Diabetes is a condition characterized by high levels of glucose (sugar) in the blood. Through a number of different mechanisms, these high sugar levels damage blood vessels throughout the body including the eye. The retina is the thin light-sensitive membrane which lines the inside of the eye and allows us to see (the retina is the "film in the camera"). Diabetic retinopathy refers to disease of the retina caused by diabetes. Diabetic retinopathy is the leading cause of blindness among working age Americans.

The earliest sign of diabetic retinopathy is the finding of microaneurysms in the retina. These are very small outpouchings which develop in damaged capillaries. They usually measure less than 1/10^th of a millimeter in diameter and look like small red dots. Later, small capillaries may break causing retinal hemorrhages. Damaged blood vessels may also leak fluid causing the retina to swell (edema). As damage to the retina worsens with time, abnormal new blood vessels may start to grow from the retina (neovascularization).

Visual loss from diabetic retinopathy can occur from a number of causes. Retinal swelling involving the central retina (the macula) is a common cause of visual loss in diabetics. Fortunately, this swelling can often be eradicated with appropriate laser treatment. Abnormal blood vessel growth is another common cause of visual loss. The vessels may bleed filling the eye with blood (a vitreous hemorrhage). Abnormal vessels may also contract and pull on the retina causing visual loss (a tractional retinal detachment). Laser treatment can also be used to cause regression of abnormal blood vessels. Occasionally, a surgical procedure (a vitrectomy) may be necessary to remove vitreous hemorrhage or relieve traction on the retina from blood vessel growth.

It is important to note that a diabetic may have advanced disease in his or her retina despite having completely normal vision. This makes it extremely important for all diabetics to have a dilated eye examination by a qualified eye doctor at least once every year (see Diabetes 2000). Once visual loss has occurred from diabetic retinopathy, it may be irreversible. Laser treatment for diabetes is much more effective when applied prior to any loss of vision. Here’s the good news – if a diabetic gets regular screening eye exams and has laser treatment instituted without delay when appropriate, he or she can reduce the risk of severe visual loss by more than 90%!

Dr. Goldman has extensive experience in the diagnosis and treatment of diabetic retinopathy. If you or someone you know has diabetes or another retinal problem, please call us to arrange a comprehensive evaluation at either of our convenient locations.

Click here to see photographs of diabetic retinopathy.