retina of the eye.

The longer diabetes is present, the more likely diabetic retinopathy will develop. Symptoms of diabetic retinopathy are floaters, blurred vision, dark streaks or a red film that blocks your vision, poor night vision, and loss of vision. Sometimes diabetic retinopathy is present without symptoms.

Nonproliferative diabetic retinopathy (NPDR) is the earliest stage of diabetic retinopathy. The damaged retinal blood vessels may leak fluid and blood into the eye. Deposits of cholesterol may leak into the retina. NPDR is a sign that the retinal blood vessels are compromised. It can be mild, moderate, or severe. The walls of the blood vessels become weak and outpouchings of the blood vessels can develop. These bulges are called microaneurysms. Fluid and blood can leak from these weak blood vessels.

Fluid that accumulates in the macula is called macular edema. Macular edema is the most common cause of vision loss in diabetes. Vision loss can be mild or severe. Laser treatments and steroid injections may help to stabilize the vision.

Proliferative diabetic retinopathy (PDR) occurs when abnormal blood vessels begin to grow on the surface of the retina or optic nerve. This is called neovascularization. The retina responds to a lack of blood supply by producing new blood vessels. However, the new blood vessels are abnormal and do not supply the retina with a normal blood flow. The new blood vessels may be accompanied by scar tissue that causes wrinkling of the retina or a retinal detachment. The new blood vessels are delicate and may bleed. This may lead to loss of vision. PDR is less common than NPDR and is more likely to cause permanent vision loss. PDR is often treated with injections inside of the eye and laser treatments.

Diabetic retinopathy can develop to anyone who has diabetes. Risk factors for diabetic retinopathy include poor control of blood sugar levels, high blood pressure, high cholesterol, pregnancy, and smoking.

The American Academy of Ophthalmology recommends that people who have diabetes get an dilated eye exam every year and more often if there are signs of diabetic retinopathy.

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