| rican Diabetes Foundation reports that more 23.6 | | | | more blood vessels are blocked, depriving several |
| million children and adults in the United States who | | | | areas of the retina with their blood supply. These |
| have diabetes. Another 5.7 million people are | | | | areas of the retina send signals to the body to |
| undiagnosed and often unaware they suffer from | | | | grow new blood vessels for nourishment. |
| diabetes. | | | | 4. Proliferative Retinopathy. At this advanced |
| Diabetes is a disease in which the body does not | | | | stage, the signals sent by the retina for |
| produce or properly use insulin. There are two | | | | nourishment trigger the growth of new blood |
| types of diabetes; Type 1- is when the body fails | | | | vessels. This condition is called proliferative |
| to produce insulin, the hormone that allows cells to | | | | retinopathy. These new blood vessels are |
| turn suage and starch to energy. Type 2- is when | | | | abnormal and fragile. They grow along the retina |
| the body is resistant or fails to peoperly use the | | | | and along the surface of the clear, vitreous gel |
| insulin, this is the most common form. | | | | that fills the inside of the eye. By themselves, |
| How diabetes effects vision | | | | these blood vessels do not cause symptoms or |
| Nealy 80% of all patients who have had diabetes | | | | vision loss. However, they have thin, fragile walls. |
| for 10 years or longer suffer from complications | | | | If they leak blood, severe vision loss and even |
| of diabetes mellitus or damage to the retina; also | | | | blindness can result. |
| called diabetic retinopathy. Diabetic retinopathy is | | | | Treatment |
| damage to the blood vessels in the eye caused | | | | Proper treatment of diabetic retinopathy can cut |
| by diabetes. It is the leading cause of visual loss | | | | the risk of vision loss by over half. Treatment |
| among American adults aged 20 to 65. Research | | | | before diabetic retinopathy causes severe loss is |
| has indicated at least 90% of new diabetic related | | | | much more effective than later in the disease. For |
| cases could be avoided with proper and vigilant | | | | this reason, early diagnosis is critical in order to |
| treatment and mointoring of the eyes. | | | | prevent visual loss and blindness. Control of |
| Symptoms & Signs | | | | diabetes and blood pressure is important; intensive |
| There generally are no early warning signs or pain | | | | control of blood glucose can delay onset and slow |
| associated with diabetic retinopathy. Characteristic | | | | progression of retinopathy. |
| signs of retinal changes may be seen during | | | | There are treatments for diabetic retinopathy, |
| examination of the retina. Severe retinopathy | | | | which usually include laser surgery or |
| may develop prior to noticeable vision loss, with | | | | ÂvitrectomyÂ. It involves removing |
| late sudden onset of vision loss with hemorrhage | | | | the cloudy vitreous and replacing it with a salt |
| or retinal detachment. | | | | solution. Because the vitreous is mostly water, |
| With the symptoms of proliferative retinopathy, if | | | | you will notice no change between the salt |
| bleeding occurs at first, you will see a few specks | | | | solution and the normal vitreous. Although laser |
| of blood, or spots, "floating" in your vision. If spots | | | | surgery and vitrectomy are very successful, they |
| occur, see your eye care professional as soon as | | | | do not cure diabetic retinopathy. Once you have |
| possible. You may need treatment before more | | | | proliferative retinopathy, you will always be at risk |
| serious bleeding occurs. Hemorrhages tend to | | | | for new bleeding. This means you may need |
| happen more than once, often during sleep. | | | | treatment more than once to protect your sight. |
| Sometimes, without treatment, the spots clear, | | | | Prevention |
| and you will see better. However, bleeding can | | | | There are ways to prevent or lessen the risk of |
| reoccur and cause severely blurred vision. You | | | | eye damage caused by diabetes. |
| need to be examined by your eye care | | | | The Diabetes Control and Complications Trial |
| professional at the first sign of blurred vision, | | | | proved that careful control of blood glucose levels |
| before more bleeding occurs. | | | | might prevent the development of diabetic |
| If left untreated, proliferative retinopathy can | | | | retinopathy. |
| cause severe vision loss and even blindness. Also, | | | | Regular eye examinations are especially important |
| the earlier you receive treatment, the more likely | | | | for children who have had diabetes for 5 years or |
| treatment will be effective | | | | longer, for adults at the time of diagnosis, for |
| Cause & Risk of vision damage | | | | those who have difficulty controlling the level of |
| Approximately 40 percent of all people with | | | | sugar in their blood, and for diabetic women who |
| diabetes have at least mild diabetic retinopathy, | | | | are considering becoming pregnant. All of these |
| which affects both Type 1 and Type 2 diabetics. | | | | people are at increased risk for diabetes-related |
| Diabetic retinopathy is a major cause of blindness | | | | eye problems. To protect your vision get a |
| and tends to be particularly severe in Type-1 | | | | comprehensive dilated eye exam at least once a |
| diabetes. | | | | year and remember that damage to the vision |
| In general, the longer one has had diabetes, the | | | | can occur without symptoms. |
| greater one`s chances of developing diabetic | | | | Future Risk |
| retinopathy. Diabetic retinopathy generally takes | | | | In a recent Washington Post article entitled |
| at least eight years to develop in juvenile onset | | | | ÂDiabetic Eye Disease Rates SoaringÂ, |
| diabetes, but may be present at the time adult | | | | the story quotes a study showing the rates for |
| onset diabetes is first diagnosed. High blood | | | | cases of diabetic retinopathy soaring from 5.5 |
| pressure and high cholesterol in the blood are | | | | million to nearly 16 million cases by the year 2050. |
| additional risk factors that your doctor will | | | | The study gave the following breakdown; |
| address. | | | | -The number of cases of vision threatening |
| Diagnosis | | | | diabetic retinopathy will increase from 1.2 million to |
| Because diabetic retinopathy can begin and get a | | | | 3.4 million. |
| foothold before it causes symptoms, all patients | | | | -Among Americans 65 and older, the number of |
| with diabetes should have an eye examination | | | | cases of diabetic retinopathy will rise from 2.5 |
| with pupils dilated at least once a year. Often your | | | | million to 9.9 million, and the number of cases of |
| doctor will take photographs of your retinas. A | | | | vision threatening diabetic retinopathy will increase |
| dye, called fluorescein, may be injected in the | | | | from 500,000 to 1.9 million. |
| blood stream to show further details of the | | | | -Cataract cases among whites and blacks age 40 |
| circulation in the retina. This is called fluorescein | | | | or older with diabetes will increase 235 percent. |
| angiography. | | | | Cataract cases among people age 75 and older |
| Diabetic retinopathy has four stages: | | | | with diabetes will increase 637 percent for black |
| 1. Mild Nonproliferative Retinopathy. At this earliest | | | | women and 677 percent for black men. Glaucoma |
| stage, micro aneurysms occur. They are small | | | | cases among Hispanics age 65 and older with |
| areas of balloon-like swelling in the retina`s tiny | | | | diabetes will increase 12-fold. |
| blood vessels. | | | | Regular eye exams, preventive measures such as |
| 2. Moderate Nonproliferative Retinopathy. As the | | | | a healthy diet and controlled blood glucose, |
| disease progresses, some blood vessels that | | | | education (understanding how your diabetes |
| nourish the retina are blocked. | | | | affects your vision) may help keep you from |
| 3. Severe Nonproliferative Retinopathy. Many | | | | being one of those statistics. |