Every person living with diabetes is at risk of vision loss or blindness.
In fact, roughly half will face diabetic retinopathy, the most common
vision-related complication of diabetes.
“If caught in its earlier stages, we can often maintain or improve
vision. But there is a point at which the vision loss from diabetic retinopathy
can be irreversible,” retinal specialist
Geeta Lalwani, MD, warned during a free health lecture held in Boulder.
“Unfortunately, even in its late stages, diabetic retinopathy can
often have no symptoms, making it critical for patients with diabetes
to have a yearly eye exam,” Dr. Lalwani added.
What is Diabetic Retinopathy?
Diabetic retinopathy results from persistently high blood sugar levels
that damage blood vessels within the retina. The damaged blood vessels
then start to leak fluid or blood into the retina.
“In early stages of diabetic retinopathy, the leakage of blood or
fluid is called nonproliferative diabetic retinopathy (NPDR). In later
stages, the leakage causes an oxygen deficiency, which can lead to blood
vessels growing in an irregular fashion. This stage is called proliferative
diabetic retinopathy, or PDR. Untreated, PDR usually proceeds to severe
vision loss,” Dr. Lalwani explained.
Either of the two diabetic retinopathy stages — NPDR or PDR —
can produce diabetic macular edema (DME), which is the accumulation of
fluid in the macula. The macula is the center part of the retina that
allows you to have fine vision.
Symptoms of DME can include:
- blurred or distorted vision
- difficulty focusing
How to Protect Your Vision
According to Dr. Lalwani, people with diabetes can prevent or delay vision
loss from diabetic retinopathy and DME by following these steps:
Control your blood sugar. Taking medications as prescribed, staying physically active and maintaining
a healthy weight are key to lowering your risk and slowing the progression
of vision complications.
Undergo dilated eye exams annually. During an exam, your doctor can check for changes to blood vessels within
the retina or warning signs of leaky blood vessels.
Lower your blood pressure and cholesterol levels. People with diabetes who also have high blood pressure and cholesterol
levels are at greater risk for diabetic retinopathy.
Stop smoking. Some studies suggest that smoking speeds up the progression of the condition.
Treatments for Reducing or Halting Vision Loss
Dr. Lalwani stated that if your diabetic retinopathy is mild or moderate
controlling your blood sugar can often slow its progression. Regular monitoring
by a physician may be all that is needed. However, if the disease advances,
the following treatments can help control its progression:
Laser treatment. A laser beam of light targets leaking blood vessels and seals them off
to stop fluid or blood leakage. Laser treatment can also prevent further
growth of new blood vessels.
steroid. Steroid medication can be injected into the eye to reduce swelling of
the macula (DME).
Injections of anti-VEGF. Eye injections of vascular endovascular epithelial anti-growth factor
drugs (anti-VEGF) can help reduce fluid buildup or widespread blood-vessel
growth, which often occurs in the more advanced stages of diabetic retinopathy.
Surgery. Patients may need surgery to remove bleeding from inside the eye or to
repair retinal detachments related to diabetes.
Dr. Lalwani said, “These treatment options don’t cure diabetic
retinopathy, but they can be effective in stabilizing vision loss and
often result in improved vision. Your eye care team can help you manage
your eye health and recommend the best treatment option.”
PowerPoint slides from Dr. Lalwani's lecture on "Preventing & Treating Diabetes-Related
If you wish to be screened or treated for diabetic retinopathy, schedule
an appointment with
Geeta Lalwani, MD by calling